Although tingling can be a symptom of various diseases and syndromes, it generally is of a neurological nature. Tingling can be a non-painful consequence of a lesion or disease affecting the somatosensory system and is thus most likely due to nerve damage of the sensory receptors. This causes abnormal sensory symptoms, such as shooting, burning, tingling or pain. Symptoms that are not painful are named dysesthesia or paresthesia. Paresthesia is an abnormal sensation that is not unpleasant, while dysesthesia is considered an unpleasant abnormal sensation. The borderline between both terms is unclear, just as tingling that can be unpleasant for one person while it doesn’t bother another. Although tingling is not painful, it is one of the symptoms of neuropathic pain. Abnormal sensations can occur in practically any part of the human body. In this case: the tongue.
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Symptoms of Tingling Tongue
Tingling tongue is often a symptom of an underlying cause and characterized by an abnormal sensation from the tongue, such as a sensation of numbness, tingling, or prickling. The tongue is a very sensitive organ of the body and has a rich nerve supply, therefore, the tongue often feels much more than other bodily organs and even has a unique sensory function: taste.
Causes and Treatment
Tingling tongue can be caused by a number of reasons including oral allergy syndrome, reaction to a medication, toxins, trauma, and various other diseases. Let us discuss the causes and their respective treatments below:
Oral Allergy Syndrome
Oral Allergy Syndrome (OAS) is “an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food”. Symptoms are usually limited to the oropharyngeal area but can vary among individuals. Also named pollen-food allergy, the symptoms occur shortly after eating raw fruits, nuts, or vegetables. Common symptoms are itching, tingling, and/or swelling of the lips, tongue, palate or throat. Severe reactions have been reported, such as anaphylaxis. The onset of OAS is common in older children, teens, and young adults, until a certain moment the allergens did not cause any problems. Treatment involves antihistamines and the avoidance of the raw form of foods that cause the reaction. The use of a food diary, as well as a dietitian or nutritionist, can be helpful to identify foods that are safe for consumption, how to prepare them, and to minimize the risk of allergen exposure.
Although a tingling tongue is most frequently caused by neurological disorders, the sensation can also occur due to substance use. Medications such as ingesting caustic agents, topic anesthetics, and prescription drugs may cause a tingling tongue. This sensation is usually short term, as a side effect, unless the medication permanently damages the tissues of the tongue or nerves.
Both natural and artificial toxins can cause paresthesia of the tongue. There are too many toxins to name here, but an example is ciguatera fish poisoning that may cause a sensation of numbness and tingling of the tongue. It is caused by eating fish that is contaminated by the toxin, mainly large reef fish such as barracuda, grouper, eel, and sea bass. Although it causes reactions in humans, ciguatera toxin is harmless to fish. There is no effective treatment. About 50.000 people are poised per year worldwide. Other widely known types of toxins that may cause tingling tongue are heavy metals and tetrodotoxin in the pufferfish.
Local Anesthesia in Dental Surgery
Most dental procedures are performed under local anesthesia, like tooth extraction, a root canal or other dental surgical procedures. The anesthetic used almost always causes sensory effects like tingling of numbness. This is a temporary effect and goes by after hours. In some cases, however, tingling is caused by nerve damage due to the dental procedure, which can lead to a permanent change of sensation. Treatment depends on the complaints and nerve damage but can involve topical analgesics or NMDA-receptor Antagonists.
Even a small but very common trauma can cause a change of sensation of the tongue, like eating or drinking very hot foods or beverages, biting the tongue or tongue piercings. On the other side, also very cold foods or beverages can cause paresthesia or dysesthesia. These sensations are temporarily present. Trauma also refers to some kinds of treatment, such as radiation for cancer treatment.
Disease and Infection
Several diseases and infections can cause a tingling tongue, such as:
Postherpetic Neuralgia (herpes zoster): Postherpetic neuralgia (PHN) is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. Postherpetic neuralgia arises after the reactivation of varicella zoster virus. It causes sensory symptoms at the place of the rash, but can also affect other body parts.
Diabetic Neuropathy: Because of diabetes, diabetic neuropathy can develop. This disease can affect many body parts, such as the eyes, feet and face. It causes sensory symptoms like tingling, burning, and numbness.
Burning Mouth Syndrome: A less common condition is named Burning Mouth Syndrome, a chronic oral pain syndrome. Mainly localized to the tongue and/or lips, it causes oral mucosal burning often associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. There is no known medical or dental cause for the syndrome. Medications as gabapentin, benzydamine hydrochloride bupivacaine, and Catuama can be used to manage the syndrome.
Lingual Neurofibroma: Neurofibroma is a benign tumor of the oral cavity derived from the cells that constitute the nerve sheath. This rare condition causes dysesthesia and irritation of the tongue. The tumor and symptoms disappear after excision.
Several vitamins and minerals are known to influence oral health, both in deficiency or excess, that may lead to a tingling tongue or other neurological signs and symptoms in the mouth. Vitamins and minerals known to have an effect are B vitamins, iron, zinc, and calcium.