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Ulceration of the Tongue

Dear Doctor, I have had a large ‘ulcer’ on the side of my tongue for about 5 weeks now. It was first caused because I had a very uneven tooth, and no matter how much I tried I couldn’t stop my tongue rubbing on it and catching. I have been to my dentist and had the tooth filed down, but the ulcer is still here, and it is very painful and annoying. What should I do?

Ulceration of the tongue occurs very frequently. Usually it is caused by damage to the tongue as a result of biting on a sharp object- commonly, a broken tooth with a sharp edge, by biting your tongue, or damaging it on a sharp bit of food e.g. hard toast. You have already done the correct thing by asking your dentist to try to smooth the sharp edge to your tooth. Normally this would suffice but the previous damage done to your tongue by the initial burn will delay the healing process. The discomfort during this time of healing can be alleviated with the application of choline salicylate (Bonjela;) about half an inch over the ulcer three times per day.

While the cause of your discomfort appears to be obvious, it is as well to bear in mind that tongue ulceration can be caused by a number of other conditions such as viral infections, for example, herpes simplex (cold sore ) and herpes zoster (shingles) when the original lesion will be in the form of a vesicle (blister) which then breaks down to form an ulcer. In these cases, the treatment is Acyclovir tablets (Zovirax) Zovirax cream can also be applied but this is quite rapidly washed away by saliva. Such an infection usually occurs when your resistance is low with flu, cold or some other debilitating illness.

Another condition causing ulceration of the tongue is Behcet’s disease which is a generalized inflammation of the blood vessels( vasculitits ) of unknown origin associated with a protein called HLA-B51. Should the ulcer be persistent but surprisingly painless, consult your Doctor or Dentist immediately as this could be a sneaky cancer of the tongue which requires an immediate expert opinion and treatment.

Finally, some ulcers randomly appear on the tongue and the lining of the mouth, they are called apthous ulcers and are of unknown origin. 20% of us get these shallow painful ulcers on the tongue or lining of the mouth and they heal without scarring. Severe and lasting ulceration can be related to a variety of important diseases in the body. Happily this doesn’t apply in your case.

Article written by Dr Colin Evans (MB.CHB.,f.r.c.s,bds.,fdsrcs). The English Medical Centre, Avda del Albir, 72. Edificio Primavera, Bloque 1. ALBIR, (Alicante) 966 868 013. Email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it