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Mouth Diseases

Can you tell me what`s on my tongue?

03/02/2009

Question:

Can you tell me what`s on my tongue? I`ve developed white lines on the top and sides of my tongue. Some of them form complete circles and some don`t. Some connect with each other and some don`t. It almost looks lacey. Usually, the areas inside the white lines become smooth. The taste buds seem to disappear. Eventually, it will go away. The taste buds will return and in a few days it will move to other parts of my tongue and start all over. It doesn`t seem to hurt, but I can`t find anything to make it any better. I do know it`s not Thrush.

Answer:

Based on your description of the morphologic changes on your tongue, I would presume that you have a condition known as “geographic tongue” or “benign migratory glossitis” or “erythema migrans”. These are descriptive terms for a condition that affects the top of the tongue and the cause is unknown. Many texts will describe an association with elevated Candida carriage and in some instances yeast can be detected, but in many individuals yeast can be detected without these classic presentations.

The name "geographic tongue" is a descriptive account that the lesion looks like a rugged coastline on a map. The other term also describes the nature of this lesion: "benign" or not generally harmful; "migratory" or ever changing its location on the tongue; and finally "glossitis" or tongue inflammation.

Some reports indicate a female predilection for this condition (2:1) and that it is observed in 1-5% of the population. The location of this condition is generally confined to the anterior two-thirds of the tongue and may involve the tip and lateral borders.

Major problems associated with having this occur besides the appearance is that you may be more sensitive to hot or spicy foods, salty foods, and alcohol-based products.

There is no real treatment except palliative care. In some cases, the irritation and burning is severe enough that topical steroids or local anesthetic may be used.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University