Differential Diagnosis for Painful Tongue
- Single most likely diagnosis
- Aphthous ulcers: These are the most common cause of painful tongue, characterized by recurrent, painful, small ulcers on the tongue and other parts of the oral cavity. The pain can be severe and is often accompanied by a burning sensation.
- Other Likely diagnoses
- Trauma: Accidental biting of the tongue, burns from hot food or drinks, or other mechanical injuries can cause pain.
- Oral candidiasis (thrush): A fungal infection that can cause white patches and redness on the tongue, leading to pain and discomfort.
- Nutritional deficiencies: Deficiencies in vitamins like B12, iron, or folate can lead to changes in the tongue's surface, causing pain and discomfort.
- Lichen planus: An autoimmune condition that can affect the mucous membranes inside the mouth, leading to pain, redness, and white patches on the tongue.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Oral cancer: Although less common, oral cancer can present with a painful tongue, especially if there's an ulcer that doesn't heal. Early detection is crucial for effective treatment.
- Erythema multiforme: A rare but serious condition characterized by skin and mucous membrane lesions, which can include the tongue. It can be a reaction to an infection or medication.
- Rare diagnoses
- Geographic tongue: A condition characterized by the appearance of single or multiple, well-demarcated, smooth, red areas on the tongue, which can be painful.
- Pemphigus vulgaris: A rare autoimmune disease that can cause blistering of the skin and mucous membranes, including the tongue, leading to pain and discomfort.
- Glossodynia (burning mouth syndrome): A chronic condition characterized by a burning sensation on the tongue and other parts of the mouth, without any visible signs of disease.