Geographic Tongue -- Top 10 Causes and
Cures
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July 5, 2010, last updated February 16, 2013

By Louise Carr, Associate Editor and Featured Columnist

[Health and fitness articles are reviewed by our team of Doctors,
Registered Nurses, Certified fitness trainers and other members of
our Editorial Board.]




Chances are, you won’t have heard of geographic tongue,
although you may have experienced this distressing
condition without ever giving it a name. Figures of exactly
how many people are affected by geographic tongue vary.
According to the authoritative review study concluded in
1992 --called "Incidence of tongue diseases based on
epidemiologic studies" by Drs. Dombi and Czeglédy,
geographic tongue affects around 3 percent of adults
worldwide. The incidence in the US is the same.  This
means that  geographic tongue  currently affects over 3
million people in the U.S. What causes geographic tongue?
Are there any natural remedies for geographic tongue? Are
there any foods that help geographic tongue or foods you
should avoid if you have geographic tongue?

What Is Geographic Tongue?

Geographic tongue is so-called for the ‘map-like’ effect the
condition produces on the tongue. People with geographic
tongue often say that their "tongue is ugly".  Geographic
tongue is usually painless and characterized by smooth red
patches ringed with grayish-white borders. The small
patches can change their location regularly, coming and
going in a period of hours or days. While the condition
doesn’t normally cause pain, you may experience a stinging
or burning sensation after eating certain foods.

Geographic tongue is a benign condition. It is much more
annoying than it is dangerous. It can look alarming, but
geographic tongue is not a sign of anything more serious.

Geographic tongue sometimes is also accompanied by
fissures in your tongue. Fissures are long grooves or cuts
in the top surface of your tongue.

What Causes Geographic Tongue?

No one really knows exactly what causes geographic
tongue, also known as benign migratory glossitis, erythema
migrans or  annulus migrans.

Geographic tongue occurs as the skin on the tongue is shed
unevenly; the skin that stays on too long takes on a white
appearance, the skin that is shed too soon looks red and
sore. Geographic tongue usually heals by itself but there
are things you can do to lessen its inconvenience and
prevent pain and anxiety.

Top 10 Causes and Cures for Geographic Tongue



























1. Foods That Cause Geographic Tongue

Sour or spicy foods can cause geographic tongue. Certain
foods can cause your tongue to react in a negative way and
make the signs of geographic tongue more prominent and
irritating.

Spicy foods and sour foods may cause burning or a slight
swelling of the tongue. The main culprits are chilies as well
as citrus fruits. Less obvious irritants include tomato,
eggplant, walnuts, strong cheeses and certain strongly-
flavored candy. Mouth washes and tooth whiteners,
particularly those with strong flavor or intense whitening
agents, are also suspects. Spicy foods don’t affect
everyone, however. A study published in Conn's Current
Therapy, 2007, found about 5 percent of geographic
tongue sufferers were irritated by hot or sour foods. Try to
avoid tobacco and alcohol if you’re experiencing a flare-up.

2.
Genetics Play A Part In Geographic Tongue

Geographic tongue tends to run in families. It has what is
called "polygenic inheritance", which means it is associated
with many different genes. Its hereditary characteristic was
first evidenced in Oral Surgery, Oral Medicine, and Oral
Pathology, November 1976.

Adults are more likely to be affected by geographic tongue
than children (Kleinman DV, Swango PA, Pindborg JJ.
‘Epidemiology of oral mucosal lesions in United States
schoolchildren: 1986-87’).

A 2007 study by Guimarães demonstrated a specific gene
variant is associated with an increased risk of developing
geographic tongue (Guimarães AL, Correia-Silva Jde F,
Diniz MG, Xavier GM, Horta MC, Gomez RS. ‘Investigation of
funcational gene polymorphisms: IL-1B, IL-6, and TNFA in
benign migratory glossitis in Brazilian individuals’) but
further research is needed to pin down the exact genetic
influences involved in the condition.

3.
Allergies Can Cause Geographic Tongue

It’s not a highly proven link, but geographic sufferers are
also more likely to be affected by allergies, eczema and
asthma. This link was demonstrated in the August 1984
issue of Oral Surgery, Oral Medicine, and Oral Pathology.

