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 (papillae) may be lost, causing the tongue to appear smooth.

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

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Symptoms

• 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.

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
• 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.

A painful tongue may be an indication of several underlying serious medical conditions and nearly always merits assessment by a doctor or dentist ^[1]

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 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.

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