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Q: For months I've had a sore tongue, and can't eat hot food, citrus fruit or spices. My GP prescribed drops, followed by a mouth gel, for thrush, but neither helped. At a walk-in centre I was told I have a dehydrated and cracked tongue, given a mouthwash and told to see a dentist.
Name and address supplied.
Sort - Complaint - Number - Causes - Diagnosis
A: This sort of complaint can have a number of possible causes, so the diagnosis involves some medical sleuthing. Presented with a patient with a sore tongue, most doctors I know first prescribe antifungal treatments, such as the nystatin drops or fungicidal gel you were given on the assumption that the problem is oral thrush.
But I think sometimes they prescribe antifungal medication more out of hope than logical thought, as thrush has such a characteristic appearance — white, curdy flecks that leave an area of bleeding when displaced — that without seeing this, antifungals don't make sense.
People - Thrush - History - Use - Trigger
People who develop oral thrush tend to have had a history of antibiotic use or other trigger factors such as the regular use of a corticosteroid inhaler (for asthma, for instance).
Both of these can reduce levels of healthy bacteria, which gives fungi — in this case the candida strain — the opportunity to take hold.
Case - Symptoms - Reason - Thrush - Culprit
In your case, given the symptoms you have listed, I see no real reason to suspect thrush is the culprit.
The more likely possibilities include a condition called burning mouth syndrome. The soreness may involve just the tongue or the entire mouth. It can also affect taste, and the mouth may feel dry.
It is rare, and mysterious in that there is no proper understanding of what causes it.
Most of those who develop it are postmenopausal women.
Possibility - Tongue - Soreness - Fissures
A second possibility is fissured tongue, although this isn't usually associated with soreness. Here the fissures or...
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