What Is Geographic Tongue?

What Geographic Tongue Is

Geographic tongue is a harmless condition that shows up as smooth red patches on the top or sides of the tongue. It is a type of glossitis, and it is also known as benign migratory glossitis or erythema migrans (not the same as the erythema migrans rash linked to Lyme disease). The condition is not dangerous, though the patches can be uncomfortable, and little is known about exactly what triggers it, so there is not much you can do to prevent it.

Signs and Symptoms

Geographic tongue can be hard to spot because many people have no clear symptoms at all. When symptoms do appear, they usually take the form of small, irregularly shaped patches on the top or sides of the tongue that sit in map-like formations, which is where the name comes from. The patches are typically smooth and red, though some are pink or white, and they are sometimes ringed by a white, gray, or yellow border. They can change size, shape, and location within hours, sometimes starting on top of the tongue and spreading to the sides. Some people feel pain or burning, especially after eating spicy or acidic foods, and in rare cases there can be tenderness in the lymph nodes.

What Causes It

The exact cause of geographic tongue is still unknown. It tends to run in families, so genetics likely plays a role. It is also associated with psoriasis, since people with psoriasis are more likely to develop tongue lesions, though the connection is not well understood and some clinicians think geographic tongue may be an oral form of psoriasis, with both possibly worsened by stress. That link rests mostly on anecdotal evidence rather than firm research. Other conditions loosely associated with geographic tongue include juvenile diabetes, reactive arthritis (Reiter's syndrome), fissured tongue, and certain allergies such as nickel sulfate, though again many of these associations are anecdotal and need more study.

How It's Diagnosed

Dentists often diagnose geographic tongue simply by seeing its telltale patches during a routine checkup, and they may look for it when a patient mentions a burning sensation. A typical exam involves looking closely at the tongue and mouth with a lighted instrument, and the dentist or hygienist may ask you to move your tongue into different positions for a better view. They may gently touch the tongue to check its texture and response, and look for any signs of infection such as swollen lymph nodes.

Treatment and Managing Symptoms

Geographic tongue usually clears up on its own, and many people never even realize they have it, especially when symptoms are mild and pass quickly. Others go through cycles of the patches fading and returning. Targeted treatment is generally not needed, but if the condition is uncomfortable a dentist or physician may suggest simple measures such as an anesthetic mouth rinse, an antihistamine rinse, a corticosteroid rinse, or over-the-counter pain relievers. You can also ease symptoms by avoiding spicy and acidic foods, hot drinks, tobacco, and whitening or tartar-control toothpastes, and by drinking plenty of water or chilled herbal tea. If patches persist or the discomfort is significant, the team at Omega Dental Specialists in Houston can take a look and rule out anything else.