How do you get Geographic Tongue?

The cause of geographic tongue is not fully understood, but it may be connected to psychological factors, inherited from family members, or related to stress.

What type of doctor should I see for Geographic Tongue?

A dentist or an oral and maxillofacial specialist.

Geographic Tongue

What is Geographic Tongue?

Geographic tongue, first identified by Rayer in 1831, is a non-harmful, long-term condition that intermittently causes inflammation in the mouth. Its cause is unknown. This condition is also known by several names, including benign migratory glossitis, erythema migrans, annulus migrans, and wandering rash of the tongue. It typically doesn’t cause symptoms and appears as red, moving, ring-shaped patches on the tongue, which make the tongue look like a map. Depending on the person, the spots may last from a few days to weeks before disappearing and then reappearing in another place on the tongue.

These spots are often found on the sides and top of the tongue. However, in some cases, these spots might appear on other areas inside the mouth such as the lips, the inside lining of the cheeks, and the bottom of the mouth. Geographic tongue has been found to be connected with other health conditions which has led to various theories about how this disorder develops.

What Causes Geographic Tongue?

The cause of geographic tongue, a condition that causes patches on the tongue, isn’t fully understood yet. But there are a few theories. Some suggest that this condition may be connected to psychological factors or is inherited from family members. A study showed that geographic tongue was more common in people with mental health conditions. Another study suggested that reducing stress could improve geographic tongue symptoms, hinting at a link between stress and this condition.

Familial and hereditary factors also seem to play a role. Research has shown that geographic tongue is more common in close family members (siblings and parents) compared to the general population. This suggests that the condition could be passed down in families in a manner involving many genes, although it’s not yet clear how exactly this might work.

Risk Factors and Frequency for Geographic Tongue

Geographic tongue is a condition that often starts during childhood. Globally, about 1% – 2.5% of people have this condition. In children, the percentage is between 0.37% and 14.3%. It’s most common in people aged 20 to 29, affecting about 39.4% of people in this age group. Women are slightly more likely to have geographic tongue than men.

Signs and Symptoms of Geographic Tongue

Geographic tongue is a condition that shows up differently in different people. It usually doesn’t cause any symptoms but appears as red, ring-shaped patches on the top and sides of the tongue. These patches might look smooth because they’re areas where tiny bumps on the tongue (called papillae) have been lost. If the same kind of patches appear somewhere other than the tongue, we call it ectopic geographic tongue. These spots rarely occur but can be found on the inside of the cheeks, lips, roof of the mouth, small dangling ball at the back of the throat (uvula), and floor of the mouth.

The pattern of patches on the tongue can change over time—sometimes they’re there, and sometimes they aren’t. The patches can also change in shape and size, giving the tongue a map-like pattern. Apart from the visual signs, some people also report a variety of symptoms such as pain, a burning feeling, discomfort in the mouth, taste alterations, and sensitivity to hot, spicy, and sour foods.

Red, ring-shaped patches on the tongue
Smooth areas due to loss of tiny tongue bumps
Possibility of patches appearing on inner cheeks, lips, roof of the mouth, uvula, and mouth floor
Changing patterns of patches on the tongue
Pain
Burning sensation
Mouth discomfort
Taste alterations
Sensitivity to hot, spicy, and sour foods

Testing for Geographic Tongue

Geographic tongue is a condition that can usually be identified by its unique symptoms and medical history. In certain unusual cases, it might be necessary to confirm the diagnosis with a tissue sample exam, also known as histology. However, this is typically very rare.

Geographic tongue has been linked with several other health conditions, so if any of these are suspected, further evaluation might be necessary. These conditions include chronic inflammatory bowel disease, psoriasis, celiac disease, HIV, atopic dermatitis (a type of skin inflammation), lichen planus (a rash), diabetes, lupus erythematosus (an autoimmune disease), Down syndrome, reactive arthritis, Aarskog syndrome, fetal hydantoin syndrome, and Robinow syndrome.

Treatment Options for Geographic Tongue

Geographic tongue is usually harmless and doesn’t usually require treatment if it is not causing any discomfort. You can rest easy knowing its benign nature- that is it’s not harmful or serious. However, if the lesions are causing discomfort, certain treatments can help. These may include topical corticosteroids, antihistamines, or cyclosporine, vitamin A, and zinc, which are applied directly to the tongue. Alternatively, pain relief may be achieved with a simple over-the-counter remedy like acetaminophen. Topical tacrolimus is another effective remedy.

Furthermore, lifestyle modifications like avoiding alcohol, hot, spicy and sour foods, as well as acidic fruits and beverages can also help prevent symptoms from getting worse. Maintaining good oral hygiene is also recommended to help manage the condition.

