Contents
What is glossitis?
Glossitis is an inflammatory disease of the tongue that is usually caused by a bacterial or viral infection. This pathology is characterized by a change in the color of the tongue, its structure, color and appearance as a whole become different. If ulcerative defects form on the tongue, plaque forms or its natural color changes, this acts as a violation signal. There are several varieties of glossitis. They differ in symptoms and causes of the pathological process. Sometimes glossitis does not act as an independent disease, but as a consequence of another pathology present in the body.
Glossitis is not a harmless disease, as it affects the neck. It develops in both adults and children. Elderly patients often suffer from glossitis. To cope with inflammation, you need to find out the cause of its occurrence. To do this, contact your dentist. The doctor will determine the type of disease. If necessary, he will refer the patient to another specialist. Sometimes patients need the help of an infectious disease specialist, a gastroenterologist, an immunologist, an allergist.
ICD code
ICD-10: K14.0
ICD-10-KM: K14.0
ICD-9-KM: 529.0
Causes of glossitis
As mentioned above, glossitis can act as an independent disease, or it can be the result of a pathology of the body. Bacteria (streptococci and staphylococci), herpes viruses and fungal flora are capable of provoking an inflammatory process.
If the disease is of a non-infectious nature, then a trauma to the tongue can serve as an impetus for its development. It can be injured by fragments of teeth, sharp edges of dentures or fillings. The tongue is a delicate organ; chemical irritants, as well as exposure to high temperatures, can break the integrity of its membranes. Increases the likelihood of developing glossitis in people who abuse alcohol and smoke a lot.
Other risk factors for developing glossitis include:
The use of hot dishes and drinks, spices and caramel
Poor oral hygiene
Using mouth fresheners or toothpaste too often and in excess
Using someone else’s toothbrushes
Wearing braces and dentures
Tongue piercing for earring
Glossitis can be the result of pathologies such as:
Vitamin deficiency (E, A, B12, folic acid)
Diseases of the dermis
Dry mouth
Anemia
Measles and scarlet fever
Diphtheria
Diseases of the digestive system
Infection with worms
Lichen planus
Allergy
Stomatitis
Rheumatism
Uncontrolled intake of antibacterial drugs.
The chronic form of the disease can be triggered by dysbacteriosis or a general drop in the body’s immune forces. At the same time, autoantibodies are produced in it, which increase inflammation.
Symptoms of glossitis
The symptoms of glossitis are varied. They depend on what exactly caused the development of inflammation. Examination of the oral cavity by a dentist allows the doctor to suspect the etiological factor of glossitis, focusing on its signs.
However, there are general symptoms that characterize inflammation of the tongue in general:
A plaque forms on the surface of the tongue, spots may form.
Often glossitis is combined with ulcerative stomatitis.
The color of the tongue changes. Moreover, it can become a different color both over the entire surface and partially.
The tongue is swollen. Sometimes the swelling is very intense.
Often the mobility of the tongue is limited.
An unpleasant odor will come from the mouth. This phenomenon is called halitosis. Bad breath indicates an overgrowth of bacteria.
Often the symptoms of glossitis are combined with a deterioration in taste sensations. Patients complain of burning and soreness in the oral cavity. All unpleasant symptoms are aggravated by eating food and by trying to move the tongue.
The general well-being of the patient is not disturbed. If this happens, then serious diseases of the internal organs can be suspected.
Types and forms of the disease
According to the severity of the pathological process:
Deep glossitis. Inflammation extends to the entire tongue, to its entire thickness. Ulcers and abscesses may form. If there is no treatment, then the pathological process can spread to the neck. This situation is hazardous to health.
Superficial glossitis. It can be confused with stomatitis, since only the surface of the tongue is affected. The disease has a mild course, most often it goes away on its own.
By symptoms:
Desquamative glossitis (geographic language). This form of the disease develops due to pathologies of the digestive tract, or against the background of a viral infection. Most often, the disease is diagnosed in women. First, a light spot is formed on the tongue, which will be small (no more than a few mm). Then it becomes larger, acquires a pink color. If there is no treatment, the spot will continue to grow in size. In many ways, the progression of the pathology depends on the emotional state of the patient.
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Candida glossitis. This disease got its name from the name of the fungus that provokes it. In this case, the inflammation will be due to the pathological growth of fungi of the genus Candida. Also, a similar glossitis is called fungal or yeast. The disease develops against the background of a decrease in immunity, which will not be able to restrain the growth of pathological flora. The chronic form of candidal glossitis has a latent course. An exacerbation occurs against the background of respiratory or other infections that affect the body. At risk for the development of candidal glossitis are children and the elderly. Therapy is based on taking antifungal drugs and immunostimulants.
