Have you noticed that you have a numbness or tingling (“pins and needles”) sensation in your tongue?
You may feel weird when you experience a sudden unusual numbness. While the condition varies, you may think it is a sign of a serious disease such as cerebral infarction.
What causes a numbness or tingling in your tongue, then?
In fact, there are various reasons that cause numbness of the tongue. Some are related to dental procedures or surgeries, while others are caused by neurological problems. Also, mental illness such as a psychosomatic disease can be a trigger. In this article, neurologist Dr. Yoshiya Hasegawa shares information about “common causes and treatments for numbness of the tongue.”
Contents
1.When to seek medical help
It is recommended to seek medical attention if you experience any of the following conditions, in addition to your tongue numbness.
1-1. Experiencing gradual progression of symptoms
A medical visit may be unnecessary if you experience only tongue numbness once in a while. You must carefully observe how your symptom goes — and you may find that it goes away by itself soon. However, you should consider visiting a doctor when you notice the symptom worsening.
1-2. Experiencing other symptoms in addition to numbness of the tongue
An immediate medical visit is required when you have other symptoms in addition to tongue numbness: pain in the tongue; loss of taste; numbness in the limbs; fatigue; shortness of breath; or dry mouth. You may want to make an appointment with a physician or neurologist when you have one of the symptoms above.
1-3. Finding unusual condition in the tongue
You must check your tongue carefully with the aid of a mirror. If you find your tongue becomes red, swollen, or develops a bump, you may need to visit an oral surgeon.
Have you experience weirdness in your tongue which does not go away?
2. Seven common diseases which cause numbness of the tongue
A common symptom of some diseases is numbness of the tongue.
2-1. Neuralgia
If neuralgia occurs in the nerves which control the tongue, you may feel numb in the tongue. When a patient describes the symptom as an “intense electric shock-like pain in addition to the numbness,” it may be caused by neuralgia. Innervation of the tongue includes two types of nerves. Anterior two thirds of the tongue is controlled by the trigeminal nerve while posterior one third of the tongue is by the glossopharyngeal nerve.
Most neuralgia occurring in the tongue is caused by “pressure of the nerves where arteriosclerosis is developed.”
An anticonvulsant called “carbamazepine (Tegretol)” is widely prescribed as one of the effective treatments. This relieves a pain by inhibiting nerve transmission and works effectively on neuralgia. Some doctors may administer this medication to confirm the diagnosis.
Trigeminal nerve
2-2. Deficiency disease
Tongue numbness may be caused by a lack of essential dietary elements, especially a vitamin or mineral. In this case, other symptoms may occur in addition to tongue numbness. A blood test is administered when any of the following is suspected.
- Zinc deficiency: Zinc deficiency leads to decreased salivation, dry mouth, or loss of taste. Tongue numbness may be triggered by those conditions in the mouth.
- Iron-deficiency anemia: Iron-deficiency anemia often causes fatigue, dizziness, tinnitus (ringing in the ears), and shortness of breath as with anemia. It also develops glossitis or cheilitis causing a burning sensation or numbness of the tongue.
- Hunter’s glossitis (vitamin B12 deficiency): Hunter’s glossitis is caused by a lack of vitamin B12 which is an essential element to produce blood. The deficiency leads to atrophy of the lingual papillae which develops glossitis. Vitamin B12 deficiency rarely happens, however people who have experienced total gastrectomy (complete removal of the stomach) often suffer from this vitamin B12 deficiency. Patients who have removed their stomach should ask for a test to measure the level of vitamin B12.
2-3. Overconsumption of food additives
You may have experienced a pin and needle sensation in the tongue when you consume processed food too much. This is caused by overconsumption of monosodium glutamate or salt, chemical additives such as food coloring or food preservative. It is very difficult to identify which additive actually causes the symptom, however you don’t need worry if your symptom disappears by itself. It is recommended to avoid consuming food with chemical additives as much as possible.
2-4. Xerostomia
Xerostomia is a disease which causes dryness in the mouth due to a gradual decrease of mucous membrane lining the inside of the mouth. Hyposalivation, a condition of reducing saliva production, leads to atrophy of oral mucosa and results in a crack in the mucous membrane, skin peeling or scratch in the mouth. The lips also become stiff and dry, resulting in cracking or bleeding. These similar symptoms appear in the tongue where a loss of the lingual papillae causes smooth and shiny tongue. A burning sensation, pain, or strange feeling in the tongue may follow. Patients may feel numbness or tingling in their tongue when these conditions occur.
