Causes, incidence, and risk factors

• Bacterial or viral infections (including oral herpes simplex).

• Poor hydration and low saliva in the mouth may allow bacteria to grow more readily.

• Mechanical irritation or injury from burns, rough edges of teeth or dental appliances, or other trauma

• Tongue Piercings

• Exposure to irritants such as tobacco, alcohol, hot foods, or spices.

• Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in confectionery, plastic in dentures or retainers, or certain blood-pressure medications.

• Administration of ganglion blockers.

• Disorders such as iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies, oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris, syphilis, and others.

• Occasionally, glossitis can be inherited.

• Albuterol (bronchodilator medicine)

A painful tongue may be an indication of several underlying serious medical conditions and nearly always merits assessment by a doctor or dentist.

The goal of treatment is to reduce inflammation. Treatment usually does not require hospitalization unless tongue swelling is severe. Good oral hygiene is necessary, including thorough tooth brushing at least twice a day, and flossing at least daily. Corticosteroids such as prednisone may be given to reduce the inflammation of glossitis. For mild cases, topical applications (such as a prednisone mouth rinse that is not swallowed) may be recommended to avoid the side effects of swallowed or injected corticosteroids. Antibiotics, antifungal medications, or other antimicrobials may be prescribed if the cause of glossitis is an infection. Anemia and nutritional deficiencies must be treated, often by dietary changes or other supplements. Avoid irritants (such as hot or spicy foods, alcohol, and tobacco) to minimize the discomfort.

Good oral hygiene (thorough tooth brushing and flossing and regular professional cleaning and examination) may be helpful to prevent these disorders. Drinking plenty of water and the production of enough saliva, aid in the reduction of bacterial growth. Minimize irritants or injury in the mouth when possible. Avoid excessive use of any food or substance that irritates the mouth or tongue.

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Dysgeusia

Dysgeusia is the distortion of the sense of taste. An alteration in taste or smell may be a secondary process in various disease states, or it may be the primary symptom. The distortion in the sense of taste is the only symptom, and diagnosis is usually complicated since the sense of taste is tied together with other sensory systems. Common causes of dysgeusia include chemotheraphy and zinc deficiency. Different drugs could also be responsible for altering taste and resulting in dysgeusia. Due to the variety of causes of dysgeusia, there are many possible treatments that are effective in alleviating or terminating the symptoms of dysgeusia. These include artificial saliva, pilocarpine, zinc supplementation, alterations in drug therapy, and alpha lipoic acid.

The alterations in the sense of taste, usually a metallic taste, and sometimes smell are the only symptoms. The duration of the symptoms of dysgeusia depends on the cause. If the alteration in the sense of taste is due to gum disease, dental plaque, a temporary medication, or a short-term condition such as a cold, the dysgeusia should disappear once the cause is removed. In some cases, if lesions are present in the taste pathway and nerves have been damaged, the dysgeusia may be permanent.

Diagnosis of dysgeusia begins with the patient being questioned about salivation, swallowing, chewing, oral pain, previous ear infections (possibly indicated by hearing or balance problems), oral hygiene, and stomach problems. The initial history assessment also considers the possibility of accompanying diseases such as diabetes mellitus or cancer. A clinical examination is conducted and includes an inspection of the tongue and the oral cavity.

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