Thursday November 6, 2003
Dear Dr. Mady: I took my daughter to the doctor because her tongue is burning off and on and looks real abnormal at times. He said she probably has geographic tongue and that it is nothing to worry about. What is it and is he right? –JJJ.
Dear JJJ: Geographic Tongue is a very common condition of the tongue and probably a lot more common than you and your daughter realize. It is also known as “benign migratory glossitis” or “erythema migrans”. It is relatively harmless and often it goes unnoticed because it is mostly asymptomatic.
Geographic Tongue usually appears as slightly depressed smooth (sometimes rough or crater-like) patches on the surface of the tongue. The outside border or outer edges of the tongue however are usually white in color. It is described as geographic due to the fact that the lesions appear like a map of an unknown country or like a bunch of islands. It has been reported to be more common in individuals with diabetes, psoriasis and that have deep fissures (grooves) in their tongue. If symptoms exist they usually manifest as a slight irritation or burning sensation that becomes exaggerated with spicy or hot foods. It sometimes even occurs in oral tissues other than the tongue.
We don’t really know what causes Geographic Tongue, but we do know that it appears in at least three percent of the population and is twice as often noticed in adult females than males or children. Histological studies describe an inflammation-like appearance, and it has been suggested that genetics may play a role in the etiology or cause.
Some affected patients have been found to have zinc deficiencies but any definitive cause is non-existing. Hormones may play a role because women taking oral contraceptives have the worst geographic tongue on day 17 of their cycle (British Dental Journal-Aug 1991). Stress seems to be a factor, for occurrence is greater at these times.
There is usually no loss of sense of taste or dexterity but increased loss of the tongue’s sense of touch has been noted. The appearance and common belief that infection exists, is what causes concern and leads affected individuals to seek treatment. It will disappear occasionally quickly and sometimes months later. Treatment is available if it is decreasing your daughter’s quality of life by way of certain steroids, usually topical. However, some of the stronger steroids may produce side effects that outweigh the benefits of the therapy. Treatment does not permanently cure this condition but provides significant improvement of symptoms. Her dentist should be able to provide you with information about treatment. Just be comfortable with the fact that Geographic Tongue is harmless and will resolve on it’s own after outbreaks, even without treatment.
This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5