Furthermore, Sjogren’s syndrome is a possible underlying disease where similar symptoms occur.
2-5. Diabetes
It is reported that patients with diabetes are more likely to experience dry mouth or malfunction of the salivary glands. The malfunction of the salivary glands leads to xerostomia. This dryness in the mouth causes atrophy of the lingual papillae, and the tongue becomes smooth and shiny on its surface. An onset of pain, burning sensation, strange feeling, numbness or tingling in the tongue follows.
2-6. Cerebral infarction
Cerebral infarction occurs suddenly. If a patient has a sudden onset of numbness of the tongue, close attention must be paid. It often occurs with other symptoms, such as motor deficit mentioned earlier in section 1-2.
The symptom caused by cerebral infarction frequently accompanies not only motor nerve paralysis but sensory nerve paralysis in one side of the body which results in numbness of the tongue.
2-7.Tongue cancer
A tumor may cause a numbness of the tongue. This occurs when a growing tumor puts pressure on the nerves. A tumor, regardless of benign or malignant, can also form in the mouth: a benign tumor can be angioma or fibroma, and a malignant tumor is considered as tongue cancer.
A benign tumor often forms a dome-shape which clearly divides tumor and its nearby tissue. The color appears different based on the type of tumor and it does not harden. If a tumor is hemangioma, it becomes bluish purple; and if it is fibroma, its color stays almost the same as its nearby tissue. In any case, a benign tumor hardly causes pain.
Tongue cancer develops a very hard lump which causes severe pain. It often occurs on the side of the tongue rather than in its center. If a lump is found on the side of the tongue which grows over time, further medical examination must be conducted.
3. Glossodynia, or burning mouth syndrome, is diagnosed after ruling out other causes
When you search for tongue numbness on the internet, “glossodynia (burning mouth syndrome)” may show up first. However, glossodynia cannot be the initial diagnosis due to the following reasons.
3-1. What is Glossodynia?
Glassodynia is a disease “which causes a pain or numbness without any particular reason.” It is considered to be one of psychosomatic disorders.
3-2. Charactistic of a patient who is more likely to develop glossodynia
Glossodynia is more likely to occur in “a female in their 40’s who is methodical, sensitive and under a stressful circumstance.” This characteristic is almost the same as “a personality characteristic which is more likely to develop psychosomatic disorders.” I had examined a female patient in her 30’s who complains of numbness of the tongue. I could not identify any abnormalities or findings in her condition from the test result. I explained to her that there are no problems at all, however she was not satisfied with my explanation.
3-3. Glossodynia is diagnosed by ruling out
Based on the above reason, Glossodynia is impossible to diagnose on a patient’s first visit. In general practice, doctors cannot give a diagnosis until they go through a diagnostic process where they eliminate all possible diseases mentioned earlier.
4. Diagnostic process in general practice
Doctors follow a process in order to give a diagnosis for tongue numbness.
4-1. Medical interview
Most numbness of the tongue can be correctly diagnosed by conducting a medical interview.
- How long and how frequently does it occur?
- Where is the numbness located?
- Any pain or burning sensation in addition to the numbness?
- Any general symptoms in addition to the numbness?
4-2. Examination
Doctors begin their examination by observing the general condition of the patient, especially their motor deficit, and not the tongue itself. Then they examine whether the tongue has developed redness, swelling, or a tumor.
4-3. Blood test
A blood test is conducted where necessary to determine whether there is any indication of diabetes, deficiencies in iron, zinc, or Vitamin B12, as well as the patient’s general physical condition.
In many cases, there are no problems in the tongue itself except a tongue cancer.
5. Summary
- There are various causes for numbness of the tongue.
- It is recommended to visit a physician or neurologist when you also have other symptoms in addition to tongue numbness.
- An oral surgeon is the best option if either redness, swelling or a tumor is appeared in the tongue.
- Your doctor will try to rule out other problems before diagnosing glossodynia or burning mouth syndrome.