The lingual papillae are reliefs in the lining of the tongue, some of which are involved in the perception of taste. The lingual papillae can be the site of various pathologies due to poor oral hygiene, or they can be prone to lesions or infections caused by other pathologies. 

The lingual papillae are small reliefs in the lining of the tongue. There are four types of lingual papillae all covered with a multi-layered epithelium (cell tissue):

• The goblet papillae, called the lingual V, number 9 to 12. They are arranged in a V-shape at the base of the tongue.
• The smaller and more numerous filiform papillae are arranged in lines parallel to the lingual V on the back of the tongue. They are covered with an epithelium, some cells of which are loaded with keratin (sulfur protein which constitutes the essential element of the epidermis)
• The fungiform papillae are scattered between the filiform papillae on the back and sides of the tongue. In the shape of the heads of pins, they are more pink than the filiform papillae.
• The foliate papillae (or foliaceous) are located at the base of the tongue in the extension of the lingual V. In the form of sheets, they contain lymphoid tissue (immune cells).

In their epithelial lining, goblet, fungiform and foliate papillae contain taste receptors, also called taste buds.

Taste role

Goblet, fungiform and foliate taste buds play a role in the perception of the five flavors: sweet, sour, bitter, salty, umami.

The taste buds contained in the taste buds are endowed with surface receptors which are proteins capable of binding to a given type of molecule. When a molecule clings to the surface of a bud, a signal is transmitted to the brain which sends back a felt message (salty, sweet, etc.) Each bud is wired with a given region of the brain that causes a sensation to be felt. pleasant (sweet) or unpleasant (bitter).

Physiological role

The perception of taste regulates food intake, modulates hunger and helps in choosing foods. For example, acid and bitter are initially rather unpleasant sensations that warn against toxic or spoiled foods.

Mechanical role

The filiform papillae, which do not contain taste buds, have a mechanical role. They form a rough surface on the back of the tongue to limit the sliding of food during chewing.

Taste buds can be prone to various abnormalities and pathologies.

Pathologies linked to poor oral hygiene

• The saburral tongue is characterized by the presence of a grayish-white coating on the back of the tongue due to the clumping of keratins in the filiform papillae. It can be associated with various local, digestive or systemic ailments.
• Villous (or hairy) tongue is a common condition caused by a failure to remove keratin-containing cells. It is characterized by the presence on the back of the tongue of brown-black, yellow or white filaments. It may cause a feeling of impasto, itchiness or a metallic taste. Smoking, alcoholism, taking antibiotics or a dry mouth are predisposing factors.

Geographic language

Geographic tongue is a benign inflammation manifested by the presence of areas of lingual depapillation on the dorsal and / or lateral part of the tongue. The location and shape of the lesions change over time. A geographic tongue can develop with certain drugs (corticosteroids, anticancer drugs) or appear in patients with diabetes or psoriasis.

Oral mucosa lesions

• Erythemas are redness that can develop on the mucous membranes of the tongue in the case of Queyrat erythroplakia, vitamin B12 deficiency or infection by a microorganism (especially Candida yeast)
• Ulcerations are superficial lesions with difficult healing (traumatic ulceration following a cavity or a bite, mouth ulcers, etc.)
• White patches are protruding lesions that may develop as part of leukoplakia, squamous cell carcinoma (malignant tumor of the oral cavity), or lichen planus
• The vesicles, protrusions of small sizes filled with a serous fluid, are observed during inflammations of the oral mucosa viral (herpes, chickenpox, shingles, hand-foot-mouth syndrome)

Inflammation of the taste buds

• Inflammation of the lymphoid tissue contained in the foliate papillae causes benign papillae enlargement
• Kawasaki disease is an inflammation of the blood vessels which manifests itself in particular as a raspberry tongue (swelling of the taste buds)
• Papillitis is an inflammation of the fungiform papillae

Papillae atrophy

Atrophy is a decrease in the building blocks of the oral mucosa. It manifests itself in the following cases:

• Iron deficiency can lead to atrophy of the taste buds with a smooth, glossy appearance of the back of the tongue
• Lichen planus can lead to permanent disappearance of the lingual papillae
• Dry mouth

Pathologies indirectly affecting the role of the taste buds

Certain pathologies disrupt the taste perception system which involves the taste buds, the nervous system and the brain:

• Paralysis of the face
• Inflammation of a facial nerve
• A tumor in the brainstem or thalamus can cause loss of taste, also called ageusia.

Pathologies linked to poor oral hygiene

The saburral tongue and the hairy tongue are treated with regular brushing and scraping associated with the reestablishment of good oral hygiene. The treatment of hairy tongue is also based on the removal of risk factors.

Geographic language

When the inflammation is painful, drug treatments may be considered including topical tacrolimus cream, corticosteroids, retinoids (topical or oral) and ciclosporin.

Other treatments

When the papillae involvement is caused by another pathology, treatment is that of the cause. For example, infections with microorganisms are treated with antibiotics or local antifungals. Papillitis heals spontaneously. 

Healthy and functioning taste buds go first and foremost through good oral hygiene:

• Morning and evening tooth brushing 
• Use of fluoride toothpaste
• Use of food thread
• Annual visit to the dentist 
• Varied and balanced diet

In addition, chewing sugar-free chewing gum after each food intake and alcohol-free mouthwashes are also recommended.