Glossitis

Glossitis
Classification and external resources
Glossitis
ICD-10	K14.0
ICD-9	529.0

Glossitis is inflammation of the tongue. It causes the tongue to swell and change color. Finger-like projections on the surface of the tongue (papillae) may be lost, causing the tongue to appear smooth.

Glossitis usually responds well to treatment if the cause of inflammation is removed. The 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, a medical emergency that needs immediate attention.

Symptoms

• Tongue swelling.
• Smooth appearance to the tongue due to pernicious anemia (vitamin B₁₂ deficiency).
• Tongue color changes (usually dark "beefy" red).
• Sore and tender tongue.
• Difficulty with chewing, swallowing, or speaking.

A health care provider should be contacted if symptoms of glossitis persist for longer than 10 days, if tongue swelling is severe, or if breathing, speaking, chewing, or swallowing become difficult.

Causes, incidence, and risk factors

• Bacterial or viral infections (including oral herpes simplex).
• Poor hydration and low saliva in the mouth may allow bacteria to grow more readily.
• Mechanical irritation or injury from burns, rough edges of teeth or dental appliances, or other trauma
• Tongue piercing. Glossitis can be caused by the constant irritation by the ornament and by colonization of Candida albicans in site and on the ornament.
• Exposure to irritants such as tobacco, alcohol, hot foods, or spices.
• Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in confectionery, plastic in dentures or retainers, or certain blood-pressure medications (ACE inhibitors).
• Administration of ganglion blockers (eg. Tubocurarine, Mecamylamine).
• Disorders such as iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies, oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris, syphilis, and others.
• Occasionally, glossitis can be inherited.
• Albuterol (bronchodilator medicine)
• Migratory glossitis, also known as geographic tongue, is a very common condition that affects the anterior two thirds of the dorsal and lateral tongue mucosa of 1% to 2.5% of the population. When lesions involve other oral mucosa in addition to the dorsal and lateral tongue, the condition is called migratory stomatitis (or ectopic geographic tongue); in this uncommon condition, lesions infrequently involve also the ventral tongue and buccal or labial mucosa, the soft palate and floor of the mouth. The etiology and pathogenesis of this phenomenon are still unknown. Symptoms may be appeared in the atrophic areas especially upon consumption of spicy, acidic, or hot food, cheese, or alcoholic beverages. It is unclear why the condition becomes suddenly symptomatic many years after presentation.

A painful tongue may be an indication of several underlying serious medical conditions and nearly always merits assessment by a Doctor or Dental Surgeon

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 daily. Corticosteroids such as prednisone may be given to reduce the inflammation of glossitis. For mild cases, topical applications (such as a prednisone mouth rinse that is not swallowed) may be recommended to avoid the side effects of swallowed or injected corticosteroids. Antibiotics, antifungal medications, or other antimicrobials may be prescribed if the cause of glossitis is an infection. Anemia and nutritional deficiencies (such as deficiencies in niacin, riboflavin, iron, or vitamin E) must be treated, often by dietary changes or other supplements. Avoid irritants (such as hot or spicy foods, alcohol, and tobacco) to minimize the discomfort.

Prevention

Good oral hygiene (thorough tooth brushing and flossing and regular professional cleaning and examination) may be helpful to prevent these disorders. Drinking plenty of water and the production of enough saliva, aid in the reduction of bacterial growth. Minimize irritants or injury in the mouth when possible. Avoid excessive use of any food or substance that irritates the mouth or tongue.