Types of glossitis
Dentists distinguish between several options, and each looks different. Catarrhal glossitis is simply redness and swelling without deep changes, usually after injury or infection. An atrophic, or “smooth” tongue loses its papillae and becomes shiny - this is typical of deficiency conditions. Desquamative, also known as geographic tongue, produces shape-changing pink spots with a white rim. The folded tongue is a congenital feature with deep grooves. Rhomboid glossitis is associated with a fungal infection and appears as a smooth diamond along the midline of the dorsum of the tongue.
- Catarrhal - redness and swelling
- Atrophic (“varnished”) - smooth shiny surface
- Desquamative (geographic) - migrating spots
- Folded - deep grooves, often congenital
- Diamond-shaped - smooth area along the midline
- Hairy tongue - elongated papillae with a dark coating
Causes and risk factors
Most often, inflammation is supported by mechanical trauma: a sharp edge of a decayed tooth, an overhanging filling, a poorly fitting denture, the habit of biting the tongue. The second large group of reasons are deficiencies: iron, vitamin B12, folic acid, B vitamins and zinc. The third is infections, primarily candidiasis, which is activated after antibiotics, inhaled hormones and diabetes. Smoking, strong alcohol, very spicy foods, mouthwashes with a high alcohol content and toothpastes with sodium lauryl sulfate also irritate the tongue.
- Injury to a tooth, filling or denture
- Deficiency of iron, B12, folic acid, zinc
- Oral candidiasis
- Diabetes mellitus and dry mouth
- Smoking, alcohol, spicy food
- Allergies and reactions to components of pastes and rinses
- Diseases of the stomach and intestines with malabsorption
- Lichen planus, autoimmune diseases
Symptoms
Complaints depend on the type of glossitis. When the tongue becomes inflamed, it turns red, swells, and there is a burning sensation and pain when eating, especially from spicy, sour and hot foods. The perception of taste changes, sometimes a metallic taste appears. In the atrophic form, the tongue looks smooth and shiny, as if polished. With candidiasis, there is a white coating that is difficult to remove and leaves a reddened surface. Geographic tongue is usually painless, but sometimes causes sensitivity to sour things. Large swelling of the tongue interferes with speaking and chewing.
- Redness and swelling of the tongue
- Burning and pain when eating
- Change or loss of taste
- Smooth shiny surface without papillae
- White plaque or spots
- Cracks, grooves, jams in the corners of the mouth
What examinations are needed
They start with an examination: the doctor looks for traumatic sharp edges, evaluates the prostheses, the condition of the mucous membrane and plaque. Next, they check the most common causes: a general blood test will reveal anemia, ferritin will show iron reserves, tests for vitamin B12 and folic acid - vitamin deficiency, glucose and glycated hemoglobin - diabetes. If there is a white coating, take a smear on the mushrooms. If tests indicate malabsorption or there are complaints from the stomach, you need to consult a gastroenterologist. A non-healing ulcer must be shown to an oncologist.
- Dental examination with evaluation of teeth and dentures
- Complete blood count and ESR
- Serum ferritin and iron
- Vitamin B12 and folic acid
- Blood glucose and HbA1c
- Mucosal smear for mushrooms
- Biopsy for a non-healing lesion
Treatment and care
They treat not the tongue, but the cause. They smooth out sharp edges of teeth, reline or change dentures, and treat caries. If a deficiency is detected, the doctor prescribes iron, vitamin B12 or folic acid supplements - you should not take them yourself, because the dose and duration are selected based on tests. Candidiasis is treated with antifungal agents as prescribed by a doctor. During an exacerbation, a gentle diet and gentle hygiene are useful. Geographic and folded tongue do not require treatment, only good hygiene and observation are needed.
- Elimination of the traumatic factor and correction of the prosthesis
- Completion of deficiencies based on test results
- Antifungal therapy for candidiasis
- Refusal of spicy, sour, hot foods during an exacerbation
- Quitting smoking and alcohol mouthwashes
- Soft brush, cleaning the back of the tongue with a scraper
- Treatment of diabetes and digestive diseases
- Control examination to assess dynamics