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Tongueitis (Glossitis) usually arises from mechanical stimuli in the oral cavity, for example from a poorly fitting prosthesis. Glossitis also occurs as an accompanying symptom of many general diseases. It shows up at every age and primarily affects immunocompromised patients. Finding the cause, diagnosis and therapy are not always easy with this disease.
Anatomy of the tongue
The tongue is a muscle covered with mucous membrane. It helps with chewing and sucking and supports the swallowing act. On their surface there are so-called papillae, which serve as tactile and temperature sensors, but are also responsible for the taste. The tongue is involved in making sounds when speaking and supports the immune system with its lymphatic cells. Medications administered via the tongue have a quick effect because they can be absorbed by the oral mucosa in a very short time. An example of this is the nitro spray, which is administered in cases of angina pectoris.
The following symptoms can indicate tongue infection:
- Pain in the tongue,
- Tongue is more sensitive than usual
- Swelling of the tongue,
- Tongue changes color,
- Trouble eating or speaking,
- Difficulties swallowing,
- Tongue changes (number of papillae decreases).
The complaints can be easy, but also difficult. Sometimes the tongue inflammation takes a long, extremely painful course. Tongue may also appear, which is more often the case with fungal infections. The inflammation causes increased blood flow, which can lead to a slight but also massive swelling. These may be so pronounced that swallowing and speaking are impeded. The tongue turns red, especially at the tip and around the edges. Pain, possibly of a burning nature, is added. The sense of taste is also often impaired. In addition, itching is often associated with tongue infections due to an allergy. In general, the symptoms are limited to the tongue and the disease does not affect the general condition.
If the inflammation of the tongue is caused by an insect bite, the severe swelling of the tongue can obstruct breathing so that death from suffocation threatens and an emergency doctor must be alerted.
Acute glossitis is common, especially in children. The tongue is swollen, dark red and there may be small bubbles on the surface. These so-called canker sores are small, round, open spots that can be up to the size of a lens. The blisters are extremely painful. In addition, there are often swallowing difficulties and an unpleasant taste in the mouth.
Chronic tongue inflammation is more common in adults. This can indicate general diseases such as sprue (gluten allergy), iron deficiency anemia or pernicious anemia (vitamin B12 - deficiency anemia).
Causes of inflammation of the tongue
The main causes are irritation of the tongue surface, for example due to sharp tooth edges or various metal alloys that are used in tooth restoration. A sudden bite that occurs while eating, burns from eating and drinking too hot, or poorly fitted dentures can also lead to glossitis. In the event of food intolerance to certain foods, such as nuts, cheese, fruit or seafood, many sufferers also react with an inflammatory reaction of the tongue. Smoking is also one of the possible causes of glossitis.
But even with certain diseases, the inflammation of the tongue is part of the appearance. Infectious diseases such as scarlet fever, diphtheria, and syphilis, among other symptoms, show tongue infection. An example of this is Sjögren's syndrome, an autoimmune disease in which the entire mouth including the tongue is also affected. A vitamin A, B or C deficiency or iron deficiency can lead to inflammatory changes. But also invaded pathogens, usually these are fungi, can cause unpleasant, painful changes in the tongue. Tongue infections also occur in connection with diabetes mellitus, diseases of the liver but also of the psyche. Tongue burning often has a psychological cause.
Diseases in which the immune system is severely weakened promote the development of tongue inflammation. This includes
- Bone marrow tumors,
- severe malnutrition,
- Autoimmune diseases such as Sjögren's syndrome.
Special forms of tongue infections
Special forms of tongue inflammation are the glossitis areata exudative, also called map tongue, the raspberry tongue and the Hunter glossitis.
Exudative area glossitis is a chronic inflammation of the tongue, which changes like a map. This disease is also found in connection with psoriasis (psoriasis) and neurodermatitis. Small white or yellowish papules, which turn into smooth, red individual foci after days and then slowly merge, form foci that resemble a map. These often spread to the palate and cheeks. Those affected report a slight burning sensation and hypersensitivity to strong spices.
The raspberry tongue, which mainly occurs together with scarlet fever, is intensely red, swollen and shows inflamed papillae. This special form also accompanies the rare diseases pellagra (hypovitaminosis - vitamin B3 deficiency) and Kawasaki syndrome (febrile childhood disease with generalized lymph node swelling).
Another special form is Hunter Glossitis. This indicates the lack of vitamin B12. The tongue is varnished and red, especially at the tips and on the back of the tongue.
