How to treat wounds on the tongue: causes, symptoms, methods of control

Relevance

The surgical method of treating tongue tumors remains the main one in the specialized treatment of benign tumors and carcinomas in the initial stages of the malignant process. Despite the postoperative “discomfort” when eating, changes in speech function, the choice of radical surgery is determined by the need for rapid and complete removal of the tumor focus in the oral cavity with its final pathohistological examination and effective “medical profitability” in the treatment of these patients. The healing process of post-resection wounds of the tongue is influenced by the state of the microbiota and factors of local immunity of the oral cavity. Therefore, the study of indigenous microorganisms and the level of lysozyme in mixed saliva before and after surgical treatment of patients with oral cavity tumors is relevant for subsequent personal preventive measures [1, 3]. The use of local oral irrigations with various drugs is also a reasonable necessity and requires modern analysis and study in the changing conditions of the pharmaceutical market.

The purpose of the study was to study the nature of postoperative wound healing and the qualitative and quantitative composition of the oral microbiota, as well as the level of lysozyme in the saliva of patients with tongue carcinoma at the stage of surgical treatment with local application of a 2% solution of acid-soluble chitosan.

Oral injuries

Damage to the mucous membrane of the tongue can occur in the following cases:

1. Brushing your teeth with a brush that is too hard.
2. Broken tooth or damaged filling.
3. Eating foods that can irritate the mucous membrane of the tongue and lead to the appearance of ulcers.
4. Installation of low-quality dentures or braces.
5. Injury to the tongue while eating with cutlery.
6. Biting with teeth.
7. Burns to the mucous membrane of the tongue due to a hot drink.
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Considering the large presence of capillaries in the mucous membrane of the tongue and the content of the bactericidal substance lysozyme in saliva, wounds on the tongue in an adult or child of mechanical origin heal quite quickly and do not require the use of special medications.

Tongue traumatism: theory

Before you begin treatment of the tongue, you should carefully study the nature of the injury and its causes.

Mechanical impact

The first type of damage - mechanical - is the most common cause of tongue injuries. Due to mechanical damage, ulcers and superficial erosions form on the tongue.

Conditions under which mechanical injuries occur are of a domestic nature:

• damage to the integument by dental instruments - probe, bur, disc;
• the occurrence of a wound under the influence of a sharp object - a bone, a knife, a fork;
• biting the tongue while eating, epileptic seizure;
• the appearance of tongue injuries from blows to the face.

Healing of a wound caused by mechanical impact occurs depending on the depth and area of ​​damage to the mucous membrane.

Chemical burn

Chemical injury to the tongue, as the second type of injury, occurs due to contact with the mucous membrane of a chemical substance of an acidic or alkaline nature.

Under the influence of an irritant, chemical burns occur on the tongue. The latter are characterized by the appearance of dark-colored areas, scars, blisters and blisters on the tongue (in severe cases).

Instant rinsing of the mouth with solutions with neutralizing properties is the key to rapid restoration of the integument.

For chemical burns, it is preferable to seek help from medical institutions.

Painful influence from the outside

Damage to the mucous membrane by steam, hot water, fire, electric current or ionizing radiation is called physical trauma to the tongue.

Characteristic of this type of injury is pain that gradually subsides from the moment of injury.

The main danger of physical injury is the development of acute catarrhal glossitis (inflammation). Consultation with a doctor in complex stages of injury is mandatory.

Deep damage to the tongue caused by various kinds of external irritants can be accompanied by complications: abscess or phlegmon of the tongue.

Painful swelling and accompanying difficulties with swallowing and speaking are symptoms of an abscess. In later stages, with increasing inflammation of the tongue, the abscess turns into phlegmon. The victim requires emergency hospitalization and surgical intervention.

Other provoking factors

There are several other reasons that can lead to the appearance of wounds on the tongue:

1. Hormonal imbalance, which is often observed during pregnancy or during menstruation in women.
2. Diabetes.
3. Hereditary predisposition.
4. The presence of viral infections in the body.
5. Deficiency of certain vitamins and minerals, for example, B12, iron.
6. Drinking coffee in large quantities.
7. Brushing your teeth with a paste that contains sodium lauryl sulfate.
8. Alcohol abuse.
9. Frequent smoking.
10. Poor oral hygiene.
11. Heatstroke.
12. Avoiding morning meals.

