Tongue Problems (cont.)

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Abnormalities of the tongue surface

Smooth areas of the tongue may be related to injury (food burn) or a nutritional deficiency of iron, folate, or vitamin B12. A smooth tongue can also result from the use of dentures.

"Geographic tongue" (or benign migratory glossitis) is the most common tongue condition. It is found in up to 14% of the U.S. population. It is a benign condition that appears as bare or smooth areas on the dorsum of the tongue. It may be one area or several areas and may even vary from time to time. It is usually painless; however, the smooth areas may have sensitivity to spicy or acidic foods for some individuals. No treatment is recommended.

Fissured tongue is the second most common tongue condition and is characterized by a deepening of normal tongue fissures and is usually associated with aging. Some medical conditions are linked to fissured tongue and include Sjögren's syndrome, psoriasis, Down syndrome, and acromegaly. No treatment is required unless food debris and bacteria get trapped and cause inflammation of the tongue. Gentle brushing should alleviate the problem.

As previously mentioned, hairy tongue is the hypergrowth of the tongue's papillae and is usually associated with white, tan, or black discoloration. Hairy tongue is the third most common tongue condition and is considered harmless. Gentle brushing or scraping of the tongue may be helpful. No other treatment is necessary.

Median rhomboid glossitis is a lesion at the midline of the dorsum of the tongue. It usually looks like a smooth, red, shiny, and sharply defined area. The underlying cause is usually a fungal infection. Treatment options include topical oral antifungal agents such as nystatin (Mycostatin) or fluconazole (Diflucan).

Medically Reviewed by a Doctor on 12/18/2015

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