Geographic tongue is typically identified by its unique symptoms and medical history. However, if the symptoms are not typical, the doctor might consider other diseases that could potentially cause similar symptoms. These include:

Erythroplakia (an oral condition presenting as red patches)
Lichen planus (a condition that causes swelling or irritation in the skin, hair, nails, and mucous membranes)
Candidiasis (a fungal infection caused by Candida, often occurring in the mouth)
Contact stomatitis (inflammation of the mouth caused by contact with certain substances)
Leukoplakia (white or grey patches that develop on the tongue, inside of the cheek, or on the floor of the mouth)
Trauma or injury to the tongue
Aphthous ulcer (also known as a canker sore)
Squamous cell cancer (a type of skin cancer)
Plaque psoriasis (a chronic autoimmune condition that causes rapid build-up of skin cells, resulting in scaling on the skin’s surface)

What to expect with Geographic Tongue

Geographic tongue is a harmless condition that typically doesn’t cause symptoms and generally has a good outcome.

Possible Complications When Diagnosed with Geographic Tongue

Geographic tongue typically does not lead to any complications.

Preventing Geographic Tongue

Geographic tongue is a simple condition that causes inflammation or swelling on the surface of the tongue. It’s nothing to worry about and often needs no treatment. However, if you’re experiencing any symptoms or discomfort from geographic tongue, treatments are available to help alleviate these symptoms.

What are signs and symptoms of Geographic Tongue?

The signs and symptoms of Geographic Tongue include: - Red, ring-shaped patches on the tongue. - Smooth areas on the tongue due to the loss of tiny bumps called papillae. - Possibility of patches appearing on the inner cheeks, lips, roof of the mouth, uvula, and floor of the mouth. - Changing patterns of patches on the tongue, giving it a map-like appearance. - Pain in the affected areas. - Burning sensation in the mouth. - Discomfort in the mouth. - Taste alterations, which can affect the ability to taste certain flavors. - Sensitivity to hot, spicy, and sour foods, which can cause discomfort or pain when consumed.

What else can Geographic Tongue be?

The conditions that a doctor needs to rule out when diagnosing Geographic Tongue are: - Erythroplakia (an oral condition presenting as red patches) - Lichen planus (a condition that causes swelling or irritation in the skin, hair, nails, and mucous membranes) - Candidiasis (a fungal infection caused by Candida, often occurring in the mouth) - Contact stomatitis (inflammation of the mouth caused by contact with certain substances) - Leukoplakia (white or grey patches that develop on the tongue, inside of the cheek, or on the floor of the mouth) - Trauma or injury to the tongue - Aphthous ulcer (also known as a canker sore) - Squamous cell cancer (a type of skin cancer) - Plaque psoriasis (a chronic autoimmune condition that causes rapid build-up of skin cells, resulting in scaling on the skin's surface)

What kinds of test are needed for Geographic Tongue?

The types of tests that may be needed for Geographic Tongue include: - Medical history evaluation - Physical examination of the tongue - Tissue sample exam (histology) in rare cases to confirm the diagnosis - Further evaluation if other health conditions are suspected, such as chronic inflammatory bowel disease, psoriasis, celiac disease, HIV, atopic dermatitis, lichen planus, diabetes, lupus erythematosus, Down syndrome, reactive arthritis, Aarskog syndrome, fetal hydantoin syndrome, and Robinow syndrome.

How is Geographic Tongue treated?

Geographic tongue can be treated with various methods depending on the level of discomfort it causes. If the lesions are causing discomfort, treatments such as topical corticosteroids, antihistamines, or cyclosporine, vitamin A, and zinc can be applied directly to the tongue. Over-the-counter pain relief options like acetaminophen can also be used. Topical tacrolimus is another effective remedy. Additionally, lifestyle modifications like avoiding alcohol, hot, spicy and sour foods, as well as acidic fruits and beverages, can help prevent symptoms from worsening. Maintaining good oral hygiene is also recommended to manage the condition.

What are the side effects when treating Geographic Tongue?

When treating Geographic Tongue, there may be some side effects associated with the treatments. These can include: - Topical corticosteroids: potential side effects may include a burning or stinging sensation, dryness, or changes in taste. - Antihistamines: possible side effects can include drowsiness, dry mouth, and blurred vision. - Cyclosporine: potential side effects may include headache, nausea, and increased susceptibility to infections. - Vitamin A and zinc: these are generally safe when applied topically, but excessive use may cause skin irritation or allergic reactions. - Acetaminophen: when used as directed, it is generally safe, but taking too much can lead to liver damage. - Topical tacrolimus: potential side effects may include burning or itching at the application site, skin redness, or acne-like rash.