Glossitis

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

Causes and Development

• 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 multiforme, aphthous ulcer, pemphigus vulgaris, syphilis, and others
• Occasionally, glossitis can be inherited

Signs and Symptoms

Symptoms may include:

• Tongue swelling
• Smooth appearance to the tongue

• Tongue color changes (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.

Treatment and Prevention

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.

With the aim being to reduce inflammation, treatment usually does not require hospitalization unless tongue swelling is severe.  Good oral hygiene is necessary; 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 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.

Good oral hygiene (thorough tooth brushing and flossing and regular professional cleaning and examination) may be helpful to prevent this disorder.  Minimize irritants or injury in the mouth when possible.  Avoid excessive use of any food or substance that irritates the mouth or tongue.

Complications; Seek medical attention if...

In some cases, glossitis may result in severe tongue swelling that blocks the airway, a medical emergency that needs immediate attention.

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.