Mouth and Tongue Disorders

Mouth and tongue disorders are a broad group of conditions that can affect the lips, gums, inside of the cheeks, roof of the mouth, and the tongue itself. Symptoms may include soreness, ulcers, swelling, burning, changes in taste, or patches/colour changes.

Many conditions are mild and temporary, but some require assessment to rule out infection, nutritional deficiencies, inflammatory disease, or more serious causes.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment to identify the likely cause of mouth or tongue symptoms and recommend an appropriate treatment plan.

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Types of Mouth & Tongue Disorders

Mouth and tongue disorders can include:

• Mouth ulcers (aphthous ulcers or traumatic ulcers)
• Oral thrush (fungal infection)
• Cold sores affecting the mouth area
• Geographic tongue (patchy areas on the tongue that change over time)
• Fissured tongue (grooves or cracks in the tongue)
• Burning mouth syndrome
• Inflammation of the tongue (glossitis)
• Dry mouth (xerostomia)
• Oral lichen planus
• Leukoplakia / erythroplakia (white or red patches that require assessment)
• Tongue swellings or lumps
• Oral trauma (from biting, sharp teeth, dentures or braces)
• Taste disturbance or altered sensation

Some symptoms overlap across conditions, so the right diagnosis is important.

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Common Causes of Mouth & Tongue Disorders

There are many possible causes, including:

• Minor trauma (biting the tongue/cheek, sharp tooth edges, braces)
• Infections (viral, bacterial or fungal)
• Dry mouth (dehydration, medications, or salivary gland conditions)
• Allergies or irritation (mouthwashes, toothpaste ingredients, spicy/acidic foods)
• Nutritional deficiencies (such as iron, folate or vitamin B12)
• Hormonal changes and stress
• Autoimmune/inflammatory conditions
• Smoking and alcohol use (increases risk of some oral conditions)
• Underlying medical conditions (such as diabetes)
• In some cases, symptoms may occur without a clear trigger

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Symptoms of Mouth & Tongue Disorders

Symptoms vary depending on the cause, but may include:

• Pain or soreness in the mouth or tongue
• Ulcers or open sores
• Burning or stinging sensation
• Redness or inflammation
• White patches or coating
• Swelling of the tongue or mouth tissues
• Lumps or thickened areas
• Bleeding or gum irritation
• Dry mouth or sticky saliva
• Bad breath or unpleasant taste
• Changes in taste (reduced taste or metallic taste)
• Difficulty eating, drinking or speaking (in more severe cases)

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Diagnosis at Royal Buckinghamshire Hospital

Your consultant will focus on identifying the cause and ruling out conditions that need treatment. Assessment may include:

• Detailed review of symptoms (timing, triggers, severity, recurrence)
• Examination of the mouth, tongue, gums and throat
• Review of medications and relevant medical history
• Checking for sources of irritation (such as dental issues or dentures)
• If needed, investigations such as:
  • Blood tests (to check for deficiency or inflammation)
  • Swabs or samples if infection is suspected
  • Referral for further testing or imaging where appropriate
  • Biopsy if a patch or lump needs closer investigation

You will be advised on the likely diagnosis, next steps, and follow-up plan.

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Treatment & Management

Treatment depends on the underlying cause and how severe symptoms are.

Self-care and symptom relief

In many cases, recommendations may include:

• Avoiding spicy, acidic or very hot foods during flare-ups
• Maintaining good oral hygiene with a gentle toothpaste
• Drinking plenty of water and managing dry mouth
• Saltwater mouth rinses (if appropriate)
• Managing triggers such as stress or irritation

Medical treatment

Depending on diagnosis, treatment may include:

• Antifungal medication for oral thrush
• Antiviral treatment for viral causes in selected cases
• Anti-inflammatory treatment for inflammatory conditions
• Treatment of nutritional deficiencies (iron, B12, folate)
• Targeted therapies for persistent or recurrent ulcers

Managing chronic or complex conditions

If symptoms are persistent or recurrent, your consultant may recommend:

• Monitoring and follow-up
• Referral for specialist input such as oral medicine, ENT, gastroenterology or rheumatology
• Investigation of underlying contributing conditions such as reflux or immune-related disease

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When to seek urgent help

Seek urgent medical advice if you experience:

• A lump or ulcer that does not heal within 2–3 weeks
• Persistent unexplained mouth pain
• A red or white patch that is new or worsening
• Difficulty swallowing or speaking
• Swelling affecting breathing
• Unexplained bleeding
• Significant weight loss, persistent hoarseness, or neck lumps

These symptoms do not always indicate a serious cause, but they should be assessed promptly.

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If you have mouth or tongue symptoms that are persistent, painful, or affecting eating and daily comfort, contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.