If wounds appear on the tip of the tongue, your doctor will tell you how to treat it, but first you need to find out the cause in order to choose effective therapy.

Let's consider some common pathologies of the body that can provoke such lesions.

Glossitis

This pathology is a type of stomatitis. Manifests itself as an infectious inflammation of the mucous membrane of the oral cavity and tongue. The disease most often develops against the background of a variety of reasons that were listed earlier, and is manifested by a variety of symptoms.

Without therapy, the situation will only get worse, so it is better to visit a doctor for advice.

Sores on the tongue due to syphilis

Among the serious pathologies that cause sores on the tongue is syphilis. With the development of such a pathology, not only internal organs, bones, and the nervous system are affected, but also the mucous membranes are revealed.

As syphilis develops, white sores appear on the tongue. In the first stages of the disease, they do not cause discomfort and are almost invisible. With the development of the inflammatory process in the body, wounds on the tongue of an adult become larger and more painful.

Such sores take a long time to heal; without effective therapy for syphilis itself, it is difficult to achieve a complete cure.

What types of wounds are there?

A wound is a tissue damage that is characterized by a violation of the integrity of the skin or mucous membranes. The wound is accompanied by pain and bleeding.

The first sign is pain. It occurs due to damage to local nerve endings, and subsequently due to swelling, which puts pressure on the nerve and irritates it. In this case, pain can spread not only along the surface of the wound, but also along the damaged nerve.

The second mandatory sign of a wound is bleeding. It occurs as a result of damage to capillaries, veins or arteries. Bleeding can be weak and drip, for example, with a small cut, and severe when the integrity of the vein and artery is damaged.

The third sign of a wound is gaping. However, gaping appears only with deep wounds, for example, with abrasions it does not exist. Gaping is the divergence of the edges of the wound on either side of the axis of the cut. If there is severe gaping, the wound is usually sutured.

There are many types of wounds. For a person in everyday life, it is necessary to know several classifications. The first is based on whether there is an infection in the wound. Wounds may be aseptic, contaminated, or infected.

An aseptic wound is a pure injury to the skin. Usually these are surgical wounds that are performed in order to penetrate the internal organs. Children most often experience contaminated wounds. This means that microbes have entered the area of ​​skin damage. At first, these are relatively safe wounds: local protective mechanisms inhibit the development of microorganisms. If a contaminated wound is not treated, it becomes infected: an infectious process develops, which is accompanied by inflammation, severe pain and suppuration. An infected wound can cause a strong reaction in the child’s body: body temperature rises, chills, drowsiness and apathy appear.

Depending on the nature of the damage, there are the following wounds:

• punctured - they occur when punctured by a narrow and piercing object, for example, when a child falls on a nail. Typically, a puncture wound bleeds slightly and hurts. Outwardly it may seem that this is a safe wound, but this is not so: large vessels, nerves are often damaged, and even an infection occurs;
• cut - occur upon contact with a sharp oblong object: a knife, razor, sharp scissors, a shard of glass and paper. With an incised wound, the tissue is usually slightly damaged. The wound bleeds heavily and hurts moderately;
• Chopped wounds occur when damaged by a heavy sharp object, such as an ax. Usually the bleeding is moderate, but the wound is very painful and gapes. May lead to serious condition;
• a bruise wound appears when struck with a blunt object or falling on asphalt. Most often, the bruised wound is located on the head, elbows and knees. The edges of a bruised wound are uneven and soaked in blood. It bleeds slightly and is moderately painful.

There are also bite wounds that occur when children are bitten by animals or other children. The difficulty with this wound is that in most cases it contains infection from the animal's oral cavity. This is how rabies, insect and snake poison, and putrefactive infection are transmitted.

