Glossitis

Definition

Inflammation of the tongue is known as glossitis. The condition is characterized by a reddish, swollen and smooth tongue. The smoothness is generally attributed to loss of papillae (normal ‘bumps’) present over the surface of tongue. Generally glossitis is a symptom representing some other underlying disease and it is associated with many other disorders. Hunter’s glossitis, median rhomboid glossitis and benign migratory glossitis are few subtypes of glossitis.

Symptoms

One of the main symptoms of glossitis is a swollen tongue. The tongue becomes tender and pain on chewing or talking may be experienced. The tongue movements become difficult and restricted. In cases of glossitis associated with vitamin deficiencies, the loss of papillae is very common which gives the tongue a smooth, bald appearance. The color of the tongue changes from pale to dark, beefy red depending on the cause of glossitis.

In case of median rhomboid glossitis an rhomboid shaped reddish patch develops at midline of the tongue. This condition is fungal in origin and most commonly seen in diabetic patients.

Benign migratory glossitis, also known as geographic tongue, presents with map-like, irregular smooth reddish patches over the surface of the tongue. These patches have a tendency to disappear and reappear at a new spots and hence the condition is named as migratory glossitis.

A burning sensation on consumption of spicy food is also very common in glossitis. In long standing cases of glossitis, the taste sensation may be affected due to loss of papillae, as the papillae contains the taste buds.

Causes

Glossitis has multiple causes and it is associated with number of conditions.

  • Use of tobacco, spicy foods and alcohol predisposes an individual to develop glossitis.
  • The most common cause of glossitis is related to deficiencies such as iron, folic acid and vitamin B12.
  • Bacterial and viral infection including scarlet fever and herpes simplex can cause glossitis.
  • Contact allergies due to tooth-pastes, mouth rinses and foods can lead to inflammation of the tongue.
  • Mechanical trauma caused by dental restorations, dentures or burns can also cause glossitis.
  • Conditions leading to reduction in saliva production and dryness of mouth such as Sjogren’s syndrome increase the chances of developing glossitis.
  • Certain medications such as albuterol, ganglion blockers and ACE inhibitors can also lead to development of glossitis.
  • Other diseases associated with glossitis include syphilis, oral lichen planus, erythema multiforme and pemphigus.

Treatment

The treatment of glossitis includes reducing the inflammation and discomfort and correcting the underlying cause.

  • Vitamins and dietary supplements should be advocated in patient suspected of dietary deficiencies.
  • Use of tobacco, smoking and spicy foods should be ceased.
  • Oral hygiene maintenance including proper brushing, flossing and tongue cleaning is recommended.
  • In severe cases, non steroidal anti inflammatory drugs such as aspirin and ibuprofen can be administered to reduce pain.
  • Antifungal drugs are prescribed in cases with glossitis caused by fungi like yeasts.
  • Antibiotics are given in presence of a systemic infection.
  • Topical steroid applications are used to reduce inflammation and swelling. Prednisolone in the form of gel or mouth rinses is generally used in the treatment of glossitis.

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