Desquamative glossitis (geographic tongue)

The tongue is quite often injured. Sometimes these damages are so minimal that we pay due attention to them; however, minor defects in the mucosa are entry points for infection. Glossitis is an inflammation of the tongue caused by various bacteria and viruses. The disease is accompanied by a number of unpleasant symptoms that interfere with normal food intake, and sometimes even interfere with talking. If measures are not taken in time, diffuse purulent inflammation may occur, spreading far beyond the oral cavity. Most often, glossitis occurs in people with reduced immunity, smokers and people who are negligent about oral hygiene.

Symptoms of glossitis

The first thing those suffering from glossitis encounter is pain, burning, and severe discomfort in the oral cavity. Over time, the intensity of these manifestations increases, making it difficult to eat food. Taste sensations are dulled and may be completely absent. Some patients develop a perverted taste. The tongue begins to swell, which causes severe discomfort. The patient's speech is impaired, any movements of the tongue bring pain. Hyperthermia and deterioration in general health are possible. Upon examination, you can reveal an enlargement of the tongue, a change in its color to a brighter one, up to crimson. Ulcers, blisters, spots, erosions, plaque, and lesions with altered epithelial structure may appear on the mucous membrane.

The most dangerous complication of glossitis is phlegmon. A focus of purulent inflammation is formed, which rapidly spreads to the chin and neck and destruction of soft tissues. Such patients require emergency medical care.

Other symptoms and signs

Often desquamative glossitis of the tongue is accompanied by additional symptoms:

• a burning sensation, discomfort in the tongue area;
• tingling;
• irritation while eating;
• problems related to taste.

This disease can significantly reduce the quality of life because it constantly reminds itself, especially during meals.

You may also hear the name of the disease as “geographic tongue.” This is due to the fact that the appearance of the surface gives the impression that in front of you is a geographical map - such a bizarre pattern is made up of various uneven foci.

Types of glossitis

Taking into account the main symptoms, glossitis is divided into the following types:

• Geographical. This type of pathology is more common in females and begins with the appearance of a light spot on the tongue with a diameter of several millimeters. Gradually, the affected area can gradually increase. Over time, the shade of the spot changes to pink and begins to stand out strongly against the background of surrounding tissues. If medical care is not provided in a timely manner, the affected area can expand to cover the entire volume of the tongue and cause a lot of problems for the patient.
• Candida. The most dangerous type of glossitis. It is caused by fungi of the genus Candida. They are always present on a person’s tongue, but do not manifest themselves; however, with the slightest weakening of the immune system, candidal inflammation of the tongue appears. Symptoms of the disease include swelling of the organ and the appearance of a brown coating on its surface. The patient suffers from a burning sensation, impaired diction, excessive salivation, and an unpleasant odor from the mouth.
• Folded glossitis. This is a congenital pathology of the tongue, leading to the formation of deep folds on its surface, which have a transverse direction. It is noteworthy that folded glossitis does not cause discomfort to a person.
• Diamond-shaped. This type of disease is characterized by the appearance of a diamond-shaped area of ​​inflamed mucous membrane on the upper surface of the tongue, closer to the root. Doctors consider this pathology as chronic. There are no complaints from patients. Diamond-shaped glossitis can be smooth or lumpy. Most often, this disease is detected in adults.
• Gunter's glossitis. The main cause is hypovitaminosis. The main symptoms of the pathology are: atrophy of the papillae of the tongue and significant redness.
• Catarrhal. The initial stage of the inflammatory process. Most often it develops due to insufficient oral care. It can also appear if the patient has fillings or dentures made of low-quality materials in the mouth. Sometimes this type of tongue pathology appears during teething in children. The disease is always accompanied by characteristic discomfort and slight swelling of the organ.
• Atrophic glossitis. The cause is an infection that causes the death of the muscle of the organ and the papillae of the tongue. As a result, it becomes thinner. It is very difficult for patients with such glossitis to eat normally.