The wound process consists of several stages:

1. In the first seconds after skin damage, local blood vessels reflexively constrict and biologically active substances are produced - platelets, which adhere to the wound area and close the damaged vessel. The blood clotting system turns on, stopping the bleeding. In a healthy child, bleeding stops on its own within 15 minutes.
2. Inflammation. Lasts 3 days from the moment of injury. Inflammation is manifested by pain, redness and local fever. Also, swelling in the form of a tumor appears on the wound within two hours.
3. 2–4 hours after injury, leukocytes migrate to the area of ​​injury. They absorb foreign particles and cleanse the wound of microorganisms.
4. Healing phase. Begins 3–5 days after injury. Bioactive substances arrive to damaged tissues, which restore vascular and skin tissue.
5. Epithelization phase. Begins 2 weeks after injury. The wound mark becomes pale and a scar forms. The epithelialization phase may be delayed if bacteria are present in the wound.

Afty Bednar

In infancy, sores may also appear on the child's tongue. Your pediatrician will tell you how to treat them. This happens in some cases due to frequent sucking on a bottle or pacifier.

The ulcers on the baby's tongue become covered with plaque, which is difficult to remove. The mucous membrane becomes red and swollen, becomes painful, and the baby refuses the breast or bottle.

This pathology can also develop in older children if they have a bad habit of sucking fingers or putting toys in their mouth.

How to treat wounds on the tongue if they are caused by thrush? This pathology often develops in children, so visiting a pediatrician will help quickly help your child get rid of the discomfort and pain that accompany the pathology.

Allergies are the cause of pain

If the wounds on the tongue, photos of which can be seen on stands in many clinics, do not have purulent contents, then the reason may be hidden in a common allergic reaction. It may appear in response to eating certain foods or using hygiene products.

Numerous studies have confirmed that there is a connection between oral wounds and one of the components of toothpaste - sodium lauryl sulfate.

Some medications cause sores on the tongue

Drug therapy in some cases can provoke side effects, which may include sores on the tongue. Most often, such conditions are caused by treatment with the following medications:

1. Heart drug "Nicorandil".
2. Non-steroidal anti-inflammatory drug "Indomethacin".
3. Phenytoin, which is used to treat epilepsy.
4. Cytotoxic drugs, which are often part of chemotherapy treatment.

Treatment of wounds on the tongue that have arisen due to medications requires an integrated approach. If the cause is clearly established, then you will have to stop taking the drugs for a while, unless the severity of the consequences exceeds the benefits of treatment, for example, for cancer. It is not recommended to make a decision on your own in such cases; it is better to discuss this issue with your doctor.

Treatment Basics

As mentioned earlier, treatment for tongue injuries depends on the nature of the injury. While a home first aid kit is sufficient to heal superficial injuries, eliminating the consequences of traumatic factors in case of serious injuries requires, first of all, consultation with a doctor who will select the necessary medications and prescribe recommended procedures.

What to do depending on the type of injury:

1. The standard method of treatment or initial treatment of mechanical injuries is the use of antiseptics (alcohol, iodine, brilliant green). Rinsing with disinfectants helps in restoring the mucous membrane: furatsilin, hydrogen peroxide, potassium permanganate dissolved in water in a ratio of 1 to 3000 or baking soda at the rate of 1 teaspoon per 250 ml. Do not neglect plant decoctions with calming properties.
2. Knowledge of chemical neutralizing reactions will be useful in case of chemical burns , because the “golden rule” of first aid for this is as follows: rinse with a neutralizing solution. Timely implementation of the necessary procedures will avoid further treatment. Blisters appearing on the tongue indicate severe damage. Opening of formations with subsequent processing should only be carried out by specialists. After neutralizing the blisters, doctors most often prescribe rinsing the mouth with disinfectants.
3. Profusely bleeding wounds require immediate tamponade. It is unacceptable to independently remove foreign bodies from ulcers.

Signs of pathology

Sores on the tongue can appear in different places, and the process of their formation goes through several stages:

1. In the first stage, swelling and small blisters appear on the tongue.
2. Next, bubbles appear.
3. The wounds are covered with a layer of white or yellow plaque, and a red border appears.

There are no age preferences for sores on the tongue; they can appear in children and adults. The frequency of their formation varies from several times throughout life, while in others they may appear with enviable regularity.

