Glossitis

Template:DiseaseDisorder infobox Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

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.

Causes

Common Causes

• Alcohol
• Benign migratory glossitis
• Deserpidine
• Erythema multiforme
• Folate deficiency
• Glucagonoma
• Iron deficiency
• Lichen planus
• Malnutrition
• Pellagra
• Pernicious anemia
• Reserpine
• Spices
• Xerostemia

Causes by Organ System

Cardiovascular	Kawasaki disease, Kwashiorkor amyloidosis
Chemical/Poisoning	Lincomycin hydrochloride, Tobacco
Dental	No underlying causes
Dermatologic	Erythema multiforme, Lichen planus, Pemphigus vulgaris, Psoriasis, Scarlet fever
Drug Side Effect	Albuterol, Deserpidine, Doxycycline, Meropenem, Reserpine, Tetracycline, Tubocurarine
Ear Nose Throat	Benign migratory glossitis, Median rhomboid glossitis, Poor oral hygiene, Xerostemia
Endocrine	Plummer-vinson disease
Environmental	Smoking
Gastroenterologic	Ariboflavinosis, Carcinoid syndrome, Celiac disease, Crohn’s disease
Genetic	Celiac disease, Cowden disease
Hematologic	Anemia, Angular cheilitis, Cheilosis, Iron deficiency anemia, Iron deficiency
Iatrogenic	Mouthwash
Infectious Disease	Aids, Aphthous ulcer, Candidiasis, Herpes simplex, Syphilis, Toxic shock syndrome, Whipple disease
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Peripheral neuropathy,
Nutritional/Metabolic	Ariboflavinosis, Dana syndrome , Dehydration, Folate deficiency, Iron deficiency anemia, Malnutrition, Niacin deficiency, Pellagra, Pyridoxine deficiency, Riboflavin deficiency, Thiamine deficiency, Zinc deficiency
Obstetric/Gynecologic	No underlying causes
Oncologic	Carcinoid syndrome, Cowden disease, Glucagonoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	Alcoholism
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Dehydration
Rheumatology/Immunology/Allergy	Allergic reaction , Immunocompromise, Kawasaki disease, Kwashiorkor amyloidosis, Lichen planus
Sexual	Aids, Herpes simplex
Trauma	Trauma
Urologic	No underlying causes
Miscellaneous	Spices

Causes in Alphabetical Order

• Aids
• Albuterol 
• Alcohol
• Alcoholism
• Allergic reaction 
• Anemia
• Angular cheilitis
• Aphthous ulcer
• Ariboflavinosis
• Benign migratory glossitis
• Candidiasis
• Carcinoid syndrome
• Celiac disease
• Cheilosis
• Cowden disease
• Crohn’s disease
• Dana syndrome 
• Dehydration
• Deserpidine
• Doxycycline
• Erythema multiforme
• Folate deficiency
• Glucagonoma
• Herpes simplex
• Immunocompromise
• Iron deficiency
• Iron deficiency anemia
• Kawasaki disease
• Kwashiorkor amyloidosis
• Lichen planus
• Lincomycin hydrochloride
• Malnutrition
• Mecamylamine
• Median rhomboid glossitis
• Meropenem
• Mouthwash
• Niacin deficiency
• Pellagra
• Pemphigus vulgaris
• Peripheral neuropathy
• Pernicious anemia
• Persistent tuberculum impar
• Plummer-vinson disease
• Poor oral hygiene
• Psoriasis
• Pyridoxine deficiency
• Reserpine
• Riboflavin deficiency
• Scarlet fever
• Sideropenic dysphagia
• Smoking
• Spices
• Syphilis
• Tetracycline
• Thiamine deficiency
• Tobacco
• Toxic shock syndrome
• Trauma
• Tubocurarine 
• Whipple disease
• Xerostemia
• Zinc deficiency

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.
• Drugs such as doxycycline, Lincomycin Hydrochloride, Meropenem and tetracycline.

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

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.

References

de:Glossitis it:Glossite lt:Glositas