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Gunter’s glossitis or Mellera-Guntera’s glossitis. This form of the disease is secondary, as it indicates the development of pernicious anemia. The papillae of the tongue become smooth and begin to die. The tongue acquires a crimson color, it becomes shiny, as if varnished. Therapy is reduced to taking folic acid and vitamin B12. This will eliminate the cause of the pathology.
Rhomboid glossitis. An oval or rhombus appears on the tongue, which has a red-blue color. It is located in the back of the body. The rhombus appears due to the fact that the epithelium of the tongue becomes thicker. The disease goes through three stages: flat (lacquered tongue), tubercular (dense tubercles appear), papillomatous. If papillomas are injured, then the likelihood of their degeneration into malignant neoplasms increases. This type of glossitis most often develops due to malfunctions in the functioning of the digestive system. Treatment must be appropriate.
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Catarrhal glossitis, which develops against the background of stomatitis. It can occur due to the fact that the tongue is often injured by teeth, dentures or tartar. The danger in terms of the development of catarrhal glossitis is represented by chemical and thermal injuries, intoxication of the body. Sometimes alcohol abuse and smoking lead to inflammation. To cope with the disease, you need to get rid of the cause that provoked it.
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Atrophic glossitis. With this disease, the papillae completely disappear or become barely noticeable. The muscles of the organ begin to die, it itself decreases in size. As scientists suggest, the disease develops due to infection, but the exact causes of its occurrence remain unknown today. To cope with atrophic glossitis, it is necessary to identify the pathogenic flora that led to the development of inflammation and eliminate it. Also, the patient is shown taking vitamins A and E.
Aphthous (ulcerative) glossitis. This form of the disease is also called ulcerative or erosive-ulcerative glossitis. Aphthae and ulcers begin to form on the tongue, which bleed heavily over time. An unpleasant odor will come from the mouth, and the tongue itself will be covered with a grayish coating. Aphthous glossitis is a consequence of catarrhal glossitis.
mycotic glossitis. This form of inflammation develops when the ENT organs are infected with fungal flora (fungal tonsillitis or fungal pharyngitis). The tongue increases in size, furrows, white spots appear on it. To cope with inflammation, you need to get rid of the underlying fungal infection.
Folded glossitis. This type of glossitis is caused by genetic mutations. The disease is diagnosed in a person from birth, so he gets used to it and does not experience any inconvenience. Treatment is rarely required when a person begins to suffer from discomfort. In the language of such people, multiple folds are formed. Therapy is carried out in the case when patients have a deficiency of vitamins in the body, the upper layer of the tongue begins to keratinize. It can hurt, become covered with cracks. Then the patient is recommended to take vitamin-mineral complexes.
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Phlegmonous glossitis. At the same time, both the tongue itself and the lower part of the oral cavity, neck and chin are involved in the process of inflammation. The patient’s state of health worsens, which is due to the developing abscess and the formation of phlegmon. Body temperature rises, headache appears. It hurts to move the tongue, it swells a lot, and can lead to breathing problems. Therapy is required by patients immediately after the first signs of inflammation appear. The patient is prescribed antibiotics, and purulent formations are removed surgically.
Allergic glossitis. It develops due to an allergy to oral care products. The tongue begins to burn, it swells and itches. Sometimes the body becomes very red. To cope with the disease, you need to eliminate any contact with the allergen and detoxify the body. It is not difficult to prevent a recurrence of the pathology, you just need to stop contacting the allergic substance.
Villous glossitis. The papillae of the tongue, which are located in its central part and on the back of the organ, become black. This is the first symptom of the disease. As the pathology progresses, the papillae grow. Their length can reach 2 cm. Until now, the causes of the villous tongue have not been established. The patient needs a comprehensive examination, testing.
Interstitial glossitis. This form of the disease refers to precancerous conditions. As the pathology progresses, the patient develops a malignant tumor. The most common cause of the development of the disease is syphilis. Therefore, this type of glossitis is called syphilitic.
Wandering glossitis. This is one of the varieties of migratory glossitis. The disease is benign in nature. In this case, the picture in the language often changes. Therapy is required when the disease causes discomfort to the patient.
