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Geographic Tongue

July 15, 2019

This is a type of lesion is inflammatory in nature, and it usually affects the top and sides of the tongue. The tongue is covered with very small mushroom shaped raised points called papilla, at the base of which is the taste buds. The Geographic Tongue looks like a map, with the “oceans” containing no papilla and therefore looks smooth or red, if it is inflamed. There is a “coastline” that is a white irregular border along the edge of affected areas of the tongue.

The clinical term is benign migratory glossitis.

  • Benign – as it does not spread.
  • Migratory – as the lesions may also completely disappear for a period of time and then reappear and move in position.
  • Glossitis – “Gloss” Latin for tongue and “itis” inflammation of – in this case – the tongue.
Left: Geographic tongue - loss of taste buds; Right: The normal tongue

Sometimes, similar appearing lesions occur in other area of the mouth, such as the palate, cheeks, under the tongue, or on the gums. These lesions are known as geographic stomatitis (or erythema migrans). Stoma is Latin for mouth.

The cause of geographic tongue is unknown and is a fairly common condition that can occur any time in life. About 1 – 2.5% of the population are affected. Several possible causes such as emotional stress, psychological factors, habits, allergies, diabetes and hormonal disturbances factors have been proposed. However, none of these factors have been conclusively proven to cause geographic tongue. Geographic tongue and fissured tongue commonly occur together. Fissure is basically a deep groove in a structure. This can be difficult to keep clean.

Geographic Tongue with fissured tongue

Treatment

Geographic tongue is not contagious and usually has no symptoms. Usually there is no need for treatment. Sometimes there is a burning sensation.  Topical anaesthetics can be used for surface numbing and anti-inflammatory drugs (cortisone-like drugs) also may be used to help control the discomfort.

Finally, there have not been any cases of geographic tongue, causing cancer. Usually, it’s not necessary to use a biopsy to prove the diagnosis of geographic tongue because it’s identifiable clinical features.

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