• Villous. Pathological increase in the size of the organ papillae. They become like villi. Villous glossitis most often appears as a result of injury to the tongue or due to bad habits.
• Ulcerative. The appearance of numerous ulcers and areas of tissue erosion on the surface of the organ. Patients complain of pain and bleeding. Often the surface of the tongue becomes yellow. There is always a putrid smell coming from the mouth. Since the tongue swells, patients have problems with diction.
• Mycotic . Caused by a fungal infection. As a rule, it develops as a complication of tonsillitis or pharyngitis. The main symptoms of the pathology are swelling of the tongue and pain. Also, characteristic spots may appear on its surface.
• Herpetic glossitis . A type of pathology provoked by the herpes virus. The main symptom of the disease is the appearance on the surface of the tongue of a large number of small bubbles containing sulfur. With herpetic glossitis, the patient complains of pain in the mouth when eating. This pathology is very contagious.
• Hypertrophic. This type of glossitis occurs when there is a lack of vitamins in the body such as: B 2, B 6 and PP. The main feature of this pathology is the appearance of gray and yellow plaque on the sides of the tongue, on which the teeth are clearly imprinted. The organ itself swells significantly.
• Allergic glossitis. This type of disease occurs due to allergic reactions. The pathology is manifested by a burning sensation, swelling of the organ and redness of the mucous membranes.
• Interstitial glossitis. This organ damage occurs with syphilis. The tongue becomes very dense, making it difficult for them to move. As a result, it is very difficult for a person to express himself. If you do not resort to treatment, the tongue may remain in this position forever.
• Viral. This pathology is characterized by the appearance of ulcers and areas of erosion on the surface of the organ. The latter look like gray or brown spots. Effective treatment of this type of pathology is possible only with the use of antiviral drugs.

It is very difficult to independently diagnose one or another glossitis, since their symptoms are largely similar. This is especially true for the initial symptoms. Therefore, when the first signs of the disease appear, you should consult a dentist.

Diagnosis and treatment methods for glossitis

In most cases, the basis for diagnosis is the patient’s complaints and visual examination of the oral cavity.

When visiting a doctor, be sure to indicate when the pathological manifestations appeared and what they are associated with. If any dental treatment was performed, be sure to mention it. It is better to seek medical help at the first signs of illness. Avoid taking any medications, especially antibiotics. This may make diagnosis difficult and reduce the effectiveness of subsequent therapy.

To determine the cause of glossitis, additional diagnostic methods are used: examination of scrapings from the mucous membrane under a microscope, ELISA, PCR. These methods make it possible to determine what pathogen caused the disease, as well as to confirm or exclude syphilitic glossitis.

Determining the causative agent of the disease is the basis for successful treatment. The emphasis is on etiotropic therapy, that is, eliminating the cause of the disease. If glossitis is bacterial in nature, properly selected antibiotics will give an excellent result, but these drugs are completely useless for viral or candidal glossitis. For fungal infections, antimycotic drugs are prescribed; for viral infections, antiviral and immunomodulators are prescribed. If the cause of glossitis is anemia, treatment of the underlying disease is necessary. Special tactics are necessary for the pathological process caused by Treponema pallidum. A dermatovenerologist must be involved in the treatment of syphilitic glossitis.

An integral part of glossitis treatment is diet. In the acute period, eating food causes serious difficulties for patients, so porridges, purees, and pureed soups are recommended. Food should not be cold or hot. Solid foods, spicy, salty, sour are excluded. This avoids irritation of the mucous membrane, which minimizes discomfort and speeds up the healing process.

In some patients, the pain syndrome is significant. In such a situation, unpleasant sensations can be relieved with the help of applications with anesthetics. To moisturize excessively dry mucous membranes, products containing glycerin are used.

Local therapy includes removing plaque from the tongue and treating with antiseptic solutions. Substances such as chlorhexidine, furacilin, and potassium permanganate are widely used. To speed up the recovery of the mucous membrane, vitamin A is used topically.

Systemic antibiotics and antiviral drugs are prescribed according to indications. This tactic is used in severe cases. With a mild clinical course of glossitis, a positive result can be achieved with local treatment.

In severe cases, swelling of the tongue can be significant and make breathing difficult. In such situations, it is necessary to take glucocorticosteroids. More often they are used in the form of ointments.

During treatment you need to give up smoking and alcohol. These substances irritate the mucous membrane and prevent its regeneration.

Some patients with glossitis have keratinized areas on the tongue. Such changes cannot be treated conservatively and can only be removed surgically.

If you consult a dentist in a timely manner and follow all his recommendations, the outcome of the disease will be favorable. Glossitis responds well to treatment if its cause is determined and targeted. If the disease is not treated, it can be complicated by an abscess or phlegmon. These conditions require surgical treatment and long-term antibiotic therapy, so it is better to start treatment at the initial stage.

Causes of glossitis

All forms of glossitis have common properties. Any glossitis can occur due to a viral or bacterial infection. Glossitis often occurs due to mechanical trauma to the tongue, chemical and thermal damage. Glossitis may also indicate the presence of a concomitant disease or allergy in the patient’s body. Glossitis can also develop against the background of another oral disease.

