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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Pain In The Tongue Indicate?

Hi. My mom has had sores (on both sides of her tongue) since Jan 2017. Since then, she has had a lot of pain on her tongue/in her mouth, even eating anything crunchy or hard is too painful. She has been to 2 ENTs who tried nystatin (oral liq), nystatin and a corticosteroid mix (oral liq), and a 10 day course of prednisone that started with a high dose and then was downtitrated. the only one of these that offered relief was the higher doses of prednisone, but condition went back to painful at lower dose and case was not resolved. there was a brush biopsy that rules out malignancy. Neither ENT could dx the condition. She has been referred to a medical center in NYC, a specialist (Dr. Lawson), but he cancelled the apt and hasn't been able to reschedule for personal reasons. I'm wondering if I should take her to an immunologist in the meantime? I don't think its Becets, but wondering if a Mab might work given that prednisone did not. Thanks.
Wed, 27 Sep 2017
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Dentist,  's  Response
Hi..
Thanks for the query..

If the ulcers are not resolving and as the brush biopsy already indicates malignancy then it has to be taken immediate care for as the cancerous ulcers tend to grow rapidly..

So my suggestion is to either consult an Oral Surgeon or an Oncologist and get evaluated as a thorough clinical examination and further investigations are needed to rule out the severity of lesions..

If surgery is possible it can be done followed by radiotherapy and chemotherapy..

Prednisolone can help in reducing inflammation and pain but cancerous ulcers cannot be treated with it and needs proper management..

Hope this helps..

Regards.
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What Does Pain In The Tongue Indicate?

Hi.. Thanks for the query.. If the ulcers are not resolving and as the brush biopsy already indicates malignancy then it has to be taken immediate care for as the cancerous ulcers tend to grow rapidly.. So my suggestion is to either consult an Oral Surgeon or an Oncologist and get evaluated as a thorough clinical examination and further investigations are needed to rule out the severity of lesions.. If surgery is possible it can be done followed by radiotherapy and chemotherapy.. Prednisolone can help in reducing inflammation and pain but cancerous ulcers cannot be treated with it and needs proper management.. Hope this helps.. Regards.