[Update:

Geographic tongue now has been strongly linked with
asthma and rhinitis. A 1984 study by Marks and Czarny of
the Monash University Department of Medicine in Australia
discovered that found that 50% of patients who had
allergies or rhinitis also had geographic tongue.  Those
suffering from both conditions seem to have a common
sensitivity to external surfaces and environments, the
researchers concluded. This finding has now been
confirmed by later studies. ]


4.
Stress Can Cause Geographic Tongue

Due to uncertainty about its causes, many experts have
looked to stress levels as a way of explaining seemingly
random occurrences of geographic tongue. A 2010 study
from the Department of Oral Medicine, Oral Pathology and
School of Dentistry, Shiraz University of Medical Science,
Shiraz, Iran found that there was an association between
geographic tongue and stress.

Decreasing stress in a geographic tongue sufferer caused
the legions on the tongue to heal more quickly. The study
looked at 60 patients with geographic tongue and 60
without, measuring their stress levels with a questionnaire
and psychological evaluation. (Read more about
foods that
help to fight stress)

5.
Vitamin B Deficiency May Cause Geographic Tongue

A deficiency in Vitamin B12 can cause cracks on the tongue.
Moreover, people suffering from geographic tongue report
that taking Vitamin B supplements helps their red tongue
patches go away.

So, taking Vitamin B12 supplements may work for you, but
further research is required for the link to be conclusively
proven.

Pernicious anemia, a condition caused by a deficiency of
vitamin B12, may also give the tongue a pale and smooth
appearance.

6.
Hormonal Changes Affect Geographic Tongue

You are more likely to suffer the ill effects of geographic
tongue if you are a woman, and even more likely to
experience the condition during ovulation, pregnancy or
menopause.

Watch your calender if you have geographic tongue. The
condition is associated with times when strong hormonal
changes take place. Taking the birth control pill, generally
around the 17th day of the cycle (British Dental Journal,
August 1991), can also make symptoms worse.

7.
Psoriasis Can Cause Geographic Tongue

Studies document that sufferers of psoriasis, a skin disease,
are also more likely to be affected by geographic tongue.
In a 1992 study of patients with psoriasis, geographic
tongue was present in 10 percent of all cases, in contrast
to only 2.5 percent in the age- and sex-related controls
(Morris LF, Phillips CM, Binnie WH, Sander HM, Silverman
AK, Menter MA. ‘Oral lesions in patients with psoriasis: a
controlled study’).

A 1996 study attempted to decipher why people with
psoriasis also had geographic tongue and concluded that a
certain type of HLA (an antigen, a substance that stimulates
the production of an antibody) called HLA-Cw6 was found
in over 50 percent of patients with psoriasis and in more
than 43 percent of patients with geographic tongue
(Gonzaga HF, Torres EA, Alchorne MM, Gerbase-Delima M.
‘Both psoriasis and benign migratory glossitis are
associated with HLA-Cw6’).

8.
Mint Gum Can Cure Geographic Tongue?

There is unfortunately no known cure or conclusively
tested remedy for geographic tongue. There are several
ways in make the condition less irritating, such as chewing
mint leaves or sucking some cooling mint gum. This can be
particularly helpful if you have mistakenly eaten a chili-rich
dish and need to stop your tongue from burning. Chewing
gum keeps the mouth moist which may help lessen
symptoms. Drink plenty of water as well.

9.
Zinc Supplements Can Lessen Geographic Tongue

If you suffer from geographic tongue, try zinc
supplements. It’s been suggested that a zinc deficiency
may be responsible for some incidences of geographic
tongue. Zinc supplements may lessen the effects of the
condition in this case but will not remove it completely.

10.
Topical Gels Improve Geographic Tongue

Often no medical intervention is needed and geographic
tongue will go away on its own. If you need some relief
during a flare-up, anti-inflammatory steroids applied
topically can clear the red patches.

Experts promote treatment with cyclosporine and topical
and systemic antihistamines (Sigal MJ, Mock D.
‘Symptomatic benign migratory glossitis: report of two
cases and literature review’, 1992). Topical anesthetics,
topical corticosteroids and antifungals may also be used to
stop the burning symptoms. If you also have psoriasis,
your red lesions may lessen through treatment of this
condition.

Update:

11.
Use Ointment to Treat Geographic Tongue

Researchers at Tohoku University in Sendai, Japan have
discovered in 2010 that geographic tongue can be
successfully treated with topical application of 0.1%
tacrolimus ointment. These cases were described as
"painful and persistent" geographic tongue.


[Meet the
Doctors and Nurses on our Medical Review team.]



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