Superficial glossitis. In this case, the upper epithelial layer of the organ suffers. It becomes inflamed, reddens, swells. Movement of the tongue can cause pain, which becomes intense when medications or other irritants come into contact with it. The tongue has a gray or white coating. The disease is caused by pathologies of the digestive system, as well as various infectious processes. To get rid of the problem, you need to eliminate the cause of inflammation.
Herpetic glossitis. This disease develops due to the penetration of the herpes simplex virus into the body. Bubbles are formed on the tongue, which will be filled with transparent contents. This glossitis is contagious. A person experiences a burning sensation, his tongue itches. General health is deteriorating. Herpetic glossitis requires taking drugs to increase immunity and antiviral drugs.
Features of glossitis in children
Glossitis in childhood is often the result of bite problems. Other reasons include: viral and bacterial infections, helminthic infestations, diabetes mellitus, genetic abnormalities. Often, inflammation manifests itself due to the use of hot food or too cold drinks, as well as when dirt enters the mouth.
Often, children under 3 years of age suffer from herpetic stomatitis. If you turn to the dentist in time, you will be able to cope with inflammation quickly.
The main causes of glossitis in children are:
Poor oral care.
Injuries to the tongue that children receive due to falls.
Allergy to dental fillings.
Poorly placed seals.
Pathological inflammation on braces, plates or other structures designed to correct the bite.
Frequent biting of the tongue by the child.
Tongue injury from hot or cold foods. In this case, the likelihood of infection is increased, which in the future will provoke an inflammatory reaction of the body.
Infestation with worms or other parasites.
Diabetes mellitus in childhood often leads to candidal glossitis. To provoke a fungal glossitis can take antibiotics.
Reduced immunity in a child.
Diseases that can cause glossitis in childhood:
Diabetes.
Atopic dermatitis.
Pathology of the endocrine system.
Any infections.
Diseases of the blood.
Diseases of the digestive system.
Sometimes children do not complain about inflammation of the tongue. Therefore, parents should regularly examine the child’s oral cavity. Although in some cases, children show some anxiety, become capricious, indicate pain in the mouth.
Diagnostics of the glossitis
If glossitis is accompanied by severe symptoms, then the dentist can understand the cause of the disease after the initial examination.
To clarify the diagnosis, you will need to perform the following diagnostic methods:
Blood donation for general and biochemical analysis. This will confirm the presence of inflammation and assess its intensity.
The surrender of saliva to identify the infection in it, which caused inflammation.
Ultrasound of the digestive system.
If it is not possible to make an accurate diagnosis, then the patient is prescribed additional examinations:
RPR test to detect antibodies to cardiolipin antigen.
Scraping from the tongue with its further microscopic examination.
Cytological analysis.
Serological tests for syphilis.
ELISA for the detection of antigens
Blood test to determine the level of vitamin B12.
When the diagnosis is clarified, the doctor will prescribe the necessary treatment for the patient.
Treatment of glossitis
Treatment of different forms of glossitis may have specific nuances. The duration of therapy is affected by the type of disease, the severity of the course, and the characteristics of clinical symptoms.
Regardless of the form of glossitis, first of all, it is necessary to eliminate the mechanical, chemical causes of the disease. The first professional help will be provided by a dentist. He will cure carious teeth, correct dentures, check the condition of crowns, adjust braces.
For the full treatment of glossitis in adults, it is necessary to use a whole group of drugs that are selected based on the type of pathogenic agent:
Antiseptic agents.
Antifungal or antibacterial.
Pain relievers.
Anti-inflammatory.
Reparative – necessary to stimulate the process of keratinization of the epithelium.
Additional vitamin therapy with vitamins A and E enhances the effect of drugs aimed at regenerating damaged tissues.
List of drugs used in therapy
Antiseptics affect protein coagulation and oxidation mechanisms in the pathogen cell. These mechanisms inhibit the reproduction of bacteria and their further death. Fungi, gram-positive and gram-negative microorganisms, viruses are unstable to most complex drugs with a wide spectrum of action. Medicines of this group have an antiseptic, anti-inflammatory, analgesic effect.
List of drugs that can have a disinfecting effect:
Solutions: Chlorhexidine, Chlorophyllipt, Furacilin, Borax solution, Methylene blue.
Spray: Hexaspray, Lugol spray, Tantum Verde.
Gels: Kamident, Metrogil Denta.
Tablets: Geksaliz, Geksoral.