Usually the sores go away quickly, but if the wound on the tongue does not heal, then you should visit a doctor and find out the cause.

Treatment of abrasions in children

How to properly treat abrasions in children:

1. Wash your hands.
2. Clean the skin around the wound from dirt, dust, debris and other objects.
3. Disinfect the wound: the abrasion can be treated with the following products: zinc oxide ointment, benzalkonium chloride cream, dexpanthenol cream, chlorhexidine, methyl blue, hydrogen peroxide, brilliant green and 5% iodine solution.
4. Usually, mild capillary bleeding occurs with abrasions. It is enough to apply a dry cloth or gauze to the damaged skin.

See a doctor urgently

It is necessary to urgently contact a specialist if:

1. A large number of ulcers, wounds and neoplasms appear in the oral cavity.
2. Open wounds appear, accompanied by severe pain.
3. The sores appeared due to wearing dentures or artificial structures in the oral cavity.
4. Sores have appeared on the tongue and are bleeding.
5. The general condition worsens, the temperature rises, weakness.
6. Sores and sores quickly increase in size.
7. I have a headache and a feeling of fullness in the mouth.

If the listed symptoms are present, only a doctor can tell you how to treat wounds on the tongue.

Wound therapy

If sores appear on the tongue that do not cause discomfort, but do not go away for a long time, then you need to consult a doctor to rule out a serious pathology developing in the body.

Comprehensive therapy is required, which will be aimed at:

1. Elimination of the provoking factor.
2. Fighting symptoms.
3. Boosting immunity.

How to treat wounds on the tongue of a child or an adult depends on the cause of their appearance. Therapy may include conservative methods and traditional recipes.

Treatment of wounds on the tongue

If a wound on the tongue occurs after biting your teeth, you can rinse with a solution of soda or hydrogen peroxide. To eliminate pain, you can dissolve tablets with Lidocaine.

In the case where the provocateur of ulcers and wounds on the tongue is an infection, the therapy may be as follows:

1. For stomatitis of a fungal nature, the wounds can be treated with ointments with an antifungal effect. For adults, Nystatin is suitable.
2. You cannot do without antiviral ointments if you have wounds due to a viral disease.
3. The resulting sores with purulent contents must be treated with antibacterial agents, for example, Tetracycline or Achromycin.
4. The fight against the inflammatory process in the oral cavity is carried out using Fluocinonide or Triamcinolone.
5. In case of severe pain, wounds can be treated with a gel with analgesic properties “Oragel”. You need to apply the product to the sores several times a day.

6. To prevent the formation of scars at the site of wounds after healing, it is recommended to use gels or ointments with regenerating properties.
7. It is recommended to rinse your mouth daily with pharmaceutical rinses; you can prepare such products yourself using sage or chamomile.

Considering that white formations on the tongue often occur due to disturbances in the gastrointestinal tract, the fight against them should also combine the use of probiotics to normalize the intestinal microflora.

Biting your tongue - everyone knows this

Biting the tongue, cheek or lip is accompanied by painful sensations, as damage to the mucous membrane occurs.

Obviously, the initial goal after a bite is to reduce pain. So, what should you do if you bite your tongue, what and how to relieve pain and inflammation?

The main rule is to remain calm. Calm down and try to come to terms with the pain, because tantrums and tears will not help heal the damage.

And then you should do the following:

1. Be sure to stop bleeding , if any. An elementary solution would be to repeatedly rinse with cold water: it will help narrow the blood vessels and reduce bleeding activity. A worthy alternative would be a piece of ice.
2. Cotton swabs soaked in 2% Lidocaine help in the fight against painful sensations . Another variation to reduce pain is eye drops with an anesthetic - Tetracaine, Alcaine.
3. It is important to disinfect the entire oral cavity : brush your teeth thoroughly and rinse your mouth.
4. Maintain regular rinsing : it is advisable to wash away the remains of eaten food after each meal.
5. Use antiseptics such as Antiangin, Trachisan, Furacilin in the form that is optimal for you: spray, lozenge or solution.
6. Avoid eating rough, cold or hot foods . During the restoration of the oral mucosa, it is advisable to create a daily menu of liquid soft foods at medium temperature: purees, soups.
7. Avoid cold foods - ice cream, frozen juice and other foods with temperatures below zero - they slow down the healing process.
8. Take a course of vitamins to help restore damaged areas. The optimal solution would be to include vitamin C and group B in the diet.

