Glossitis

The symptoms of glossitis include:

• Change in tongue color from its normal pink to a paler pink, dark red, or bright red

• Pain or discomfort with chewing, swallowing or talking

• Smooth texture and appearance of the tongue

• Tongue pain, soreness or tenderness

• Tongue swelling

In some cases, glossitis can be caused by a serious infection that is spreading, or lead to moderate to severe tongue swelling that can block the airway and interfere with breathing. Seek immediate medical care (call 911) if you, or someone you are with, have these serious symptoms:

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Respiratory or breathing problems, such as severe shortness of breath, difficulty breathing, labored breathing, making noises with breathing, not breathing, or choking

• Sudden swelling of the face, lips and tongue

Glossitis may occur by itself, or it may be caused by a variety of diseases, disorders and conditions. Some causes of glossitis are potentially serious and even life threatening, such as pernicious anemia or pemphigus vulgaris (an autoimmune disorder). Other causes may be relatively mild, such as a small cut when you have bitten your tongue.

Bacterial, yeast and viral infections can also lead to glossitis. Other causes of a glossitis include a variety of irritants and exposure to very hot foods or beverages, spicy foods, tobacco, and alcohol. In addition, glossitis can be a side effect of certain medications.

Potential infectious causes of glossitis include:

• Herpes simplex virus infection

• Strep infection (bacterial infection)

• Syphilis

• Yeast infection

Glossitis can be due to mild or serious allergies and allergic reactions including:

• Allergies to oral hygiene products, such as toothpaste, mouthwash, dental floss, dentures, and mouth guards

• Drug allergies

• Food allergies

Glossitis can arise from physical irritants and trauma including:

• Alcohol

• Biting the tongue

• Burning the tongue, such as with hot liquids, hot food, or spicy food

• Dental appliances such as dentures

• Tobacco

Glossitis can be due to a variety of other diseases, disorders and conditions including:

• Canker sores

• Folic acid deficiency
  

• Iron deficiency anemia

• Lichen planus (disease that produces a mouth or skin rash)

• Pemphigus vulgaris (a serious, life-threatening autoimmune disorder)

• Pernicious anemia (decrease in red blood cells due to poor vitamin B₁₂ absorption)

• Sjögren’s syndrome (an autoimmune disease in which the body attacks its own moisture-producing glands, producing a dry mouth and other symptoms)

A number of factors increase the risk of developing glossitis. Risk factors include:

• Advanced age

• Alcohol abuse

• Chronic dry mouth

• Dentures or other dental appliances

• Parent or sibling with glossitis

• Poor nutrition

• Poor oral hygiene

• Smoking or chewing tobacco

• Weakened immune system

You may be able to lower your risk of developing glossitis by:

• Avoiding hot liquids, hot food, or spicy food if they cause you to have symptoms of glossitis

• Eating a balanced diet

• Ensuring that dentures and other dental appliances fit property and do not cut or chafe your mouth

• Not drinking alcohol or limiting alcohol intake to one drink per day for women and two drinks per day for men

• Practicing good oral hygiene techniques, such as regular tooth brushing and flossing, tongue brushing, and getting regular professional cleanings and checkups

• Seeking treatment for chronic dry mouth

• Seeking treatment for infections, such as syphilis and yeast infection as appropriate

• Stopping smoking or chewing tobacco

Treatment of glossitis varies depending on the underlying cause. The goal of treatment is to control tongue inflammation regardless of the cause of glossitis. In addition to avoiding very hot liquids, treatment includes:

• Anesthetic mouth rinses such as viscous lidocaine (Xylocaine)

• Antihistamine mouth rinses such as diphenhydramine (Benadryl)

• Antimicrobial medications and mouth rinses to treat infectious causes of glossitis

• Corticosteroid mouth rinses such as dexamethasone (Decadron)

• Dietary changes and nutritional supplements to treat anemia and nutritional deficiencies

• Magic Swizzle or Magic Mouthwash, which are generic terms for mouthwashes containing a variety of ingredients, such as antacids, anesthetics, antihistamines, antimicrobials and corticosteroids. The specific recipe will be determined by your healthcare provider.

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naprosyn (Naproxen, Aleve), and indomethacin (Indocin)

Complications associated with glossitis can be progressive and vary depending on the underlying cause. Because glossitis can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to contact your healthcare provider when you experience any kind of tongue swelling or other symptoms of the mouth or tongue. Once the underlying cause is diagnosed, following the treatment plan you and your healthcare provider develop specifically for you will minimize the risk of complications including:

• Difficulty breathing, ineffective breathing, and respiratory arrest due to blockage of the airway

• Difficulty chewing or swallowing

• Discomfort

• Speech problems

• Spread of infection

• Surgery to remove the tongue due to a serious infection or malignant condition