This common symptom is usually caused by poor dental hygiene. As a presenting complaint it is seen far more often by dentists than other clinicians. It may be detected when examining a patient for an unrelated complaint, and rarely but significantly can herald serious pathology.
The primary cause of this symptom is nearly always infection, usually because of poor dental hygiene: an endemic problem worldwide. Systemic problems may also cause gum pain or bleeding. While a dental referral is likely to be the end result, it is worth checking for general causes or easily remediable problems before directing the patient to the dentist.
Mouth lumps and marks can be unfamiliar territory – partly because it is rarely an area of expertise for most clinicians, and partly because many mouth problems are picked up by, or presented to, dentists in the first place. A proportion of patients will choose primary care as the first port of call, so a working knowledge of the area is useful.
This common symptom generally has common causes which are simple to detect and treat, and it is clearly important to spot the occasional serious problem at an early stage. Examination is simple, and a dentist may well have a clearer idea if referral is necessary in more obscure cases.
Pain in the tongue is usually caused by something immediately apparent on examination, but there are a few less obvious causes. This is something much more likely to be seen by a dentist, but is not strictly dental and therefore a working knowledge of the symptom is firmly within the remit of primary care.