Glossitis

Definition

Glossitis is a condition in which the tongue is swollen and changes color. Finger-like projections on the surface of the tongue (called papillae) are lost, causing the tongue to appear smooth.

See also: Geographic tongue

Alternative Names

Tongue inflammation; Tongue infection; Smooth tongue; Glossodynia; Burning tongue syndrome

Causes, incidence, and risk factors

Changes in the appearance of the tongue may be a primary condition (not due to another disease or event), or it may be a symptom of other disorders (a secondary condition).

Glossitis occurs when there is acute or chronic inflammation of the tongue.

Causes include:

• Bacterial or viral infections (including oral herpes simplex)
• Mechanical irritation or injury from burns, rough edges of teeth or dental appliances, or other trauma
• Exposure to irritants such as tobacco, alcohol, hot foods, or spices
• Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in candy, plastic in dentures or retainers, or certain blood pressure medications (ACE inhibitors)
• Disorders such as iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies, oral lichen planus, erythema multiform, aphthous ulcers, pemphigus vulgaris, syphilis, and others
• Yeast infection
• Dry mouth associated with connective tissue disorders, such as Sjogren syndrome

Occasionally, glossitis can be inherited.

Symptoms

• Tongue swelling
• Smooth appearance to the tongue
• Tongue color usually dark "beefy" red
  • Pale, if caused by pernicious anemia
  • Fiery red, if caused by deficiency of B vitamins
• Sore and tender tongue
• Difficulty with chewing, swallowing, or speaking

Signs and tests

An examination by a dentist or health care provider shows a swollen tongue (or patches of swelling).

Finger-like projections on the surface of the tongue (called papillae) may be absent.

Your health care provider may ask detailed questions about your medical history and lifestyle to determine the possible source of tongue inflammation, if injury or other cause is not easily identified.

Blood tests may be done to rule out other medical conditions.

Treatment

The goal of treatment is to reduce inflammation. Treatment usually does not require hospitalization unless tongue swelling is severe.

Good oral hygiene is necessary, including thorough tooth brushing at least twice a day, and flossing at least once a day.

Antibiotics, antifungal medications, or other antimicrobials may be prescribed if the glossitis is due to an infection.

Dietary changes and supplements are used to treat anemia and nutritional deficiencies.

Avoid irritants (such as hot or spicy foods, alcohol, and tobacco) to reduce any tongue discomfort.

Expectations (prognosis)

Glossitis usually responds well to treatment if the cause of inflammation is removed or treated. This disorder may be painless, or it may cause tongue and mouth discomfort. In some cases, glossitis may result in severe tongue swelling that blocks the airway.

Complications

• Discomfort
• Airway blockage
• Difficulties with speaking, chewing, or swallowing

Calling your health care provider

Call for an appointment with your health care provider if symptoms of glossitis persist for longer than 10 days.

Call your health care provider if tongue swelling is severe or breathing, speaking, chewing, or swallowing is difficult.

Blockage of the airway is an emergency situation that requires immediate medical attention.

Prevention

Good oral hygiene (thorough tooth brushing and flossing and regular professional cleaning and examination) may help prevent glossitis.

References

Burning mouth syndrome, burning tonuge (glossodynia). In: Buttaravoli P, ed. Minor Emergencies. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 44.