1.General information
The apt, albeit somewhat frivolous name “geographic tongue” refers to the inflammatory-dystrophic process in the mucous membrane of the tongue, also known as “wandering glossitis”, “migratory oral erythema”, “exfoliative glossitis” (formulation in ICD-10), “desquamative glossitis”, etc. Exfoliative in translation means “flaky”, desquamative means “deprived of scales”, glossitis is inflammation of the tongue. Peeling of the epithelium in combination with inflammation and dystrophic changes together form red and white patterns on the tongue, which in many cases really resemble a fragment of a geographical map.
In different historical periods in medicine, there were different views on the essence and pathogenesis of desquamative glossitis (the term and concept were introduced into the medical paradigm in 1831), and the discussion continues to this day. Thus, some authors consider this process to be neurodegenerative, others to be purely inflammatory, and others generally consider it as a non-pathological variant of the norm.
The prevalence of “geographic language” varies significantly depending on the age, gender, and clinical composition of the studied samples; in terms of the general population, it is estimated at 2-5% of the population. There is a slight predominance of women, children and adolescents.
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Nutritional Features
To speed up the recovery process for geographic tongue, the treatment process should be combined with dietary nutrition. To do this, you need to adhere to the following recommendations:
- Adults need to stop smoking and drinking alcohol.
- Limit consumption of sour, spicy and fatty foods.
- Do not eat excessively hot or cold foods. The food temperature should be optimal.
- Avoid drinking coffee, sweet carbonated drinks, chocolate and cakes.
- The basis of the diet should be low-fat soups, boiled meat and fish, cereals and vegetables. You can also eat eggs, dairy products, nuts, fruits and drink homemade juices in small quantities.
The best prevention is careful oral hygiene.
Moreover, after each meal you should definitely rinse your mouth so that no traces of food remain on your tongue. You need to follow this diet for at least a couple of weeks until the mucous membrane of the tongue is completely restored.
2. Reasons
There is no single point of view regarding the etiopathogenesis of inflammatory desquamation of the tongue; the issue continues to be studied and discussed. According to the most reasoned hypotheses, the cause may be infections (both bacterial and viral), hereditary predisposition, diseases of the liver, pancreas, gastrointestinal tract (primarily gastritis, gastroduodenitis, peptic ulcer and intestinal malabsorption syndrome), endocrine and metabolic disorders, exudative diathesis in children, autoimmune diseases, helminthiasis.
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Prevention
To prevent the development of such a disease, you need to follow some simple preventive rules:
- Promptly treat all diseases that provoke the development of pathology.
- Do not abuse alcoholic beverages, tobacco products, sweet foods and sugar, and strong coffee.
- Take enough vitamins to avoid vitamin deficiency.
- Perform hygiene .
- Treat caries in a timely manner.
There are separate preventive measures for children:
Caring for baby teeth – timely treatment and removal of baby teeth. If a child complains of dry mouth, rinse with herbs such as sage, St. John's wort or chamomile.
Brushing your teeth should be done only with toothpastes, since the powders contain mint oil and menthol, which are bad for the oral mucosa in children.
3. Symptoms and diagnosis
The first manifestations are usually small, up to several millimeters, light gray lesions. Then such an area from the center turns red and swells somewhat, beginning to protrude above the surface and become covered with red papillary dots. The shape of desquamation foci can be very different, from round to arched. The alternation of inflamed, exfoliated and keratinized areas (usually they are multiple) forms a bizarre picture that can change quite quickly. The process is usually localized on the upper and lateral surfaces of the tongue, sometimes spreading to the lower areas.
In rare cases, desquamative glossitis causes subjective discomfort at the level of sensations - usually a burning or tingling sensation, less often pain when eating. In most cases, the disease is asymptomatic, for years or even decades; A recurrent (recurrent) type of course with long-term remissions is often noted.
To establish a diagnosis, an examination, collection of complaints (if any) and anamnesis are usually sufficient. However, given the importance of desquamative glossitis as a possible indicator of serious diseases, a multifaceted laboratory study is indicated (they begin with the appointment of general clinical and biochemical tests).
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Preventive measures
To reduce the likelihood of developing a condition such as geographic tongue, it is important to adhere to the following prevention recommendations from specialists:
- Consult a doctor in a timely manner and treat any pathologies of the oral cavity and teeth, including. Thus, even when the first unpleasant sensations appear in your mouth, you should immediately contact your dentist.
- Monitor the normal level of B vitamins in the body. To do this, you should regularly undergo clinical tests. Also, in order to prevent vitamin deficiency, it is important to enrich your diet with foods rich in B vitamins. These primarily include fish, legumes, all types of salad greens, dairy products and cereals. These products should be consumed regularly, at least five times a week.