The following are the most common causes of glossitis:

• damage to the tongue from sharp pieces of food or dentures;
• negative effects of hot water and food, thermal burns;
• insufficient oral care;
• smoking, alcohol abuse, poisoning with heavy metal salts;
• allergic reaction to toothpaste, mouthwash elements, orthopedic materials;
• the presence of herpes viruses, staphylococci, and yeast-like fungi in the body.

Glossitis can be a symptom of a general disease in the body. The most common cases of glossitis as a symptom of a concomitant disease are observed in the following diseases:

• infectious diseases (scarlet fever, measles and others);
• diseases of the gastrointestinal tract;
• blood diseases;
• hypervitaminosis;
• diseases of the oral cavity (especially stomatitis).

Also, different forms of glossitis can manifest themselves differently in different conditions of the body.

Diagnostics

Diagnosis of desquamative glossitis of the tongue is not easy, because sometimes it is necessary to exclude many diseases. For this purpose, different methods are used in laboratory studies:

• microbiological;
• biochemical;
• morphological;
• immunological;
• serological.

Patients undergo blood, stool, and saliva tests, and, if necessary, receive consultations from additional specialists. This is a dermatologist, allergist, endocrinologist, gastroenterologist, and often also a psychotherapist.

How is tongue inflammation treated?

The nature of treatment largely depends on the form and type of pathology. Therefore, diagnosing the disease is important when prescribing effective treatment.

In some cases, it is useless to treat glossitis itself until the root cause of the pathology is eliminated - one of the diseases of the internal organs.

Treatment of glossitis has the following general principles:

• A doctor prescribes a procedure to improve the health of the entire oral cavity.
• Using various antiseptics to rinse the mouth, for example, Miramistin, Chlorhexidine, Furacilin. If the disease manifests itself in a child, then the drug Nystatin can be used for treatment.
• When erosive areas and ulcers appear on the surface of the tongue due to glossitis, the patient is prescribed ointments with a healing effect: Kamistad, Malavit, Vinizol.
• After removing the main symptoms of the pathology, treatment of glossitis is usually completed by treating problem areas with various oils of plant origin.
• The last stage is to carry out activities aimed at increasing general and local immunity.

The methods of treatment of tongue diseases listed above are advisory in nature for all. However, they will be quite effective in most cases.

Please note that folded glossitis does not require treatment.

How to treat

The treatment methods used will directly depend on the reasons that provoked the development of glossitis, so high-quality diagnosis comes to the fore.

It is impossible to say for sure which doctor treats glossitis, since it will depend, again, on the reasons that caused the disease: you should start by visiting a dentist, who, in turn, may need to consult a therapist and even a surgeon.

If glossitis is a consequence of diseases (syphilis, gastrointestinal problems, anemia), then it is necessary to eliminate these diseases.

To reduce pain, the doctor may recommend applying local lotions with Lidocaine, Pyromecaine and other anesthetics. This procedure can actually be carried out at home. In order to speed up recovery, the tongue is regularly cleaned of plaque with a cotton swab soaked in Chymotrypsin. If there are ulcers, lotions with Iruksol are prescribed. Traditional medicine methods are also allowed, for example, rinsing with a decoction of chamomile or soda, lubricating the affected areas with propolis and much more.

There are quite a few treatment options: the doctor will be able to choose the most effective one, so at the first signs of illness you should not delay visiting him.

Preventive techniques for glossitis

Most often, the disease is much easier to prevent than to treat.

For this reason, dentists advise following the following preventive techniques:

• following the rules of dental and oral hygiene;
• systematic preventive examination in the dental office;
• reducing the use of hot spices that irritate the mucous membrane of the tongue;
• giving up cigarettes and alcoholic beverages.

Timely and high-quality treatment can easily eliminate glossitis, while the complete absence of therapy leads to irreversible and sad consequences.

Hairy black tongue (villous glossitis)

This form of glossitis is characterized by the growth and keratinization of filiform papillae (they become hair-like). The mechanism of development of this disease is not fully understood. According to one version, the development of villous glossitis is facilitated by the influence of local irritating factors, as well as candidiasis that develops while taking antibiotics.

Treatment of this form of glossitis includes mechanical (tweezers) removal of filiform papillae and subsequent treatment of the surface of the tongue with a solution of copper sulfate. For candidiasis, antifungal agents are prescribed.