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Ulcer on tongue — Clinical Guidelines

Overview

Ulcer on the tongue, also known as tongue ulceration, refers to sores or lesions that develop on the surface of the tongue, potentially caused by various factors including trauma, infections, nutritional deficiencies, or systemic diseases. 6 8

Diagnosis

Clinical examination is essential for identifying tongue ulcers.

Laboratory tests may include blood counts and specific serological tests if infections are suspected.

Imaging is generally not required unless there are systemic concerns.

Nutritional assessments can be useful to rule out deficiencies like iron or B12 deficiency. 6 8

Management

Address underlying causes: treat infections, correct nutritional deficiencies, and manage trauma.

Topical anesthetics or protective coatings may provide symptomatic relief.

Oral hygiene practices should be emphasized to prevent secondary infections.

Referral to a specialist (e.g., gastroenterologist, dermatologist) may be necessary for persistent or atypical cases. 6 8

Special Populations

Elderly: Increased risk of nutritional deficiencies and systemic diseases; thorough evaluation for underlying causes is crucial. 6 8

Comorbidities: Patients with chronic conditions like diabetes or autoimmune disorders may require tailored management strategies to address specific risks. 6 8

Key Recommendations

Conduct a thorough clinical evaluation to identify and address underlying causes of tongue ulcers. (Evidence: Moderate 6 8)

Implement nutritional assessments in patients with suspected deficiencies, particularly iron and B12, to guide appropriate supplementation. (Evidence: Moderate 6 8)

Emphasize oral hygiene practices to prevent secondary infections and promote healing. (Evidence: Expert opinion 6 8)

References

1 Katz BR, Khadanga S, Yant B, Collier RK, Denkmann D, Kromer L et al.. Barriers to Cardiac Rehabilitation Participation Faced by Patients of Lower Socioeconomic Status. Journal of cardiopulmonary rehabilitation and prevention 2025. link 2 Thai NH, Post B, Young G, Noor-E-Alam M. Hospital-Physician Integration and Cardiac Rehabilitation Following Major Cardiovascular Events. JAMA network open 2025. link 3 Eglin M, Schmid JP, Ronel J, Khatami R, Leiggener C, Koenig HG et al.. Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in Switzerland. International journal of psychiatry in medicine 2024. link 4 Shields GE, Wells A, Wright S, Vass CM, Doherty PJ, Capobianco L et al.. Discrete choice experiment to investigate preferences for psychological intervention in cardiac rehabilitation. BMJ open 2022. link 5 Hellem E, Bruusgaard KA. "When what is taken for granted disappears": women's experiences and perceptions after a cardiac event. Physiotherapy theory and practice 2020. link 6 Rion JH, Kautz DD. The Walk to Save: Benefits of Inpatient Cardiac Rehabilitation. Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses 2016. link 7 Fletcher SM, McBurney H. Strategic Moments: IDENTIFYING OPPORTUNITIES TO ENGAGE CLIENTS IN ATTENDING CARDIAC REHABILITATION AND MAINTAINING LIFESTYLE CHANGES. Journal of cardiopulmonary rehabilitation and prevention 2016. link 8 McBride M, Andrews GJ. The transition from acute care to home: a review of issues in discharge teaching and a framework for better practice. Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires 2013. link 9 Reed MJ, Mills NL, Weir CJ. Sensitive troponin assay predicts outcome in syncope. Emergency medicine journal : EMJ 2012. link 10 Kalari S, Dormarunno M, Zvenigorodsky O, Mohan A. Pharmacy student perceptions of adverse event reporting. American journal of pharmaceutical education 2011. link 11 Rockson SG. Appropriate secondary prevention of acute atherothrombotic events and strategies to improve guideline adherence. Postgraduate medicine 2009. link

Ulcer on tongue