- Give up bad habits, especially smoking and drinking alcohol.
- Limit consumption of coffee, hot drinks, sweets and spicy foods.
- It is important to regularly maintain good oral hygiene and also brush your tongue so that pathogens do not accumulate on it.
- You should rinse your mouth with special antibacterial solutions at least twice a day.
- Promptly treat any pathologies of the digestive system that can affect the development of glossitis.
- When severe chronic diseases are identified, they must be treated and maintained in a stable course, avoiding exacerbations. This will significantly reduce the risk of developing glossitis, as well as other complications.
- Promptly identify and treat caries, during which the development of the process of demineralization of hard tooth tissues is observed. To do this, you need to visit the dentist at least twice a year for a preventive examination.
- Treat acute viral or infectious lesions of the human body systems in a timely manner.
4.Treatment
In cases of asymptomatic disease, if there are no signs of underlying somatic diseases, therapy is not required and is not prescribed. The exception is the mandatory sanitation of problematic teeth and oral cavity, as well as normalization of the diet - which, however, is indicated for absolutely all people.
If there are symptoms of a particular disease that may be the cause or basis for the development of desquamative glossitis, the patient is referred to a specialist of the appropriate profile, where he receives etiopathogenetic treatment.
To treat or not to treat: doctors' opinion
It is interesting that some experts consider desquamative glossitis to be a normal variant or a feature of the body. Especially if it appears in childhood and during puberty. And then doctors only offer wait-and-see tactics and observation, claiming that sooner or later everything will go away on its own. But this, of course, is only provided that a comprehensive examination of the body has been carried out and no causes have been identified.
Expert opinion
Alina Vyacheslavovna Fedulova
Specializations: Dentist-therapist, hygienist
Experience: 5+
“Geographic language in itself is not dangerous in a child or adult. Does not contribute to the deterioration of well-being, does not affect the quality of life (only from a psychological point of view). It does not degenerate into oncology and is not considered contagious. In many children, it tends to go away on its own, so it is not always treated if the cause has not been established and all possible factors have been excluded. However, sometimes the cause that provokes the appearance of desquamative glossitis can pose a threat to the body, and therefore this symptom obliges adults to conduct a comprehensive examination of the child and, if necessary, undergo specific treatment.”
What is glossitis?
Glossitis (from the Greek glossa (tongue) + suffix –itis) is an inflammation of the tongue. The reasons for its occurrence are different. Glossitis can develop as a result of a viral or bacterial infection, or as a result of another disease in the body. In addition, there are some other factors that provoke the development of the disease. These include mechanical, chemical and thermal damage to the oral cavity; nicotine; food that is too spicy or too hot; alcohol; caramel; some components present in toothpastes.
Glossitis has the following forms:
- folded
- diamond-shaped median
- desquamative
- hairy black
- Gunter's
- interstitial
According to the duration of the inflammatory process, acute and chronic glossitis are distinguished. The acute form of glossitis manifests itself as inflammation of the tongue, a change in its structure or color. Symptoms of the chronic form are more varied, but in most cases the disease is diagnosed by the presence or absence of papillomas - fungal growths on the tissues of the tongue. There are cases when the cause of the disease can be identified only after comprehensive medical research. True, this happens quite rarely and, as a rule, is associated with the presence of congenital, hereditary diseases.
ethnoscience
Traditional medicine can alleviate the suffering of the patient, speed up the recovery of damaged areas of the tongue, and strengthen the immune system.
The most popular folk remedies are:
- chamomile decoction for antiseptic, healing effect;
- infusion of sage, coriander, basil;
- bedstraw decoction - for healing wounds;
- oil baths;
- aloe applications – for healing and relieving inflammation;
- soda solution with a couple of drops of iodine;
- lotions or rinsing with vegetable glycerin;
- bee products.
It should be remembered that traditional medicine cannot be a replacement for official medicine; without medications it is impossible to cure the original cause of the disease.
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Manifestations of tongue glossitis in children
In children, glossitis usually occurs at an early age - from 1 to 5 years. The causes of this pathological process have not yet been fully studied and can be very diverse: from infection to poor heredity. Externally, glossitis in children is manifested by the appearance of spots on the tongue, which slightly swells and itches. Itching and a burning sensation are the most unpleasant signs of glossitis, since a small child begins to scratch the tongue, thereby contributing to the appearance of microcracks with their subsequent infection. However, the disease does not pose a threat to the child’s life. The famous pediatrician Komarovsky does not recommend panicking about this and self-medicating by giving the baby serious medications. As a rule, multivitamins and a gentle regimen will have a positive effect within a week.