Do not forget to adhere to sanitary and hygienic measures: do not reach into the oral cavity with dirty hands, do not put pressure on the resulting injury.

Never pour iodine or brilliant green or peroxide into a wound: give preference to treating the environment around the injury. Antibiotics can only be used as prescribed by a doctor.

In practice, there are cases of tongue biting. In such a situation, it is important to remain cool, act quickly and in an organized manner: place the “particle” in a bag filled with ice and go to the hospital. To relieve painful sensations, it is permissible to ingest cold food: suck ice cream, frozen juice, ice, drink water.

Use of Medicines

If home remedies do not help get rid of sores on the tongue, then you cannot do without medications. Most often, doctors prescribe:

1. Antiseptic drugs that destroy bacteria, reduce the sensitivity of the mucous membranes of the tongue and oral cavity, thanks to analgesic components. This category includes: “Inhalipt”, “Gexoral”, “Strepsils”.
2. Products with disinfecting properties can be used: ethyl alcohol, alcohol solution of iodine, hydrogen peroxide.
3. Dental gels and ointments that not only disinfect, but also relieve pain. These include: “Kamistad”, “Cholisal”, “Solcoseryl”.
4. Rinsing the mouth with a solution of “Furacilin”, “Chlorhexidine”, “Chlorophyllipt”. If you don’t have these drugs on hand, you can prepare a rinse solution from iodine, salt and soda.

All of the listed remedies must be used only with the permission of a doctor and with extreme caution so as not to cause even greater harm to the mucous membrane of the tongue. Medicines should be applied to wounds purposefully, trying not to affect adjacent healthy areas.

Wound treatment algorithm

What to do if your child falls, cuts or hits himself:

1. Make sure you're safe: you've shooed the dog away, put away the knife, turned off the chainsaw, removed any broken glass.
2. Usually, in a situation of injury, the child is frightened: by pain or by the fact of the cut. Reassure him and tell him that nothing bad happened. Make him feel protected.
3. Before treating a wound, first wash your hands with soap.
4. Remove clothing from the wound site: roll up your shirt sleeve, lift up your T-shirt or pant leg. Examine the wound. Try not to touch the wound with dirty hands.
5. If the capillaries are damaged, bleeding is minor. Rinse the wound with warm water, apply hydrogen peroxide and bandage with gauze.
6. Gently clean the wound of debris and dirt under warm water. To do this, use cotton swabs or gauze soaked in a disinfectant.
7. Disinfect the wound. Usually at home there is always an alcohol solution of iodine, cologne, hydrogen peroxide, alcohol or strong drinks. Dilute alcohol with water so as not to burn the wound. If the wound is extensive, alcohol and iodine cannot be used, they will lead to a chemical burn and the wound will heal more slowly.
8. Apply sterile material to the wound and bandage it. You need to bandage so that the bandage covers the wound site. It should not be tight or too soft.

What to do if your child is bleeding heavily:

1. Assess the severity of bleeding. If the wound bleeds heavily with dark or scarlet blood, spurts out and the blood erupts synchronously with the heartbeat, the bleeding must be stopped at any cost.
2. Call an ambulance. One person provides first aid, the second calls the team. Please note that if the wound is penetrating, that is, a screwdriver or knife is stuck into the body, you cannot remove the object yourself. Be sure to wait for an ambulance.
3. Find a tissue or any other tissue in your bag or home medicine cabinet that can be applied to the wound.
4. If the wound is on the extremities, place the child on his back and raise the injured limb above the level of the heart, bending them at the elbow or knee. This is temporarily uncomfortable but slows down blood flow.
5. Apply a tourniquet. If you don't have one, use a belt, tie, suspender or wire. You need to place a napkin or cloth under the tourniquet so as not to injure the skin. For arterial bleeding, a tourniquet is applied above the wound site; for venous bleeding, a pressure bandage is applied to the wound. Note the time of application of the tourniquet, write it down with a pen or felt-tip pen (not red) on the skin near the tourniquet. Remember that in summer the maximum time for applying a tourniquet is 90 minutes, in winter – 60 minutes. If after this time the ambulance has not arrived, and you have not yet reached the hospital, carefully loosen the tourniquet so that the tissues of the limb receive blood, while pressing the bleeding site with gauze. If the bandage becomes saturated with blood, tighten the tourniquet again until the bleeding stops completely and record the new time on the skin.

