Geographic tongue, also known as benign migratory glossitis, causes the surface of the tongue to have an irregular, cracked appearance. This condition gets its distinctive name from the fact that the cracks can resemble a geographic map.
If the appearance of this condition alarms you, don’t worry.
The tongue is covered in small hair-like structures called papillae that are pinkish-white in color. In the geographical tongue, there are areas in which they do not have these papillae, which is why they have the appearance of red, smooth islands. These patches usually heal on their own and move to a new area of the tongue, which is why the condition is known as migratory glossitis.
What is the geographic tongue?
In dental terms, geographic tongue is known as benign migratory glossitis. It is an oral pathology characterized by the marked appearance of white and red spots, with small cracks visible around the surface of the tongue.
These well-known irregular spots change their size and position throughout the process. Some people may confuse its appearance with that of a cracked or fissured tongue, although this pathology does generate some grooves on the lingual surface, complicating adequate oral hygiene.
If you suspect that you might be developing this condition, don’t be alarmed. We are talking about a completely benign condition of an inflammatory nature that subsides over time. It is generally painless, although if it is not detected it can cause discomfort or even small ulcers.
This pathology does not represent the possibility of contagion, it can be chronic and usually repeats itself over periods in the form of small outbreaks.
According to studies carried out by several societies of oral health specialists, geographic tongue mainly affects 10% of the world’s population, with cases more frequently occurring in women and children. But how can you know if you suffer from this anomaly? Knowing your symptoms.
The diagnosis of geographical tongue?
*Thorough physical examination of the entire surface of the tongue, taking a clinical history.
*Perform a differential diagnosis where mycosis is ruled out; that is, a fungal infectious process.
*Assessment of alterations in the immune system in case it is a case of allergy.
*Nutritional aspects should also be analyzed in case there are vitamin deficiencies or cases such as celiac disease or even anemia.
How do you cure geographical tongue?
The idea is to find the cause and solve it, but this is not always easy or obvious. For example, in case of vitamin deficiency, supplements are prescribed.
In general, the geographic tongue does not cause discomfort, but for those patients who do experience some sensitivity or discomfort, it is recommended:
*Eliminate irritating factors, such as tobacco, alcohol, and spicy and acidic foods.
*Maintain adequate oral hygiene, without forgetting the tongue.
*Mouthwashes with hyaluronic acid that help regenerate taste buds.
*Mouthwashes with antihistamines or anesthetics to reduce swelling or itching.
*Ointments or mouthwashes with corticosteroids for the most serious cases with very severe discomfort.
What are the main causes of geographic tongue?
Benign migratory glossitis affects approximately 1 to 2.5% of people and usually begins in childhood. It is very common between 4 and 5 years old.
It also appears in adults under 30 years of age and appears more frequently in women than in men.
Although the causes that activate this tongue disease are not very clear, it seems that it has an autoimmune origin and that stress has a lot to say. After many studies, these are some causes that could affect you :
1. Nutritional deficiencies:
There is strong evidence that a lack of vitamins and minerals, especially vitamin B12, iron, and zinc, causes this glossitis.
2. Scrotal tongue:
Those who have these inflammatory outbreaks usually suffer in parallel from the scrotal tongue, which this organ has deep fissures or cracks.
3. Systemic pathologies
Certain treatments for various general disorders lead us to suffer from oral problems, thus damaging our dental health. Furthermore, those diseases that affect more than one organ, such as diabetes, are reflected in a cracked tongue or map-shaped spots. This is because resistance to infections is low.
From those that are created by allergic reactions to dental hygiene products, food, or medications, to infections caused by bacteria, fungi, or viruses (including oral herpes); burns or worn edges of the teeth, and even poorly fitting dentures, in which case a review for orthodontic treatment is recommended.
5. Stress and anxiety:
Emotional factors are strongly associated with the onset of this inflammatory disorder. They can act as a trigger for the first outbreak and greatly slow down healing.
6. Hormonal changes:
Since women suffer from it more, it is necessary to take into account whether there is a change in the menstrual cycle – ovulation, pregnancy, menopause – when diagnosing. On these occasions, the body may not absorb folic acid and produce this lingual alteration.
7. Pathologies of allergic, systemic, inflammatory, or autoimmune origin:
Studies corroborate that people with allergic, systemic diseases – diabetes, arthritis, fibromyalgia… -, inflammatory diseases such as psoriasis or atopic dermatitis, or autoimmune diseases such as lupus or celiac disease, are more predisposed to suffering from geographic tongue.
8. Genetic predisposition:
If someone in your family, such as parents or siblings, has suffered from this condition, you will likely have it at some point, since it has a hereditary component.
9. Smoking and alcohol consumption:
Harmful habits for health, such as smoking or drinking alcohol regularly, also have an impact on the activation of benign migratory glossitis.
10. Hot, sour, or spicy foods:
These types of foods can irritate the tongue and reactivate inflammation, so it is advisable to reduce their intake as prevention or to accelerate healing.
11. Gastroesophageal reflux:
Sometimes, when the muscle at the end of the esophagus does not close properly, it allows the contents of the stomach, along with its acids, to return to the mouth, producing inflammatory changes like this.
Patients who suffer from this disease experience migratory glossitis more frequently. The presence of geographic tongue has been framed as an early expression of psoriasis.
13. Family history:
Hereditary genetic factors are part of one of the causes, being more likely to present geographic tongue. This has been proven through studies of the patient’s direct relatives.
On many occasions we tend to ingest products with excess salt, very spicy or hot, acidic, and even cause reflux, these becoming activators of the disorder in question.
