A Family Doctor's Tale - GLOSSITIS

DOC I HAVE GLOSSITIS

Again this topic may come under the conditions seen by dental surgeons or ENT surgeons but it is frequently seen by family doctors. A swollen painful tongue occurs as a result of food or chemicals irritating the tongue.

Glossitis is an acute or chronic inflammatory disease of the tongue which can cause swelling of the tongue and change of color of the tongue.


The finger like papilla on the surface of the tongue may be lost as a result leading to a smooth tongue.



Bacterial Infections:
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1.Gram positive bacteria such as Streptococcus and Staphphylococcus may be painful and lead to upper respiratory tract infection


2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia ( A Simple Guide to Chlamydia)


Viral infections:
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Herpes simplex ( A Simple Guide to Herpes)


Non-infectious:
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1.Dryness of the mouth and low saliva in the mouth may allow bacteria to grow more readily.


2.Local dental abnormalities, rough edges of teeth ,ill fitting dental appliances, or other trauma to the tongue


3.Tongue Piercings


4.irritants such as tobacco, alcohol, hot foods, and spicy food.


5.Sensitivity to toothpaste, mouthwash, breath fresheners,and dental material


6.Allergies to dyes in candy or preservatives in food.


7.Drug induced such as anticholinergics (cause dryness of mouth), certain blood-pressure medications (ACE inhibitors).


8.Mouth breathing


Systemic diseases:
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A painful tongue may be due to several underlying serious medical conditions:

1.iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies


2.Skin diseases such as oral lichen planus( A Simple Guide to Lichen Planus), erythema multiforme, aphthous ulcer, pemphigus vulgaris,


3.Systemic diseases such as syphilis, and others.


Occasionally, glossitis can be inherited.


Symptoms:

1.Swelling of the tongue


2.Tongue color changes often dark red


3.Pale if caused by anemia.


4.Fiery red if due to vitamin B deficiency


5.Sore and tender tongue


6.Smooth tongue


7.Aphthous ulcers ( A Simple Guide to Mouth Ulcers) of the tongue


8. Swollen tongue resulting in difficulty with chewing, swallowing, or speaking.


This may require emergency treatment especially if breathing is compromised.


Complications may occur such as :
1.difficulty in breathing and swallowing


2.cervical lympadenosis (enlarged lymph nodes of the neck)


3.upper respiratory tract infection



The goal of treatment is to reduce inflammation and swelling.

1.Good oral hygiene


2.Attend to dental problems


3.Antibiotics and antifungal treatment depending on the organism found


4.Corticosteroids may be given to reduce inflammation


5.For mild cases, topical applications of steroid mouth rinses or creams that is not swallowed are used


6.Underlying causes such as Anemia (A Simple Guide to Anemia)and nutritional deficiencies must be treated, often by dietary changes or other supplements


7.Avoid irritants (such as hot or spicy foods, alcohol, and tobacco) to minimize the discomfort.


8.hospitalization may be required if unless tongue swelling is severe.



Prognosis is usually very good.


Recurrences are common


Prevention is by:
1.Avoid smoking


2.Healthy lifestyle with balanced diet and exercise.


3.Regular cleaning of gums and teeth by brushing and flossing


4.Gargling of mouth after meals


5.Regular dental checkups