It is not recommended to give your child painkillers. This is hampered by the fact that each drug has an expiration date and doctors need to recalculate the doses of a new painkiller or wait for the previous one to expire in order to avoid an overdose. But if you cannot do without pain relief, write down the time and name of the drug you gave your child. Save the empty vials of medication and give them to the ambulance crew so they know what you gave to the victim.

Traditional recipes for getting rid of ulcers

How to treat wounds on the tongue if there are no necessary medications in your home medicine cabinet? Then you can use folk recipes that will help alleviate the condition at least a little. Among these are the following:

1. Use of infusions of medicinal herbs. Among the gifts of nature, the following have powerful antiseptic properties: St. John's wort, sage, viburnum berries, and yarrow.
2. Aloe and sea buckthorn oil have healing properties. They can be applied several times a day to wounds.

3. The healing properties of oak bark, propolis, honey and onions have been proven.
4. A decoction of coriander will help cope with sores on the tongue. To prepare it, you need to take a tablespoon of seeds, pour 200 ml of boiling water, and simmer over low heat for half an hour. After cooling, strain and can be used to rinse the mouth. Before the procedure, the broth must be diluted slightly with water.
5. Juice from fresh cabbage will help eliminate the inflammatory process and reduce formations. Soak a cotton swab in the juice of the plant and treat the wounds.
6. Propolis. For treatment you need to prepare a decoction. Pour boiling water over several pieces of propolis and keep in a water bath for 30-40 minutes. Cool to room temperature and use to rinse your mouth every hour.
7. Potato. Peel raw potatoes. Cut into pieces to be applied to the wounds on the tongue. The starch in tubers relieves inflammation and reduces pain.
8. Onion and garlic. Grind one of the vegetables into a paste and apply to damaged areas on the tongue. Phytoncides promote rapid relief of the inflammatory process and suppress the development of pathogenic microorganisms.
9. You can also apply lemon juice directly to the wounds on your tongue.

Greater effectiveness can be achieved if you combine drug treatment with the use of traditional recipes. When using folk remedies, it is necessary to exclude the presence of allergies to some natural gifts.

Results and discussion

Analysis of local criteria for assessing the healing of tongue wounds showed that all patients of group 2 who received “traditional” local treatment, a day after surgery, indicated aching severe pain in the oral cavity and inability to swallow. 16 (88.9%) patients in this group experienced an increase in body temperature, on average to 37.8 °C, within 2-3 days after surgery. All patients were found to have severe swelling and hemorrhage of the tongue stump, as well as moderate hyperemia of the suture line. In 15 (83.3%) patients, a clinical blood test revealed leukocytosis (on average up to 11.5·109/l), and an acceleration of ESR (on average up to 21.5 mm/h) was noted in all.

3 days after surgery, severe pain and inability to swallow were noted by 7 patients of group 2 (38.9%). All patients had low-grade fever. Severe swelling of the tongue tissues and hyperemia of the suture line were detected in 4 (22.2%) patients. In 16 (88.9%) cases, partial divergence of the sutures in the middle and distal fragments of the wound was noted. All patients had no wound discharge; the stump of the tongue was covered with fibrinous plaque.

On the 5th day after surgery, 4 patients in this group (22.2%) still had low-grade body temperature. A clinical blood test revealed leukocytosis up to 11·109/l in 14 (77.8%) patients and acceleration of ESR up to 20 mm/h in 16 (88.9%) people. 7 (38.9%) patients complained of minor pain in the wound, and 14 (77.8%) patients complained of difficulty swallowing water. All patients had partial suture divergence, with 4 (22.2%) of them having an area of ​​divergence of more than 70%. The edges of the wound in 5 (27.8%) patients were covered with purulent-necrotic masses, as well as purulent wound discharge. Sluggish granulation of wound surfaces was detected in 7 (38.9%) patients.

