Glossitis

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Glossitis is an inflammation of the tongue characterized by a smooth surface and redness. It can be a sign of local conditions (e.g., allergic reaction, injury) or systemic conditions (e.g., Sjögren syndrome, vitamin deficiencies).

Causes

  • Nutritional deficiencies, such as lack of iron, folate or other B vitamins
  • Allergy to food or medication
  • Bacterial, yeast, fungal or viral infections
  • Trauma, such as a burn or abrasion
  • Alcoholism and tobacco use
  • Eating spicy or hot foods
  • Acid reflux
  • Dry mouth

Types

  • Acute glossitis-it develops usually during an allergic reaction
  • Chronic glossitis- Recurring due to underlying health condition
  • Atrophic glossitis- typically gives the tongue a glossy appearance and may occur when papillae are lost

Signs and symptoms

  • Inflammation of the tongue
  • Loss of papillae on the surface of the tongue
  • Difficulty with chewing, swallowing or speaking
  • Burning sensation
  • Pain or tenderness in the tongue
  • Change in the colour of your tongue
  • Loss of papillae on the surface of your tongue

Investigations

  • Physical assessment of the tongue
  • Samples of the saliva and blood laboratory test

Treatment objectives

  • Reduce inflammation
  • Relieve pain
  • Restore tongue to normal

Non-pharmacological treatment

  • Salt and water gargle

Pharmacological treatment

Paracetamol oral

Adult:

500mg-1g every 6-8 hours

Child:

6-12 years: 250-500mg every 6-8 hours

1-5 years: 120-250mg every 6-8 hours,

3 months-1 year: 60-120mg every 6-8 hours when required

OR

Ibuprofen oral

Adult:

200-400mg every 8 hours 

Child:

100-200mg every 8 hours

Antibiotics may only be used if there is indication of bacterial infection

Amoxicillin oral:

Adult:

500mg every 8 hours for 7 days

Child:

6-12 years:  250mg every 8 hours for 7 days

1-5 years 125mg every 8 hours for 7 days,

<1 year:   62.5mg every 8 hours for 7 days

OR

Metronidazole oral

Adult:

400mg every 8 hours for 7 days

Child:

100-200mg every 8 hours for 7 days