Anti-inflammatory drugs inhibit the activity of cyclooxygenase and the synthesis of prostaglandins, which support the inflammatory response. Sprays, gels, solutions for rinsing and applications have a local anti-inflammatory and anti-edematous effect. In addition, the drugs of this group contribute to the restoration of normal blood microcirculation.
Antifungal agents. If a patient is diagnosed with a fungal (candidiasis) glossitis, then the tongue is first treated with antiseptic compounds, and then an ointment (Candide or Pimafucin) is applied. For oral administration, Fluconazole, Nystatin, Diflucan tablets are used.
Antibiotics. Antibacterial drugs are prescribed for glossitis infrequently. Any antibiotics can be used only after consulting a doctor. They are used for purulent glossitis, or for phlegmonous inflammation. They allow you to destroy bacteria and lead to a full recovery. Most often, drugs are used in tablet form: Amoxiclav, Suprax, Cefodox.
Anesthetic drugs. If the pain is very severe, then the patient is prescribed painkillers. They contain novocaine or lidocaine. These products are available in the form of sprays and gels. They are used for topical application.
Hormonal ointments (hydrocortisone or prednisolone) can be used for a short period of time. They allow you to prevent the development of the withering away of the tissues of the tongue.
Wound healing ointments. In order for the damaged tissues of the tongue to recover faster, the patient is prescribed ointments that accelerate cell regeneration. It can be Solcoseryl, Olazol, Carotiline.
Immunomodulatory drugs. To increase the body’s defenses, drugs such as: Viferon, Leukinferon, Kipferon, Interferon alfa, Imudon, Immunoglobulin are prescribed.
Antiviral drugs. With herpetic glossitis, oral antiviral agents will be required. It can be Gerpevir, Acyclovir, Cycloferon.
Multivitamin complexes, including vitamins PP and group B, are able to influence the focus of inflammation, stimulate local metabolism in tissues, and restore damaged cells. Active compounds restore redox mechanisms, expand the lumen of blood vessels.
If a person suffers from pain in the mouth that occurs against the background of drying of the mucous membranes, then it is necessary to treat them with glycerin and anesthesin. These components are pre-mixed with each other.
Treatment of the catarrhal form
The catarrhal form of glossitis most often develops in adult men who abuse smoking. Symptoms of the disease appear and progress in people who often consume spicy foods, alcoholic beverages. With appropriate therapy, uncomplicated catarrhal glossitis is completely cured within a week.
Is it possible to cure catarrhal glossitis at home? Yes, this form responds well to treatment. The main recommendations are to rinse the mouth with an antiseptic solution after each meal. If the inflammation is focal in nature, it is advisable to perform applications.
For rinsing, you can prepare decoctions from medicinal plants, which are known for their antiseptic properties:
Chamomile.
Basil.
Mother and stepmother.
Koriandr.
Sage.
Podmarennik.
Calendula.
If the patient complains of constant dryness of the oral mucosa, oregano and yarrow are recommended, which contribute to profuse salivation.
The treatment procedure consists not only in rinsing the mouth. It should be with a cotton or gauze swab dipped in a decoction, solution, to remove plaque formed on the mucous membrane. After cleansing, a healing gel is applied to the surface. Regular performance of therapeutic procedures can completely eliminate all symptoms of inflammation.
For a faster recovery of the mucous membrane of the tongue and the preservation of the result, the patient must adhere to certain recommendations regarding nutrition:
Give preference to pureed dishes, cereals, mashed soups, vegetable, fish, meat soufflés.
The optimum food temperature is not higher than 40°C.
For the duration of treatment, refuse spicy, spicy, acidic foods, alcohol, carbonated drinks, coffee.
Treatment of the candidal form
If it is established that the cause of glossitis was a fungus, then the treatment is subject to some adjustment:
All antibacterial, corticosteroid drugs are cancelled.
Comorbidities are being treated.
Assign adaptogens, vitamins, biostimulants, bifidumbacterin to restore the protective functions of the body, improve the general condition.
Eliminate foods rich in carbohydrates from the diet.
Mild treatment regimen. To suppress mild candidiasis, treatment of the oral mucosa with a 2% solution of sodium bicarbonate (baking soda), iodinol, and aniline dyes is prescribed. Be sure to irrigate the foci with antiseptics with a fungicidal effect, nystatin (1-2 tablets per 5 ml of milk). All manipulations are performed until the mucosa is completely restored. If all the patient’s complaints have been eliminated, the treatment is continued for another seven days, gradually reducing the number of procedures.