Tongue burning can be triggered by irritation in the mouth together with tongue inflammation or can also occur with various general diseases. The burning sensation on the tongue occurs in diseases such as diabetes mellitus, anemia, lack of vitamins and infections with bacteria and fungi. But mechanical stimuli in the mouth, such as a pressing prosthesis, poorly fitted braces or an allergic reaction to the materials used during dental treatment, can also trigger tongue burning. Externally, the tongue is not necessarily something to look at, which complicates the diagnosis accordingly. Those affected suffer from burning, itching and / or stinging, similar to a feeling of soreness. Often the cheeks and the palate are affected.
Women suffer from glossodynia (tongue burning) much more often than men, especially in phases of life with profound physical changes, such as during the menopause. There is also a so-called daily rhythm, so that the symptoms usually increase in the evening. Tongue burning can occur along with a feeling of furry, dry mouth and also taste disorders.
Finding the causes of this unpleasant sensation often presents considerable difficulties. In this way, affected people are encountered by doctors from a wide range of specialties. First of all, the way usually leads to a dentist who tries to find out the causes through a detailed medical history and examination of the oral cavity. Other diagnostic procedures, such as a blood test, are often required from other specialists to find out the cause.
Stress, constant stress or fears can also cause tongue burning. But the intensity of the complaints is often exacerbated by a stressed psyche. Burning Mouth Syndrome is a disease limited to the oral cavity. This occurs primarily in women between the ages of forty and forty-five, but the disease can also be found beyond the age of sixty. The patients wake up in the morning with a burning tongue. Finding the cause and diagnosis is usually a challenge in BMS (Burning Mouth Syndrome) because the clinical picture is multifactorial.
If the cause of the inflammation of the tongue is known, it is treated with suitable methods. Depending on the pathogen, infection is treated with antifungal, antibacterial or antiviral therapy. In general, all stimuli must be excluded during treatment, such as hot spices, food and drinks that are too hot, but also disruptive factors such as poorly fitted prostheses or braces. Various mouthwash solutions are prescribed to relieve the symptoms. Thorough oral hygiene after every meal is essential. Rinsing with chamomile or sage tea can be used as a support and help alleviate the symptoms.
Here, too, the cause is first searched for, in order then to treat it exclusively or in conjunction with conventional medicine with suitable naturopathic remedies. Measures that strengthen the immune system are usually part of the therapy. A wide variety of procedures exist in naturopathy, such as autologous blood therapy, injections with strengthening preparations and individually tailored intestinal rehabilitation. The myrrh tincture, already known from grandmother's time, is applied directly to the mucous membrane of the tongue. This can be used diluted with water as a mouthwash or used very carefully to dab the affected areas. Sage, chamomile and peppermint are also suitable for mouthwashes. In any case, hot and hot food and drinks should be avoided. If there is an allergy, the allergen must be strictly avoided.
The effectiveness of homeopathy is scientifically controversial. Nevertheless, many people trust homeopathic remedies. In the case of glossitis, the remedy Marum verum is used, which is made from the juice of the medicinal plant cat herb. In addition, Schüssler salts are also used, for example.
The tongue in traditional Chinese medicine
In traditional Chinese medicine, the tongue has been used for diagnosis for around five thousand years. In the meantime, this form of diagnosis has established itself in many naturopathic practices. Color, texture, shape and coating provide information on a wide variety of organic disorders. The tongue reflects the body's organs at certain points and can thus indicate illnesses or preventive dispositions. According to the TCM (Traditional Chinese Medicine), the tip of the tongue reflects the heart, the middle of the tongue the spleen and stomach, the lateral edge of the liver and gallbladder and the tongue root of the kidneys and colon. Depending on the medical system, naturopathic therapists interpret redness, cracks, bumps and colored deposits differently. Appropriate forms of therapy are then selected according to the diagnosis. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Amboss GmbH: Tongue changes (access: 05.09.2019), amboss.com
- German Professional Association of Otorhinolaryngologists: Tongue Burning (accessed: 05.09.2019), hno-aerzte-im-netz.de
- U.S. National Library of Medicine: Glossitis (access: 05.09.2019), medlineplus.gov
- Prof. Dr. med. Peter Altmeyer: Glossitis K14.00 (access: 05.09.2019), enzyklopaedie-dermatologie.de
- Thomas Lenarz, Hans-Georg Boenninghaus: Otorhinolaryngology, Springer, 14th edition, 2012
ICD codes for this disease: K14ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.