Tongue Problems (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Tongue basics
- What are common tongue problems?
- What causes tongue problems?
- What are the treatments for tongue problems?
- White tongue
- Red tongue
- Black tongue
- Increased size/swelling
- Abnormalities of the tongue surface
- Tongue movement
- What are common tongue problems in infants and children?
- What are common tongue problems in pregnancy?
- How are tongue problems diagnosed?
- What is the prognosis for tongue problems?
- Can tongue problems be prevented?
- Find a local Doctor in your town
Abnormalities of the tongue surface
Smooth areas of the tongue may be related to injury (food burn) or a nutritional deficiency of iron, folate, or vitamin B12. A smooth tongue can also result from the use of dentures.
“Geographic tongue” (or benign migratory glossitis) is the most common tongue condition. It is found in up to 14% of the U.S. population. It is a benign condition that appears as bare or smooth areas on the dorsum of the tongue. It may be one area or several areas and may even vary from time to time. It is usually painless; however, the smooth areas may have sensitivity to spicy or acidic foods for some individuals. No treatment is recommended.
Fissured tongue is the second most common tongue condition and is characterized by a deepening of normal tongue fissures and is usually associated with aging. Some medical conditions are linked to fissured tongue and include Sjögren's syndrome, psoriasis, Down syndrome, and acromegaly. No treatment is required unless food debris and bacteria get trapped and cause inflammation of the tongue. Gentle brushing should help alleviate the problem.
As previously mentioned, hairy tongue is the hypergrowth of the tongue's papillae and is usually associated with white, tan, or black discoloration. Hairy tongue is the third most common tongue condition and is considered harmless. Gentle brushing or scraping of the tongue may be helpful. No treatment is necessary.
Median rhomboid glossitis is a lesion at the midline of the dorsum of the tongue. It usually looks like a smooth, red, shiny, and sharply-defined area. The underlying cause is usually a fungal infection. Treatment involves use of topical oral antifungal agents such as nystatin or fluconazole.
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