On the 9th day after surgery, minor pain in the wound was noted by 7 (38.9%) patients of group 2, swallowing was free in all patients. In 4 (22.2%) there was slight hyperemia around the preserved suture material, in 5 (27.8%) patients there was a serous nature of the wound discharge. All patients had active granulation, in some areas even with the growth of hypergranulation, and partial epithelization of the wound surface. On the 9th day, the existing sutures were removed.

On days 12–14 after surgery in patients of the study group, complete epithelization of the wound surface was observed in only 3 (16.7%) patients. In 15 (83.3%) there was an area in the center of the wound that was not covered by epithelium. Complete epithelization of the wound surface in this group with the formation of a dense, linear scar was completed by the 19th day after surgery.

A comparative analysis of the nature of healing of tongue wounds in patients who received a 2% solution of acid-soluble chitosan in the postoperative period revealed that on the 5th day after treatment, 13 (72.2%) patients of the 1st group had partial suture dehiscence on average and distal fragment of the wound and slight swelling of the tongue tissue. In 5 (27.8%) patients in this group, wound healing occurred without suture dehiscence. The surfaces of the wound and tongue stump were covered with a fibrinous film, after removal of which formed granulations were visible.

On the 9th day after surgery, 13 (72.2%) patients in the group with identified wound dehiscence had an active granulation process and partial epithelization of the wound surface. In 5 (27.8%) patients with primary wound healing, the sutures were removed. Complete epithelization of the wound surface in all patients of group 1 was completed by the 14th day after surgery. All of them developed a linear, dense scar.

Thus, in patients of this group, a favorable picture of reparation of damaged oral tissues was clinically observed and in earlier stages of healing than in patients of group 2.

A study of the microbiocenosis of mixed saliva in 36 patients with tongue carcinoma before surgery established the predominance of streptococci and staphylococci (100 and 87.5%, respectively), less often - bacteria of the Enterobacteriaceae

(37.5%),
Bacteroides
(31.3%),
Sarcina
and
Candida
(25%),
Lactobacillus
(18.8%),
Stomatococcus
(13.3%),
Veillonella
(12.5%),
Corynebacterium
and
Fusobacterium
(6.3%).
The number of isolated microorganisms was as follows: Streptococcus
spp.
— 7.4±0.13 lg CFU/ml, Fusobacterium
spp.
— 6.3±0.23 lg CFU/ml, Corynebacterium
spp.
— 6.1±0.26 lg CFU/ml, Staphylococcus
spp.
— 5.9±0.08 lg CFU/ml, Candida
spp.
— 5.6±0.78 lg CFU/ml, Bacteroides
spp.
— 5.3±0.07 lg CFU/ml, Lactobacillus
spp.
— 5.2±0.09 lg CFU/ml, Stomatococcus
spp.
— 5.1±0.20 lg CFU/ml, Sarcina
spp.
— 4.8±0.25 lg CFU/ml, Veillonella
spp.
- 4.5±0.11 lg CFU/ml, family Enterobacteriaceae
- 3.9±0.24 lg. The pathogenic potential of the isolated microbiota in patients with tongue carcinoma was more pronounced than in healthy people during the initial examination. 66.7% of staphylococcal strains had hemolytic and lecithinase activity, and 43.8% of streptococci had hemolytic activity. In 62.5% of patients, associations of 3-4 cultures of microorganisms were detected, and in 38.5% - of 5-6 cultures.

Thus, the identified dysbiotic state of the oral microbiota of patients with tongue carcinoma before surgery is regarded as grade III dysbiosis, requiring correction in order to prevent purulent complications of the upcoming surgical intervention on oral tissues.

On the 10th day of using acid-soluble chitosan (group 1), a repeated study showed positive dynamics of changes in the microbiocenosis of the oral cavity (Fig. 1).

