Ear, nose, and throat (ENT) doctors, also known as otolaryngologists, are medical doctors who specialize in treating conditions related to the ears, nose, throat, head, and neck. While they are best known for treating common issues like sinus infections, tonsillitis, hearing loss, and sleep apnea, ENTs can also help diagnose and treat various tongue conditions and complaints.
What kinds of tongue issues do ENTs treat?
Some of the most common tongue-related problems that ENTs may help with include:
- Tongue pain – An ENT can help determine the cause of a sore or painful tongue, such as irritation, inflammation, or infection.
- Coated tongue – A white, yellow, or black coating or film on the tongue could be caused by medications, poor oral hygiene, smoking, dry mouth, or other factors. An ENT can identify the cause and recommend treatment options.
- Tongue swelling – Swelling of the tongue that persists could be a sign of an allergic reaction, inflammation, or edema. An ENT can help find the source of the swelling.
- Birth defects – Some babies are born with tongue-related birth defects like tongue-tie (ankyloglossia) or tongue thrust. ENTs can diagnose, treat, and manage these conditions.
- Oral thrush – A fungal infection in the mouth that causes cottage cheese-like patches on the tongue and other areas. An ENT can prescribe anti-fungal medications to clear up thrush.
- Leukoplakia – White patches or plaques on the tongue that may be precancerous. An ENT can biopsy these patches and provide treatment as needed.
- Oral cancer – ENTs play an important role in diagnosing and treating cancer of the tongue, mouth, and throat area.
- Tongue movement disorders – Uncontrolled tongue movements could be a sign of a neurological condition. An ENT can collaborate with neurologists on a diagnosis.
How do ENTs diagnose tongue conditions?
During an appointment with a patient complaining of tongue problems, an ENT will likely:
- Ask about symptoms, including when they started, how severe they are, and any other associated symptoms
- Review the patient’s medical history and medication list
- Conduct a physical exam of the tongue and rest of the mouth and throat
- Look closely for any visible abnormalities, such as sores, swelling, or discoloration
- Ask the patient to move their tongue in different directions to observe range of motion
- Press around the tongue to check for tenderness or pain
- Swab the tongue and collect cell samples as needed for laboratory testing
- Order blood work, allergy testing, or imaging scans if infectious causes are suspected
- Refer the patient to an oral surgeon or other specialist for a biopsy if cancer is a concern
These diagnostic steps help the ENT pinpoint the nature and cause of any tongue complaints so appropriate treatment can be provided.
What tongue treatments do ENTs offer?
The tongue treatment an ENT recommends will depend on the specific diagnosis. Some examples include:
- Medications – Prescription anti-fungal, anti-inflammatory, or antimicrobial medications for infections causing tongue pain, swelling or discoloration.
- Surgery – Procedures like a frenulectomy to repair tongue-tie or glossectomy to remove cancerous lesions on the tongue.
- Lifestyle changes – Stopping smoking or improving oral hygiene to resolve leukoplakia or coated tongue.
- Speech therapy – Working with a speech therapist to improve tongue mobility for disorders like tongue thrust.
- Biopsies – Removing a small sample of abnormal looking tissue for laboratory analysis and diagnosis.
- Radiation therapy – For advanced tongue cancers, removing cancerous cells from the tongue.
- Allergy management – Avoiding triggers, taking antihistamines, or undergoing immunotherapy for tongue swelling caused by allergies.
ENTs may manage tongue treatment themselves or collaborate with the patient’s general dentist, oral surgeon, speech therapist, or other specialists as needed.
What conditions don’t ENTs treat related to the tongue?
While ENTs play an important role in tongue health and care, there are some tongue-related conditions they do not directly treat, including:
- Neurological disorders – Speech problems stemming from brain conditions like ALS, MS, or Parkinson’s disease are managed by neurologists.
- Congenital abnormalities – Complex tongue defects present from birth may be treated primarily by pediatricians or specialists like pediatric surgeons.
- Dental problems – Issues like tooth sensitivity from a chipped tooth or gingivitis are handled by general dentists.
