Causes

Glossitis is often a symptom of other conditions or problems, including:

• Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in candy, plastic in dentures or retainers, or certain blood pressure medications (ACE inhibitors)
• Dry mouth, when the glands that produce saliva are destroyed (see: Sjogren syndrome)
• Infections with bacteria or viruses (including oral herpes simplex)
• Injury from burns, rough edges of teeth or dental appliances, or other trauma
• Low iron levels (called iron deficiency) or certain B vitamins, such as vitamin B12
• Skin conditions such as oral lichen planus, erythema multiform, aphthous ulcers, pemphigus vulgaris, syphilis, and others
• Tobacco, alcohol, hot foods, spices, or other irritants
• Yeast infection in the mouth

At times, glossitis may be passed down in families and is not due to another disease or event.

Symptoms

Symptoms of glossitis may appear quickly or slowly over time. They include:

• Difficulty with chewing, swallowing, or speaking
• Smooth surface of the tongue
• Sore and tender tongue
• Tongue color changes
  • Pale, if caused by pernicious anemia
  • Fiery red, if caused by a lack of other B vitamins
• Tongue swelling

Exams and Tests

An examination by a dentist or health care provider shows:

• Finger-like bumps on the surface of the tongue (called papillae) may be missing
• Swollen tongue (or patches of swelling)

Your health care provider may ask detailed questions about your medical history and lifestyle to find the cause of tongue inflammation if there was no obvious injury or other cause.

Blood tests may be done to rule out other medical conditions.

Treatment

The goal of treatment is to reduce inflammation. Most people do not need to go to the hospital for treatment unless tongue swelling is severe.

• Good oral hygiene is important. Brush your teeth thoroughly at least twice a day and floss at least once a day.
• Antibiotics, antifungal medications, or other antimicrobials may be prescribed if the glossitis is due to an infection.
• Dietary changes and supplements are used to treat anemia and nutritional deficiencies.
• Avoid irritants (such as hot or spicy foods, alcohol, and tobacco) to reduce any tongue discomfort.

Outlook (Prognosis)

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. In some cases, glossitis may result in severe tongue swelling that blocks the airway.

Possible Complications

• Airway blockage
• Difficulties with speaking, chewing, or swallowing
• Discomfort

When to Contact a Medical Professional

Call your health care provider if:

• Symptoms of glossitis last longer than 10 days
• Tongue swelling is severe
• Breathing, speaking, chewing, or swallowing is difficult

Blockage of the airway is an emergency situation that needs immediate medical attention.

Prevention

Good oral hygiene (thorough tooth brushing and flossing and regular professional cleaning and examination) may help prevent glossitis.

Alternative Names

Tongue inflammation; Tongue infection; Smooth tongue; Glossodynia; Burning tongue syndrome

References

Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. 2010;81(5):627-634.

Mirowski GW, Mark LA. Oral disease and oral-cutaneous manifestations of gastrointestinal and liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 22.

Update Date: 3/5/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.