Rice.
1. Frequency of isolation of microorganisms in mixed saliva in patients with tongue tumors before and after treatment. The frequency of isolation of pathogenic and opportunistic microbiota decreased and representatives of normal microbiota began to be isolated to a greater extent. Thus, the prevalence of staphylococci decreased by more than 4 times, and yeast fungi of the genus Candida
and micrococci decreased by 2 times; Enterobacteriaceae, bacteroides, stomatococci, corynebacteria, veillonella, and fusobacteria were not isolated. At the same time, the frequency of detection of representatives of normal microbiota, lactobacilli (60%) increased 3 times; peptostreptococci began to be isolated in 90% of cases, peptococci, non-pathogenic candida, epidermal staphylococci, and actinomycetes began to be isolated in 20-30% of cases. Quantitatively (Fig. 2)

Rice. 2. The number of microorganisms in the mixed saliva of patients with a tongue tumor before and after treatment. There was also a decrease in the level of representatives of pathogenic and opportunistic microbiota - 2 times staphylococci, 1.5 times streptococci, candida, micrococci. Against this background, the amount of normal microbiota - peptostreptococci, peptococci, etc. - increased.

The microbiocenosis of saliva in patients of group 2 after the use of traditional antiseptic drugs was also restored to normocinosis, but much more slowly than after the use of chitosan irrigations. The quantitative and qualitative composition of normobiota and non-pathogenic representatives of the microbiota is lower than in patients of group 1.

A study of the level of lysozyme activity in mixed saliva of healthy people showed (Fig. 3),

Rice. 3. Lysozyme content in mixed saliva of healthy people and patients with tongue tumors before and after surgical treatment. that the amount of lysozyme averaged 47.4 ± 10.1 μg/ml.

The lysozyme level of all primary patients with tongue carcinoma before surgical treatment averaged 25.4±8.5 μg/ml.

After tumor removal, an increase in the level of lysozyme was observed: in group 2 - up to 78.125±18.7 μg/ml; in group 1, the amount of lysozyme increased 8 times and averaged 202.87±56.85 μg/ml.

Danger of wounds on the tongue

If you do nothing and do not find out the cause of the appearance of ulcers and wounds on the tongue, then there is a high probability of developing various complications. These may include the following:

1. Abscess formation.
2. Formation of an abscess with purulent contents inside.
3. When an abscess ruptures, pathogenic microorganisms can enter the bloodstream, causing the infection to spread throughout the body.

If wounds and ulcers appear on the tongue, which do not go away for a long time, and the situation only gets worse over time, you should not put off visiting a doctor. Timely therapy will avoid serious consequences.

The best way out is to avoid injury

Statistics show that most tongue injuries are mechanical in nature, which, in turn, is evidence of negligence. To avoid damage to the oral cavity, follow these simple rules:

• do not get lost in thoughts while eating;
• When eating, do not be distracted;
• do not talk with your mouth full of food;
• Chew your food thoroughly and slowly.

Often the cause of wounds is a malocclusion or unsuitable dentures. An improperly growing or filed tooth also poses a risk to the integrity of the oral cavity.

Be extremely careful and remember that it is better to prevent a traumatic situation from occurring than to suffer trying to cope with its consequences. If you observe suspicious symptoms, be sure to seek help from a dentist or ENT doctor.

How to prevent pathology

It is easier to prevent the disease than to deal with long-term treatment later. Preventive measures include the following tips:

1. Brush your teeth carefully so as not to injure the oral mucosa.
2. Choose a brush of medium hardness.
3. Visit the dentist regularly to treat caries and remove damaged teeth.
4. To clean your teeth, purchase toothpastes that do not contain sodium lauryl sulfate.
5. In the diet, reduce the amount of spicy, sour foods that can irritate the mucous membranes.
6. Use cutlery carefully.
7. Treat infectious and bacterial diseases in a timely manner.

Any wounds and ulcers in the mouth are not only painful and unpleasant, but can also be a symptom of a serious pathology, so you should not rely on self-medication, but rather visit a specialist. Only after finding out the exact cause can effective therapy be selected.