15. Alcohol and tobacco
As they are irritating products, the consumption of these substances generates the condition of the geographic tongue for many people.
Those people who suffer from pathologies such as asthma, eczema, celiac disease, rhinitis, atopic dermatitis, and high levels of immunoglobulin E are more vulnerable to having geographic tongues compared to individuals who do not suffer from these diseases. The reason is the weakness of the immune system.
Symptoms of the geographic tongue
Although many patients do not have symptoms, the most common are areas that do not have taste buds that appear on the geographic tongue and appear smooth and red with a slightly raised white edge, which means that these lesions are often confused with fungi. These patches give the tongue the appearance of a map as if they were islands. It is a quite striking alteration that can occupy from just small areas of the tongue to the entire organ, producing a certain burning in the affected areas when consuming acidic or spicy foods.
*Map-like lingual surface.
*Patches that move from one day to the next.
*Smooth, red, irregularly shaped spots on the top of the tongue.
*Frequent changes in the location, size, and shape of lesions.
*Discomfort, pain, or burning sensation when eating spicy or acidic foods.
Treatment for geographic tongue?
In the same way that there is no way to prevent the disease, there is no specific treatment to treat it. As we have already explained, the spots and symptoms disappear on their own over time.
If any of the pathologies as possible causes of migratory tongue had been detected in the clinical examination, specific treatments would have to be applied; That is, it would be a possible allergy, a case of celiac disease, or, for example, a lack of vitamins.
Apart from this, there are a series of recommendations to relieve symptoms:
*For discomfort resulting from stinging, burning, or swelling :
*Mouthwashes or gels with analgesic and antiseptic components.
*Treatment with anti-inflammatories and/or mouthwashes with hydrocortisone.
*If applicable, antihistamines
*Steroid ointments for direct application are recommended exclusively in cases where the condition is very severe.
*For nutritional alterations, vitamin supplements.
*For lingual sensitivity :
*Elimination of irritating agents in the diet: spices, citrus fruits, or foods that are too hot.
*Control over tobacco and alcohol consumption.
You may be interested in reading: The Importance of Mouthwash
And, of course, rigorous oral hygiene that includes:
*Brushing your teeth three times a day, after meals and flossing.
*We recommend mint-free toothpaste to relieve the discomfort of itching, as it has anesthetic properties.
*Mouthwash with hyaluronic acid also offers an excellent result because it balances the water level and activates the production of fibrocytes, essential for the regeneration of taste buds and adequate healing.
*And, of course, pay special attention to cleaning the tongue, since it is where most bacteria can concentrate due to the roughness it has. To do this, we recommend that you use a tongue cleaner (or scraper) which will be a great tool for prophylaxis of your tongue.
What treatments are recommended for geographic tongue?
The discomfort caused by geographic tongue usually disappears on its own in the short term, but there are recommendations to soften the negative effects:
Maintain oral hygiene:
Dental specialists have recommended including cleaning the tongue through brushing in oral hygiene. The tongue is a source of bacteria that must be removed correctly using, for this purpose, the tongue scraper.
We also recommend that you attend your dental clinic regularly, practice regular oral cleanings, and be careful with orthodontic treatments, since lack of attention can cause discomfort causing geographic tongue.
Take care of your diet:
It is advisable to avoid the consumption of very hot, acidic, or spicy foods so that they do not complicate the healing process of the lesions, as well as eliminate the consumption of liquor and tobacco.
Antihistamines or anti-inflammatories:
The dentist may prescribe antihistamines or anti-inflammatories to control burning and swelling. Additionally, if there are nutritional problems, you should consume vitamin supplements to solve them.
If you experience severe pain due to the condition, the application of topical steroid ointments is recommended.
Geographic Tongue Risk Factors
Migratory glossitis occurs in approximately 1-2 percent of the population although it can occur at any age. It affects younger adults more often. It appears to be hereditary, so there may be a genetic link. People with cleft tongue, a condition in which the tongue is deeply furrowed and has a wrinkled appearance, may also be at increased risk of developing this migratory glossitis, as may those who have a vitamin B deficiency or have inflammatory tongue disease, skin, psoriasis.
Although certain disorders can often occur along with the geographic tongue, for example, psoriasis, atopic conditions, anemia, and hormonal disturbances, there is no real evidence that they play a role in the cause.
Tips for daily tongue care
In addition to the treatment provided at the Dra. Borro Dental Clinic, there are measures you can take to care for and maintain the health of your tongue:
*Avoid spicy, acidic, or hot foods or drinks that can irritate the tongue.
*Maintain good oral hygiene by gently brushing your tongue during regular tooth brushing.
*Rinse your mouth with warm salt water after each meal to help maintain oral hygiene and reduce tongue irritation.
*Avoid smoking and excessive alcohol consumption, as these habits can aggravate the symptoms of geographic tongue.
*Maintain a balanced and nutritious diet, ensuring you get enough vitamins and minerals essential for oral and general health.
*Manage stress, because emotional stress can trigger or worsen geographic tongue symptoms. Look for activities that help you relax and manage stress effectively.
It is very common to focus on our teeth and forget about the tongue, which has its conditions. Among them is geographic tongue which, although it does not usually have symptoms, can be an indication that you are under the effects of stress or an autoimmune disease is developing.
One of the best control systems is adequate oral hygiene, with special attention to the tongue, and periodic cleanings at your dentist.
In addition, he will confirm that you are not suffering from anything serious since the geographical language is very striking.
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