Glossitis is the inflammation of the tongue. This typically presents as a painful tongue and changes in the tongue’s appearance, such as the texture and colour. There are different types of this condition, and can be caused by various factors. Glossitis can be acute (appearing suddenly) or chronic (persists for a long period of time). There are medications available for treatment.
Other common terms for glossitis are; tongue infection, burning tongue syndrome, smooth tongue, or tongue inflammation.
Types of glossitis
- Acute glossitis: This is glossitis that develops suddenly and is associated with severe symptoms, it could also be as a result of an allergic reaction
- Chronic glossitis: May be due to an underlying condition, resulting in chronic inflammation of the tongue
- Atrophic glossitis: This is caused by the loss of papillae which are the tiny bumps on the tongue surface. It causes a change in the tongue's color and appearance giving the tongue a glossy appearance. Atrophic glossitis is also referred to as Hunter glossitis1
- Median rhomboid glossitis: This is often caused by a fungal infection by the candida species
- Geographic glossitis: The tongue has a map-like appearance due to irregular patches on the tongue's surface. It is associated with soreness and burning pain in some cases. Geographic glossitis is also referred to as benign migratory glossitis
Causes of glossitis
- Vitamin B deficiencies3: which includes B1 B2 B3 B6 B9 B12 deficiency
- Infections: Viral ( e.g herpes virus), Bacterial (in immunocompromised patients)4, Fungal (Candida species)5, Malaria parasite6
- Medications: such as ACE inhibitors, lithium carbonate7, albuterol, some antibiotics,8 and oral contraceptive pills9
- Triggers such as alcohol, tobacco, and spicy foods
- Mechanical mouth injuries, such as burns, and dental trauma10
- Lack of hydration
- Burning mouth syndrome
- Down syndrome
- Autoimmune conditions
Signs and symptoms of glossitis
There are some common symptoms that indicate that you have glossitis. However, these symptoms vary depending on the cause. They include;
- Sore or pain in the tongue
- Swollen tongue
- Tongue redness
- Burning or itching sensation in the tongue
- Changes in the texture of the tongue surface
- Difficulty eating, swallowing, or speaking
Management and treatment for glossitis
Glossitis may not require treatment because most causes are self-limiting. Treatment depends on the underlying cause:
- Good oral hygiene and mouth rinses: ensuring good oral hygiene helps to provide symptomatic relief, it also helps to keep microorganisms that can cause infections away. Practice good oral hygiene by brushing your teeth with fluoride toothpaste two to three times daily and avoid using hard-bristled toothbrushes. Mouthwashes that contain corticosteroid and lidocaine are also helpful in acute exacerbations of glossitis
- Medications: depending on the cause, you may require medications to treat glossitis. Your physician can prescribe antibiotics, antifungals, or antivirals if your glossitis is due to infection. They may also prescribe other medications such as corticosteroids to help soothe glossitis symptoms such as soreness and redness
- Supplements: your physician can prescribe vitamin supplements if your glossitis is caused by nutritional deficiencies. Oftentimes vitamin B12 is prescribed as well as other essential vitamins and nutrients that help to correct your deficiency and resolve your symptoms
- Medication-induced glossitis would require you to discontinue the medication
- Dietary changes: certain foods such as spicy foods can trigger glossitis flare up in some individuals. There is a need to avoid these foods, it is also necessary to avoid triggers such as smoking if you are prone to glossitis flare-ups
Physical examination of your mouth is a crucial part of glossitis diagnosis, your physician or dentist will examine your mouth and tongue to check for abnormalities in color, texture, and appearance. Your physician may need some information about your health history, diet, and lifestyle to determine the cause of the tongue inflammation. You may also have samples of your saliva or blood taken for laboratory tests to rule out other medical problems.
How can I prevent glossitis?
You can lower your risk of getting glossitis by:
- Practicing good oral hygiene: brush your teeth at least twice a day with fluoride toothpaste and a soft-bristled toothbrush, floss regularly
- Maintaining a healthy diet: a healthy diet consisting of fruits and vegetables that contains necessary vitamins, minerals, and other nutrients is essential to reduce your risk of getting glossitis
- Avoiding triggers: avoid spicy or hot foods, alcoholic beverages, and cigarette or tobacco smoking, these can increase your risk of getting glossitis if you are prone to it
How common is glossitis?
A lack of available information makes it difficult to determine how common glossitis is. This is further complicated as there are so many different types of glossitis, each with a different prevalence rate.
Who is at risk of glossitis?
Some factors can increase the risk of getting glossitis. People at risk are those who:
- Have mechanical mouth injuries such as burns and other dental trauma
- Have Anemia
- Wear braces or dentures that can irritate the tongue
- Have certain infections such as herpes
- Have a suppressed immune system or diseases that affect the immune system
- Consume hot or spicy foods11
- Have food allergies
Is glossitis contagious?
No, Glossitis itself isn’t contagious. However, glossitis sometimes is caused by an underlying infection. This Infection can be contagious, for example, herpes, which can be transmitted from one person to another through saliva, amongst other routes.
When should I see a doctor
You should reach out to your doctor if you experience::
- Glossitis which persists and does not go away after some time
- Severe symptoms such as extreme tongue swelling that block your airways, could be an indication of a serious underlying condition that needs emergency medical attention
Some types of glossitis resolve on their own over time while others that require treatment resolve with full recovery when treated correctly. However, when symptoms persist despite treatment or when you experience severe symptoms that greatly affect your quality of life, you should seek proper medical attention.
- Robinson AN, Loh JSP. Atrophic glossitis. N Engl J Med. 2019 Oct 17;381(16):1568. Available from: https://pubmed.ncbi.nlm.nih.gov/31618542
- Kobayashi A, Iwasaki H. Pernicious anemia presenting as glossitis. CMAJ [Internet]. 2020 Apr 20 [cited 2023 Jun 17];192(16):E434. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207183/
- Stoopler ET, Kuperstein AS. Glossitis secondary to vitamin B12 deficiency anemia. CMAJ [Internet]. 2013 Sep 3 [cited 2023 Jun 17];185(12):E582. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761039/
- Adler I, Denninghoff VC, Alvarez MI, Avagnina A, Yoshida R, Elsner B. Helicobacter pylori associated with glossitis and halitosis. Helicobacter. 2005 Aug;10(4):312–7. Available from:https://pubmed.ncbi.nlm.nih.gov/16104947
- Patil S, Rao RS, Majumdar B, Anil S. Clinical appearance of oral candida infection and therapeutic strategies. Front Microbiol [Internet]. 2015 Dec 17 [cited 2023 Jun 17];6:1391. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681845/
- Shuai Y, Liu B, Zhou G, Rong L, Niu C, Jin L. Oral manifestations related to malaria: A systematic review. Oral Dis. 2021 Oct;27(7):1616–20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PM
- Picciani BLS, Domingos TA, Teixeira-Souza T, Santos V de CBD, Gonzaga HF de S, Cardoso-Oliveira J, et al. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review. An Bras Dermatol. 2016;91(4):410–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999097/
- Brown A. Glossitis following the administration of sulphanilamide and sulphathiazole: report of two cases. Glasgow Med J [Internet]. 1949 Apr [cited 2023 Jun 17];30(4):140–3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971956/
- Picciani BLS, Domingos TA, Teixeira-Souza T, Santos V de CBD, Gonzaga HF de S, Cardoso-Oliveira J, et al. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review. A Bras Dermatol. 2016;91(4):410–21. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999097/
- Sharabi AF, Winters R. Glossitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK560627/
- Shareef S, Ettefagh L. Geographic tongue. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK554466/