Geographic Tongue

Geographic tongue also called benign migratory glossitis is a condition affecting up to 3% of the general population.

A typical manifestation of geographic tongue is an erythematous area on the surface of your tongue with missing filiform papillae that is surrounded by a white raised border.

These lesions appear like a map of an area, that is why the condition is known as geographic tongue.

Often, this lesion undergoes spontaneous resolution in one area only to have a new lesion develop in a different area of your tongue.

A majority of patients with geographic tongue have no symptoms, while some people may complain of tongue discomfort and an increase in sensitivity to hot and spicy foods.

This is a harmless condition though it appears alarming, and it does not cause any health problems.

It affects both males and females and is more prominent among adults than in children.

Most people with geographic tongue are asymptomatic. The signs and symptoms of geographic tongue may include:

• Burning sensation or an irritation of the tongue during intake of hot, spicy, salty or acidic foods.
• Smooth, reddish, irregularly shaped patches on the top or side portion of your tongue.
• Map-like appearance and frequent changes in the location, size and shape of lesions.
• The symptoms of geographic tongue persist over a few months or years. The problem usually disappears on its own but may reappear after some time.

When to see a doctor

Geographic tongue is a benign condition though it causes discomfort sometimes. However, the lesions of the tongue may be an indication of a more serious condition of the tongue or diseases involving other parts of the body.

If you notice that lesions on your tongue do not resolve within 7-10 days, see your doctor or dentist.

The exact cause of geographic tongue is not known, and because of this, there are no ways to prevent this condition.

It may be thought to be caused by a deficiency of vitamin B and irritation from hot, spicy foods and alcohol. The lesions occur with increased frequency in patients with psoriasis, but more research is required to establish a link between these two conditions.

However, a polygenic mode has been suggested for inheritance of geographic tongue.

Your dentist will diagnose geographic tongue by looking at your tongue.

If you have a concern regarding the appearance of your tongue, make an appointment with your dentist.

Prepare questions before going to the appointment so that you can make the most of your appointment. Basic questions you may ask include:

• What may be the cause of my condition?
• Is there any other possible cause?
• Is this a permanent problem?
• What treatments do you recommend?
• Are there any self-care methods to relieve discomfort?
• What can I do if my condition reappears again?

In most cases, geographic tongue does not require any medical treatment. Although geographic tongue can cause tongue discomfort sometimes, it is otherwise a harmless lesion.

Your doctor may recommend the following medications to manage the discomfort or sensitivity:

• Over-the-counter pain relieving medications
• Mouth rinses containing an anesthetic agent or antihistamine
• Corticosteroid ointments or mouth rinses

As these treatments have not been studied rigorously, their benefit too is uncertain. Moreover, the lesion resolves on its own and has a very irregular course, because of which the efficacy of the symptomatic treatments is obscure.

Lifestyle modifications are necessary in order to cope with geographic tongue.

Avoidance or limited use of substances known to aggravate the sensitive oral tissues helps reduce the discomfort associated with geographic tongue.

The substances to be avoided include:

• Hot, spicy, acidic or salty foods
• Tobacco products
• Toothpastes containing tartar-control additives, heavy flavoring or whitening agents

Geographic tongue is a benign lesion, and does not pose a health threat or cause long-term complications that can further increase the risk of major health problems. However, anxiety about this condition is common because of the following reasons:

• The appearance of the tongue may be alarming, depending on how evident the lesions are
• Difficulty to reassure that there is no serious problem

Studies about the factors that are likely to be associated with an increased risk of geographic tongue have given mixed results. Factors that are most commonly associated with an increased risk include:

• Family history: A few patients with geographic tongue do have a family history of the disorder, therefore inherited genetic factors may increase the risk.
• Fissured tongue: Patients with geographic tongue commonly have another disorder called fissured tongue,which is characterized by the appearance of deep fissures or grooves on the tongue surface.