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Glossitis: Symptoms and Treatment


Glossitis is a pathological inflammation of the tissues of the tongue, which is often a symptom of common diseases of the body, but in rare cases acts as an independent disease.

The mucous membranes of the tongue, as well as the entire oral cavity, may be affected by any infectious and inflammatory diseases occurring in the human body.

Glossite classification

The language reacts to catarrhal inflammation with an acute or chronic course to various pathological conditions of the body. The inflammatory process is localized in the thickness of the tissues of the tongue as an abscess or phlegmon.

There are several classifications of glossites, but the most comprehensive and up-to-date classification is considered by E. V. Borovsky and N. F. Danilevsky:

  1. Desquamative glossite or geographic language;
  2. Diamond-shaped glossitis;
  3. Black hairy tongue (hyperplasia of the chronic papillae of the chronic form);
  4. Folded or scrotal tongue.

Desquamative Glossite

desquamative glossite photo Inflammatory-dystrophic lesion of the mucous membranes of the tongue is called "desquamative glossitis." The disease was described by several scientists under different names:

  • "Exfoliative glossitis",
  • "Geographical language",
  • "Glossitis of benign, migratory"

The causes of desquamative glossitis are not yet fully understood, but many doctors consider the disease to be a symptomatic manifestation of pathological processes occurring in the body, and in the very first instance - the gastrointestinal tract.

The desquamative process occurs on the mucous membrane of the tongue and in diseases of the blood-forming organs and the endocrine system, as well as in violation of the balance of vitamins.

Autointoxication plays a significant role in the pathogenesis of the disease; therefore, some experts are inclined to its allergic origin.

Desquamative glossitis is most common in young girls.

Symptoms of desquamating glossitis

Glossite photo The clinical picture is not particularly rich in subjective symptoms. Patients may not have complaints about the general condition of the body, but some note light tingling on the tip and lateral surfaces of the tongue when they eat spicy or hot foods.

The pathological process begins as a small whitish-gray area on the tongue, which signals the rejection of the upper epithelial layers. After some time, the epithelium is completely rejected and the red underlying tissue is exposed. The site that was subjected to desquamation is surrounded by gray filiform papillae as a rim. These nipples are gray in color, as they are covered with a layer of not yet torn epithelium. In the center of the lesion, the filiform papillae are atrophied, but the fungi are still preserved.

Gradually, detachment continues along the edges of the desquamation focus, and a new epithelial layer forms in the center. Thus, the process captures large areas of the language and creates a pattern that is similar to a map. That is why desquamating glossite is sometimes called "geographical language".

There are several clinical forms of desquamating glossitis:

  1. The surface is characterized by the appearance of red spots and stripes with clear boundaries. Spots surround mucous membranes of normal color. When the epithelial layer is exfoliated, the tongue becomes shiny and smooth, with burning and itching of the tongue.
  2. The hyperplastic form is the foci of compaction of the filiform papillae with the formation of foci of gray, yellow and white color on the tongue.
  3. For lichenoid form, the appearance of desquamation sites of various shapes and sizes, on which enlarged mushroom papillae are noticeable, is characteristic. In this case, the patient feels a burning sensation of the tongue.

This form of desquamating glossitis occurs when the mucous membrane of the tongue is hypersensitive to metals used in orthopedics and in the presence of endocrine disorders.

Based on clinical and morphological studies, the fixed and migratory forms of this type of glossitis are distinguished:

  1. Often there is a migrating surface form, in which there are no pronounced pain symptoms, and pathological foci form quickly and have a short period of epithelialization.
  2. For the fixed form, the appearance of superficial erosive-ulcerative lesions is characteristic.

Desquamative glossitis occurs as a chronic process with short and spontaneous remissions, but changes in the mucous membrane of the tongue are reversible.

Differential diagnosis is carried out with:

  • Secondary syphilis in the recurrence stage, in which deep ulcers or erosion are formed in the center of the lesion, which is not observed during glossitis. In controversial cases, the Wasserman reaction and the pale treponemes in the patient's analyzes become decisive.
  • Red flat lichen, which is characterized by a rash in the form of pearly bubbles, folding in a pattern on the surface of the unchanged oral mucosa. When deprived, the patient feels tightness and dryness in the affected areas, and such symptoms do not occur with desquamative glossitis.
  • Flat leukoplakia, characterized by foci of hyperkeratosis on the background of a healthy mucosa. Whitish plaque with leukoplakia is not removed, and with glossitis it goes off by itself, exposing the deeper layers of tissue. In addition, when leukoplakia disturbed taste perception and there is a burning sensation in places of defeat.
  • Language changes in diseases of the gastrointestinal tract (gastrointestinal tract):

- with colitis and enterocolitis, various glossitis, stomatitis, and jammed occur in the oral cavity.