Scheme of treatment of the moderate form. Requires the appointment of Nystatin ointment, gels, aerosols with Clotrimazole, special antifungal chewable tablets. After treatment of the affected area of the mucosa, antifungal compounds practically do not penetrate into the bloodstream. Local preparations of antimycotic action are used for 2-3 weeks. After all the symptoms of the disease pass, the treatment is continued for another 7 days.
Severe form of treatment. If the disease progresses, antifungal drugs are taken orally.
Comprehensive treatment is carried out in a hospital with a mandatory appointment:
Fortifying complexes.
Immunomodulators.
Antiallergic agents.
Probiotics.
The scheme of treatment of the chronic form. Chronic glossitis does not respond well to local antifungal therapy. Antimycotics are unable to be absorbed into the deep layers of the mucosa, therefore, they do not have the proper effect on the foci of fungal infection. A positive effect is possible only after repeated courses of taking specific drugs orally.
An integrated approach implies:
Carrying out a course of general strengthening drugs;
Restoration of physiological intestinal microflora;
Immunocorrection;
Treatment of the underlying disease;
Antiallergic therapy.
Complete oral hygiene is provided by an antifungal toothpaste, such as President Exclusive. From the usual diet exclude sweet foods and drinks. Be sure to regularly consume fermented milk products enriched with bifidobacteria. The patient should receive a large amount of proteins, vitamins.
Treatment of the desquamative form
At the heart of therapy is a complete care for the condition of the oral cavity. Complex therapy consists of a number of activities:
Treatment of dental diseases.
Consultation of a therapist in order to determine concomitant somatic disorders, restore the normal functioning of the gastrointestinal tract.
Elimination of the infectious focus with the help of antiseptics.
Restoration of the normal mucosa.
Appointment of adaptogenic, multivitamin preparations.
Antiallergic treatment.
Reception of sedative phytopreparations.
Treatment of the folded form
The development of folded glossitis is an irreversible process. Treatment is prescribed if the patient has complaints.
If signs of inflammation appear, the following recommendations should be followed:
Rinse your mouth with antiseptic solutions after each meal. Folds are treated with chlorhexidine, 3% hydrogen peroxide solution, decoctions of chamomile or calendula, miramistin.
Perform applications with regenerating, enzymatic agents.
Periodically undergo a course of laser therapy of 5-10 sessions.
These measures contribute to the complete removal of dead cells of the epithelium, the restoration of the mucous membrane. If the treatment of the underlying disease requires the use of corticosteroids or antimicrobials, the patient is regularly examined by a doctor. This is necessary for the early detection of candidal foci. In this case, irrigation is prescribed with antifungal solutions, aniline dyes.
Diamond shape treatment
If the patient does not present any complaints, specific therapy is not required. In the event of symptoms of inflammation, an integrated approach is required:
To give up smoking.
Examination of the oral cavity, elimination of probable etiological factors.
Mouth rinse and local applications with antiseptic solutions.
When establishing the fact of a fungal infection, the appointment of specific anticandida drugs.
If necessary, use sedatives, tranquilizers.
In the case of tissue proliferation with tuberculous or papillomatous glossitis, surgical intervention is necessary.
Possible complications
If the symptoms of glossitis are ignored by a person, then he will definitely develop complications of the disease.
They may show signs such as:
The pain starts to radiate to the neck.
Body temperature increases.
Increased salivation.
The tongue greatly increases in size.
Inflammation of the tongue can lead to the development of phlegmon.
Symptoms characteristic of this complication:
Swelling of the mouth and neck.
Suppuration of the tissues of the tongue.
Difficulty with breathing.
Refusal to eat, increased weakness.
Increased body temperature.
The general health of the patient is deteriorating, signs of intoxication of the body are growing. This complication requires emergency medical attention.
Prognosis and prevention
If the treatment was started on time, the disease does not lead to serious complications. In other cases, the likelihood of developing an abscess, phlegmon, and even a cancerous tumor increases.
To prevent the development of glossitis, the following recommendations must be observed:
Your mouth and teeth need to be taken care of daily. Orthodontic designs must be verified and not injure the tongue.
Bad habits should be abandoned. This applies to alcohol abuse, smoking, chewing foreign objects.
The menu should be balanced.
Spend as much time as possible outside. It is good if a person is hardened and leads an active lifestyle.
Allergic reactions must be prevented and eliminated in time.
It is important to undergo preventive examinations at the dentist, gastroenterologist and otolaryngologist.
Children must be vaccinated according to the national calendar. Infants should not be switched to formula unless indicated to do so.
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