- Autoimmune disorders – Systemic conditions like Sjögren’s syndrome that cause dry mouth and tongue symptoms are treated by rheumatologists or other specialists.
- Diabetes complications – Tongue problems stemming from uncontrolled diabetes are managed by endocrinologists.
However, ENTs can collaborate with providers in these specialties to optimize care for patients with complex tongue complaints stemming from multiple medical conditions.
When should you see an ENT for tongue problems?
You should make an appointment with an ENT if you experience any of the following tongue symptoms that persist:
- Pain or burning sensations on the tongue
- Visible white, yellow, black or red patches on the tongue
- Swelling of the tongue that won’t go away
- Bleeding from the tongue or mouth
- Difficulty chewing, swallowing or moving the tongue
- Loss of tongue mobility or motor control
- Tongue ulcer or sore that won’t heal
- A sore under or around the tongue
- Changes in taste sensations
Any tongue symptoms or changes lasting more than 10-14 days warrant medical evaluation. Catching tongue problems early provides the best chance of effective treatment by an ENT. Don’t hesitate to ask an otolaryngologist for help managing troubling tongue symptoms that concern you.
Conclusion
ENT doctors play a central role in evaluating, diagnosing, and treating a wide range of tongue-related conditions. Their specialized training in disorders of the head and neck area equips them to manage common tongue complaints like pain and swelling as well as more complex problems like oral thrush, leukoplakia, and tongue cancer. While some tongue problems fall outside of their scope, like neurological disorders or diabetes complications, ENTs will work closely with providers in other specialties to ensure their patients get the comprehensive care they need for optimal recovery and wellness.
| Condition | ENT Treats? |
|---|---|
| Tongue pain/burning | Yes |
| Tongue ulcers/sores | Yes |
| Coated tongue | Yes |
| Tongue swelling | Yes |
| Tongue cancer | Yes |
| Leukoplakia | Yes |
| Oral Thrush | Yes |
| Tongue-tie | Yes |
| ALS | No |
| Sjogren’s Syndrome | No |
| Diabetes complications | No |
| Gingivitis | No |
This table summarizes some of the key tongue conditions ENT doctors do and do not directly treat. They focus on structural and inflammatory issues affecting the tongue itself. Systemic, autoimmune, and neurological disorders causing secondary tongue symptoms are managed by other specialists. However, ENTs work closely with providers across these specialties to optimize care for their patients.
When to see an ENT for tongue concerns
You should make an appointment to see an ENT if you have any of the following tongue symptoms:
- Persistent pain or soreness
- Visible patches, swelling, or discoloration
- Bleeding from the tongue or mouth
- Difficulty moving the tongue
- Changes in taste
- Ulcers or sores lasting more than 2 weeks
It’s important not to ignore changes in your tongue. Early evaluation and treatment provides the best results. ENT doctors have the expertise to accurately diagnose and provide the appropriate care for all types of tongue disorders.
What to expect at your ENT appointment
When you see an ENT for tongue concerns, they will likely:
- Ask about your symptoms and medical history
- Examine your tongue, mouth, and throat
- Have you move your tongue in different directions
- Order tests like blood work or imaging as needed
- Collect cell samples for laboratory analysis
- Discuss treatment options such as medications or surgery
Being prepared to describe your symptoms in detail and asking questions will help you make the most of your ENT visit and get the answers and treatment you need. Don’t put off making an appointment if you have any tongue issues that concern you.
Takeaway
ENTs have advanced training in diagnosing and treating a wide range of tongue conditions. Their expertise covers common problems like pain, swelling and inflammation as well as potentially serious issues like infections, precancerous lesions, and oral cancers. While some complex neurological and systemic disorders affecting the tongue fall outside of their scope, ENTs coordinate closely with other specialists to provide complete care. If you notice any persistent changes or issues with your tongue, schedule an appointment with an ENT. Timely evaluation and treatment provides the best opportunity for resolving your symptoms and preserving your tongue health.