Glossitis

Glossitis

Also called: Glossitis Tongue

Reviewed By:
Kenneth Cheng, D.D.S.

Summary

Glossitis is defined as an inflammation of the tongue and may be a condition in itself or a symptom of disease elsewhere. This condition may appear as a beefy red coloration of the tongue with a smooth, bald texture as a result of the loss of tiny finger-like projections that cover the top surface of the tongue (papillae). geographic tongue is the most common form of glossitis, where areas of lost papillae resemble the pattern of a map. 

Glossitis may result from several factors, including allergies, infections, reactions to irritants and various medical conditions (e.g., anemia, vitamin deficiency, certain skin diseases). Patients with glossitis typically experience swelling of the tongue. While the tongue tends to become dark red, in some cases it may turn other colors. Glossitis also causes tenderness and soreness of the tongue. Patients with geographic tongue experience irregularly shaped red, smooth, swollen patches on the tongue, sometimes surrounded by a white border.

A dentist will examine a patient’s mouth when trying to diagnose glossitis. In particular, the dentist will look for swelling and will check to see if papillae are absent. Glossitis is not dangerous to a patient’s health and usually does not require treatment. In many cases, the condition disappears on its own, but it may take years before this occurs.

Patients can help reduce or prevent symptoms of glossitis by practicing good oral hygiene. Treatment with prescription drugs may be necessary in some cases to control tongue soreness and inflammation.

About glossitis

Glossitis is an inflammation of the tongue resulting in a change in the appearance of the tongue surface. The inflammation process results in the loss of finger-like projections on the top surface of the tongue (papillae), which often contain taste buds. This loss of papillae results in the bald, smooth texture of the tongue associated with glossitis. The pattern of loss may resemble the features of a map, and has led to the name geographic tongue (also known as benign migratory glossitis). Geographic tongue is the most common form of glossitis.

Glossitis may be associated with several factors, including:

  • Allergies (e.g., mouthwash, toothpaste, certain drugs, candies)
  • Bacterial, fungal or viral infections (e.g., cold sores)
  • Exposure to certain substances (e.g., alcohol, spices or tobacco)
  • Hormonal changes
  • Immune system reaction
  • Irritation (e.g., rough edges of teeth, dental appliances, burns)
  • Mineral or vitamin deficiencies
  • Reactions to medication
  • Various medical conditions (e.g., diabetes, anemia, syphilis, pemphigus, ulcers)

In addition, some cases of glossitis may be inherited. People with glossitis may find that the condition flares up when they are under stress or involved in a trauma. In addition, glossitis sometimes occurs in tandem with burning tongue syndrome, which causes a burning sensation in the mouth.

Glossitis may first appear in childhood or adolescence. However, it tends to be more common in adults than children.

Signs and symptoms of glossitis

Patients with glossitis typically experience swelling of the tongue, which tends to become dark red. In some cases, the tongue may turn other colors. For example, patients whose glossitis results from pernicious anemia may see their tongue turn pale. Glossitis related to vitamin B deficiency tends to turn the tongue fiery red, and is also typically smooth.

Glossitis occasionally causes tenderness and soreness of the tongue. Patients may have difficulty chewing, swallowing or speaking.

Patients with a specific form of glossitis called geographic tongue experience irregularly shaped red, smooth, bald areas of lacking papillae interspersed with areas of normal tongue texture resulting in a map-like pattern. This pattern constantly changes and may continue for months, or may go away and then recur.

The cause of geographic tongue remains unknown, although factors that are believed to contribute include allergies, a woman’s pregnancy or menstrual cycle, irritation from certain foods (e.g., hot or spicy foods, cheese), and the use of alcohol or tobacco. There is no cure for this condition and treatment is generally aimed at easing symptoms and reassuring the patient since the condition is benign. However, some patients with geographic tongue may experience burning pain or soreness of the tongue. They are urged to seek immediate medical attention if their tongue becomes severely swollen or if they have trouble breathing, speaking, chewing or swallowing.

Median rhomboid glossitis is another inflammatory condition of the tongue characterized by a diamond or oval shaped red lesion in the middle of the tongue. It is thought to be congenital and may be secondarily infected with the fungus Candida. Once diagnosis is made (which may involve a biopsy), no treatment is required.

Diagnosis methods for glossitis

A dentist will examine a patient’s mouth when diagnosing glossitis. In particular, the dentist will look for swelling and will check to see if tongue papillae (finger-like projections on the tongue) are absent. Blood tests may be ordered to check for illnesses that may be causing glossitis, or to rule out certain conditions.

Treatment and prevention options for glossitis

Glossitis is not dangerous to a person’s health and usually does not require treatment. In many cases, the condition disappears on its own, but it may take years before this occurs. Patients can help reduce or prevent symptoms of glossitis by practicing good oral hygiene. This includes brushing twice daily, flossing twice daily and maintaining regular dental examinations every year.

Treatment may be necessary in some cases to control tongue soreness and inflammation. This can be accomplished with medications ranging from topical anesthetics to corticosteroids and antidepressants. When corticosteroids are used, dentists usually prefer a topical solution, which has less potential for side effects than oral corticosteroids. Gargling with a saltwater rinse may be effective in less severe cases of glossitis.

If glossitis is caused by infection, the patient may be prescribed antibiotics, antifungal or other antimicrobial medications. Changes in diet or use of supplements may be recommended for patients whose nutritional deficiencies are believed to be the source of glossitis.

Finally, patients who avoid certain irritants may be able to reduce symptoms of glossitis. This includes hot and spicy foods, alcohol and tobacco. In addition, certain mouthwashes and toothpastes (such as those with tartar-control additives or heavy flavoring) may exacerbate symptoms. After the source of glossitis has been identified and treated, the patient’s prognosis is typically excellent.

Questions for your doctor regarding glossitis

Preparing questions in advance can help patients to have more meaningful discussions regarding their conditions. Patients may wish to ask their dentist the following questions related to glossitis:

  1. How will you diagnose my glossitis?
  2. What do you suspect is the cause?
  3. What type of glossitis do you suspect?
  4. What other conditions might be associated with my glossitis?
  5. Will I need to take prescription drugs to treat my glossitis?
  6. What are the side effects of these medications?
  7. How can I prevent symptoms?
  8. Can you suggest good options for mouthwashes and toothpastes that are less likely to cause symptoms?
  9. I have flare-ups during my menstrual periods. Is there a short-term treatment that can help me at those times?
  10. What is my long-term prognosis?
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