- in chronic gastritis, desquamating glossitis with atrophied and smoothed papillae of the tongue can be observed.

- in case of stomach ulcers, migratory (constantly changing localization) desquamating glossitis may develop.

- in diseases of the gallbladder, liver, various types of hepatitis, liver cirrhosis, desquamation of the epithelial layer of the tongue occurs.

- with changes in the oral cavity due to the disease of the cardiovascular system (cardiovascular system) the surface of the tongue becomes shiny and smooth, there is a burning sensation, there are stickings in the corners of the mouth.

- at pathological phenomena in the language in people who have undergone ionizing radiation, desquamative and atrophic glossitis develops in 70% of patients.

Treatment of desquamating glossitis

Treatment should consist of general and local manipulations.

General treatment consists of the following steps:

  1. Normalization of the functions of the digestive tract and treatment of common diseases of the body.
  2. Full reorganization of teeth and oral cavity and professional teeth cleaning.
  3. Psychotherapeutic help for cancer phobia (fear of cancer).
  4. The use of sedatives (motherwort, valerian).
  5. Antiallergic therapy with drugs with a desensitizing effect (suprastin, tavegil).
  6. Acceptance of calcium pantothenate within a month.
  7. Reception of complex vitamins and microelements.
  8. Reception of a solution of dalargin within ten days.
  9. Acceptance of vascular drugs (trental, tanakan, stugeron).

Local treatment:

  1. The appointment of painkillers in the presence of pain (pyromecain, anesthesin).
  2. Oral baths and irrigation with the appearance of burning sensation in the mouth.
  3. Applications with oil solutions of vitamin A, rosehip, keratoline.
  4. Novocainic blockade in the projection of the lingual nerve.
  5. Reception of the concentrated fish oil.
  6. Physical therapy sessions with analgin.

Black hairy tongue

Black hairy tongue photo This disease manifests itself as growth and keratinization of the filiform papillae in the middle and posterior third of the tongue.

Etiology , unfortunately, is still not clear, but there are predisposing factors:

  • Diseases of the digestive tract;
  • Hypovitaminosis and avitaminosis (vitamin deficiency);
  • Infectious diseases;
  • Disruption of metabolic processes in the tissues of the tongue;
  • Physico-chemical factors (smoking, alcohol, changes in the acidity of saliva and certain types of drugs).

Chronic hyperplasia of the filiform papillae develops more often in middle-aged and elderly men. At the same time, patients may have no subjective sensations in the oral cavity, although some pay attention to the change in the appearance of the tongue. Sometimes there is a feeling of having a foreign body on the tongue, an emetic reflex and itching.


The clinical picture of chronic hyperplasia of the filiform papillae is characterized by lengthening and thickening of the papillae and changing their color to brown or black. The lesion has an oval shape and is located in the center of the tongue. Some scientists believe that the darkening occurs due to cumulation (accumulation) in the tissues of food dyes.

The filiform papillae at the tops are darker and thinner, and at the base they become lighter and thinner. On visual inspection, it seems that the tongue is covered with hair.

Differential diagnosis of hairy tongue is carried out with:

  • Conditions arising from the use of certain drugs (rinsing with a solution of manganese and chloramine, taking corticosteroids, antibiotics).
  • Coloring the language of food dyes.
  • The changes accompanying a pigmentary and papillary dystrophy.
  • Changes in the mucous membrane of the tongue in the presence of Addison's disease (skin pigmentation, stripes of blue, purple and black color on the mucous membrane and organs of the oral cavity and on the lips).
  • Changes accompanying thyroid disease (enlargement, folding of the tongue with papillae hyperplasia).
  • Increased tongue and papilla hypertrophy in acromegaly.
  • Hyperplasia of fungoid and filiform papillae with myocardial infarction.
  • Changes in diseases of the gastrointestinal tract.



  1. Elimination of somatic diseases.
  2. Sanitation and professional oral hygiene.
  3. Medication for stress and psychotherapy.
  4. Reception of multivitamins in combination with trace elements.
  5. Calcium pantothenate intake.
  6. Reception of antiallergic drugs.
  7. Antifungal therapy in the presence of candidiasis.


  1. The use of keratolytics (solutions of resorcinol and salicylic acid).
  2. Blockade with novocaine and trental.
  3. Cryodestruction to stimulate rejection of hyperplastic papillae.
  4. To give up smoking.
  5. Applications with keratoplasty (oil solutions with vitamins A and E, wild rose and sea buckthorn).
  6. Cleansing the tongue at least twice a day.

Diamond Glossite

Diamond-shaped glossite photo The chronic inflammatory process, in which the nipples of the tongue atrophy, is called rhomboid glossitis.

Etiological factors are:

  • Smoking;
  • Diseases of the digestive tract;
  • Lack of vitamin C;
  • The presence in the lesion of fungal infection - candidiasis.

