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Glossitis: Inflammation of the Tongue

Glossitis is defined as an inflammation of the tongue characterized by a change in the color and texture of the tongue surface. It may appear as a beefy red coloration of the tongue with a smooth, bald texture, while the tongue may be swollen. Geographic tongue, characterized by a map-like appearance of the tongue surface, is the most common type of glossitis. Changes in the tongue appearance are due to the loss of tiny finger-like projections that cover the top surface of the tongue called papillae. Glossitis may be a condition in itself or a symptom of another disease elsewhere in the body. It is usually a harmless condition. Although glossitis affects people of all ages and may first appear in childhood or adolescence, it is more common in adults than children.

Causes of Glossitis

Glossitis may result from numerous factors, including infections, allergies, hormonal changes, reactions to irritants, mineral and vitamin deficiencies, compromised immune system, family history and certain medical conditions such as anemia, diabetes, syphilis, ulcers and a skin disease called pemphigus. Patients with glossitis may experience flare-ups when they are under stress or involved in a trauma. Furthermore, glossitis may occasionally occur in tandem with burning tongue syndrome.

Symptoms of Glossitis

The most typical symptom of glossitis is swelling of the tongue, which tends to become dark red. Sometimes, the tongue may turn other colors. For instance, when glossitis results from pernicious anemia the tongue may turn pale or when it is related to vitamin B deficiency the tongue may turn fiery red and become smooth. In some cases, glossitis may cause tenderness and soreness of the tongue.

Geographic tongue. People with a specific form of glossitis called geographic tongue experience irregularly shaped red, smooth, swollen patches on the tongue, sometimes surrounded by a white border. Texture of the tongue surface has a map-like pattern, this pattern changes constantly and may continue for months or may go away and then recur. Some patients with this condition may experience burning pain or soreness of the tongue. In serious cases of geographic tongue, patients may have trouble breathing, chewing, swallowing or speaking.

Median rhomboid glossitis is another type of glossitis characterized by a diamond or oval shaped red lesion in the middle of the tongue. It is considered to be congenital (birth defect) and may be secondarily infected with the Candida fungus.

Treatment and Prevention of Glossitis

In the vast majority of cases, glossitis is not a dangerous condition to a person’s health and usually does not require any special treatment. Most of the time, the condition disappears on its own, though it may take years before this occurs. Patients can help reduce symptoms and prevent flare-ups of glossitis by practicing good oral hygiene.

Sometimes, treatment may be necessary to help control tongue soreness and inflammation. This can be accomplished with topical anesthetics or corticosteroids. Gargling with a saltwater rinse may help relieve less severe cases of glossitis. If the condition is caused by infection, the patient may be prescribed antibiotics or other medications needed to fight infection (e.g., antifungals). Changes in diet or dietary supplements may be recommended for patients whose nutritional deficiencies, such as vitamin B deficiency, are suspected to be the source of glossitis.

In addition, patients may be able to reduce symptoms of glossitis by avoiding certain irritants including hot and spicy foods, tobacco, alcohol and alcohol-based mouthwashes and heavily-flavored toothpastes.