Geographic tongue : Symptoms, Causes, and Treatment

Overview

What is geographic tongue?

Geographic tongue is an inflammatory disorder that affects the tongue’s surfaces. Although it may appear concerning, it is mostly harmless and has no connection to an infection or cancer. On the tongue, it frequently vanishes and then reappears at different locations. The patches that these lesions produce resemble the shapes of land and water on maps is how they get their name. This article discusses few facts about the condition, symptoms, risk factors, causes, management and its complications.

Key Facts

• Rayer was the first to describe it in 1831.¹Overview| Researched based study from Nlm.nih.gov
• Other names for the condition include wandering tongue rash, erythema migrans, benign migratory glossitis, and annulus migrans.
• It is not contagious and cannot be spread from one individual to another.
• Geographic tongue is quite a common condition.
• It can happen at any point in life, even during childhood.
• It is believed that 1 to 2.5% of the global population is affected.¹Overview| Researched based study from Nlm.nih.gov

Symptoms

Symptoms of Geographic tongue

Most of the time, they do not manifest symptoms and are ignored by those affected. Doctors and dentists most frequently find it when performing regular checkups.

Common symptoms include

• Red, smooth patches.
• Irregularly shaped patches.
• With white or grey borders.
• Burning sensation or pain.
• Lymph node swelling.

Individuals will have different symptoms, some of which may include

• Irregular, smooth, and red areas on the tongue²Symptoms| Researched based study from Nlm.nih.gov These areas may have a raised border that is white or grey.
• Patches can be found in multiple areas of the tongue, palate (roof of the mouth), or floor of the mouth.
• Patches or lesions disappear and reappear at different sites in the mouth, especially the tongue. These lesions regularly alter in size and shape.
• Narrow or deep fissures on the tongue.¹Symptoms| Researched based study from Nlm.nih.gov
• Swollen lymph nodes in and near the lower jaw.
• A burning feeling or pain after consuming spicy or acidic drinks or foods²Symptoms| Researched based study from Nlm.nih.gov

Causes

What are the common causes of Geographic tongue?

Researchers and doctors are still determining what produces geographic tongue. However, they claim that some situations, such as the ones listed below, increase the risk of a person developing geographic tongue

• Asthma.
• Eczema.
• Psoriasis³Causes| Researched based study from Nlm.nih.gov
• Lichen planus.
• Type 1 diabetes.
• Reactive arthritis.
• Allergies to food, other materials, or drugs.
• Digestive or intestinal disorders.

Can geographic tongue occur due to a vitamin deficiency?

• Yes, it has been proven that deficiencies in vitamin D, B6, B12, folic acid, iron, and zinc may also be important factors contributing to a geographic tongue⁴Causes| Researched based study from Nlm.nih.gov

Other risk factors may include

• Hereditary factor – People who have at least one affected parent are more likely to develop geographic tongue than people who have unaffected parents⁵Causes| Researched based study from Nlm.nih.gov
• Gender – females are more affected than males.¹Causes| Researched based study from Nlm.nih.gov
• Stress – It has been demonstrated that reducing stress helps reduce the symptoms of individuals with geographic tongues.¹Causes| Researched based study from Nlm.nih.gov
• Birth control pills – It has been observed that women taking oral contraceptives develop Geographic tongue, especially during their seventeenth day of the cycle.⁶Causes| Researched based study from Nlm.nih.gov
• Pregnancy – hormonal fluctuations during pregnancy, deficiencies in specific vitamins and minerals, and stress may increase a pregnant woman’s risk of developing symptoms similar to those of a geographic tongue⁷Causes| Researched based study from Nlm.nih.gov

Can eating particular food produce a geographic tongue?

• No, eating a particular food cannot induce a geographic tongue.
• However, spicy or acidic foods may cause burning or pain in those with the condition⁴Causes| Researched based study from Nlm.nih.gov

Diagnosis

Diagnosis of Geographic tongue

A doctor or dentist typically diagnoses a geographic tongue after performing an oral examination and asks the patient whether they have any symptoms, such as discomfort or burning.

Physical examination – examination of the mouth

• The doctor could instruct the patient to move their tongue in various directions.
• Inspect the lower jaw for any enlarged lymph nodes.
• The tongue, roof of the mouth, inside surfaces of the cheeks, and floor of the mouth may all be examined with the help of light.
• Also, the doctor may lightly touch affected areas to check for changes in texture, burning, or pain.

Treatment

What is the best way to treat Geographic tongue?

The geographic tongue typically doesn’t need any treatment without discomfort.¹Treatment| Researched based study from Nlm.nih.gov

However, the symptoms of the geographic tongue can be managed with the help of the following drugs:

• Painkillers like acetaminophen.
• Topical corticosteroids in the form of ointments and mouth rinses.
• Antihistamines to relieve any allergic reactions ⁸Treatment| Researched based study from Clevelandclinic.org
• Vitamin treatment with vitamins A, B6, and B12.
• Zinc supplements⁹Treatment| Researched based study from Nlm.nih.gov
• Topical tacrolimus ¹⁰Treatment| Researched based study from Nlm.nih.gov
• Cyclosporine tablets suppress immunity¹⁰Treatment| Researched based study from Nlm.nih.gov
• Ayurveda – Geographic tongue has been treated naturally using Ayurvedic methods in some cases. ¹¹Treatment| Researched based study from Researchgate.net

Prevention

Can people prevent getting Geographic tongue?

Not, since doctors are still trying to figure out what causes it. However, there may be ways to lower the risk of an individual by:

• Consuming a balanced diet with enough iron, zinc, folic acid, and B6 and B12 vitamins.
• Managing stress effectively by doing yoga, meditation, or mindfulness or participating in sports, dance programs, or exercising regularly.
• Maintaining proper oral hygiene.

To prevent making the symptoms worse, individuals can also refrain from the following:

• Alcohol.
• Flavored toothpaste.
• Acidic or spicy foods or drinks¹Prevention| Researched based study from Nlm.nih.gov

Complications

Complications associated with Geographic tongue

The geographic tongue doesn’t increase the possibility of severe health issues or cause long-term difficulties.

A few complications from the condition may include:

• Embarrassment-related anxiety is quite common.
• The biggest worry for a person can be how their tongue looks.
• They could not eat or drink their preferred foods due to a burning feeling.
• It may recur multiple times with a period of disappearance in between.

Prognosis

Prognosis of Geographic tongue

The condition is self-limiting, and the patches gradually disappear on their own without the need for treatment. Depending on the person’s underlying medical circumstances, a geographic tongue’s duration may vary. In some, they may persist for a very long time. In some people, they might appear and then instantly vanish, or there might be significant pauses. A person who has a geographic tongue will lead an ordinary life. Nothing will help avoid the disease from reoccurring in the future. Thus, the person does not need to alter their way of life. Speak with a medical professional if you see any changes in your mouth so they can find out what caused those changes.