Symptoms of rhomboid glossitis

A center in the form of a rhombus or oval with a width of not more than 2 cm and a length of not more than 5 cm is formed in the center of the tongue.

The following forms of rhombic glossitis are distinguished:

  1. The smooth shape is characterized by the defeat of small sizes of red or pink color with clear areas. Papillae are absent, palpation is felt compaction and pain appear. Patients complain about the feeling of a foreign body on the tongue, tingling and burning, which are aggravated during the meal, but in some cases there are no subjective sensations.
  2. In case of bumpy glossitis, the lesion area consists of mounds of various sizes, separated by folds. Folds and bumps lack papillae. The color of the pathological focus is red, often with a bluish tinge. The epithelium hardens, but the site of the lesion does not change its size and shape.
  3. Hyperplastic forms are characterized by growths of papillary formations on a tongue with broad bases and flat tops.

Rhomboid glossitis in rare cases can malignant, but most often is a benign formation.

Differential diagnosis of rhombic glossitis is performed with:

  • Candidiasis;
  • Glossite of another form;
  • Malignant neoplasms;
  • Inflammatory processes ( syphilis , tuberculosis ).

Treatment of rhomboid glossitis

Treatment of rhomboid glossitis should be complex, but divided into general and local.


  1. Professional hygiene and sanitation of the mouth and teeth;
  2. To give up smoking;
  3. Antifungal treatment for the detection of Candida fungi in the lesion.
  4. Psychological assistance for cancer phobia (fear of cancer).
  5. Calcium pantothenate intake.


  1. The flat form of rhomboid glossitis is not amenable to treatment.
  2. In case of bumpy and hyperplastic forms, cryodestruction is performed after surgical excision of the lesion and histological examination of altered tissues.

Folded tongue

Folded or scrotal tongue is considered a consequence of developmental disability, and occurs in childhood.

Folded appearance of the tongue appears due to the increase in its surface. In the middle of the tongue, along its entire length, there is a longitudinal main fold, with transverse folds extending from it.

Bacteria and fungal infections accumulate in the folds, leading to candidal glossitis and catarrhal inflammation.

The tongue is soft, the nipples are not changed. Folded tongue often appears in combination with the desquamating form of glossitis.


Special treatment in the presence of a folded tongue is not required, but in order to prevent, regular rehabilitation of the teeth and oral cavity is carried out.

| March 22, 2014 | | 10 917 | Dentistry
Leave your feedback

B M: My dermatologist diagnosed me through blood work as a strep carrier. After treating me with strep meds, d3, and vit a, my geographic tongue went away.

Macy Truitt: I've had geographic tounge most my life (since I was 3) and i have found some things that sooth my tounge when it itches, sometimes however my tounge will start to burn and nothing really helps (the stuff in Google that is supposed to help tends to not help me so idk if this will help anyone else but I hope it does help) -club soda (anything carbonated but I suggest club soda esspecially if you need something before bed, this won't rot your teeth as much as others) -horseraddish mixed with sour cream (enough to just nearly make it more creamy than creamy horseradish) -pretty much anything cold (I usually use ice or ice cream) -mochi -chocolate (Cotes your tounge) -dipping tounge in ibeprofen (just a small amount) -dry mouth pills My geographic tounge isn't as bad as others, so again bit sure if this will help but I hope it will. sorry this comment was so long.

Good Bye: I just scratch it with my top row of teeth when it stings. It’s honestly not bad at all. Just never stuck my tongue out when I was a kid because I was embarrassed it did not look like everyone else’s! Lol. Better a weird tongue than non at all.

Barbara martinez: I never knew this wasn’t a common thing. I thought everyones tongue was the same. Until a dentist one day asked what was wrong with my tongue in a shocking way. I’m not planning on finding a cure for it because I’ve always lived with it. But I do know to stay away from certain things. I can’t eat very sour candy like sour skittles because when I lick the sour stuff it hurts. Licking the hot stuff of the Takies also makes it hurt. Basically anything you lick off and it’s sour or spicy will make it hurt.

Neither Here Nor There: I've had this since I was a kid it changes through about a 6month period spots heal then others do it, it's weird but I'm use to it, it only hurts it if I brush it too much.

motivational shivhare jee: please sir help me because i have a many wounds on my tongue i am very much feeling sad and im always depressed to my tongue so please would you like to do help with me and i dont understand what is this symptoms i want to its my tongue coming as well as soon. will be normal .

Rosanne Allen-Hewlett: Thank you. I have a slight version of this and noticed it during my last visit to India while eating some of their amazing foods. I have eaten semi-hot Southwest cuisine for over 20 years , but now ... Ouch ! It may not be serious, thank you again, but it's disturbing when you love spices!! Namaste'