What Causes Glossitis and How Can it Be Treated?

What is Glossitis?

Glossitis is a condition characterized by tongue swelling and inflammation. It can also make your tongue look smooth or discolored. In severe cases, you might notice pain in your tongue or difficulty swallowing.

You can develop tongue swelling quickly or over an extended period. The condition has many causes, including anemia, nutrient deficiencies, and infections.¹ 

While glossitis typically isn’t a cause for alarm, see a doctor to identify the underlying issue. Your symptoms should resolve once your doctor treats the cause.

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What Causes Glossitis and How Can it Be Treated?

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Types of Glossitis

Glossitis may present as one of a few different types, including:

1. Acute Glossitis

Acute glossitis develops rapidly and can be severe. You’re most likely to develop it if you’re having an allergic reaction.

2. Chronic Glossitis

Chronic glossitis comes on slowly over time. It may disappear and recur multiple times. If you have long-term or recurring glossitis, it’s likely a symptom of another underlying condition. 

3. Atrophic Glossitis

In atrophic glossitis, also called Hunter glossitis, you lose all or part of your papillae, the tiny protrusions on your tongue. The loss of papillae often makes your tongue’s surface look smooth and glossy.

Many cases of Hunter glossitis develop from a vitamin deficiency, such as iron or zinc.²

4. Benign Migratory Glossitis

Benign migratory glossitis is also called geographic tongue. It causes patches of missing papillae on your tongue. These appear as red tongue lesions with white borders.

The cause of geographic tongue is unknown, but the condition is harmless.

5. Menopausal Glossitis

Better known as burning tongue syndrome, menopausal glossitis affects the tip of your tongue and the roof of your mouth. It’s most common during the menopausal period.

The primary symptom of menopausal glossitis is a painful tongue. You might also experience a burning sensation on your tongue.

Doctors treat burning tongue syndrome with various therapies, including pain relievers and hormone replacement.³

What are the Symptoms of Glossitis?

The symptoms of glossitis vary depending on the type. The most common include:

• Tongue inflammation or swelling
• A smooth tongue
• Pain or tenderness in the tongue
• Beefy red tongue
• Pale tongue

More severe cases might include symptoms like:

• Difficulty eating, speaking, or breathing
• Blocked airway

If you develop symptoms quickly or experience difficulty breathing, seek immediate medical attention.

What Causes Glossitis?

The causes of glossitis include:

Allergic Reactions

An allergy to food, medication, or other allergens can cause a swollen tongue. Other symptoms of an allergic reaction include:

• Hives or rash
• Facial swelling
• Itchiness
• Throat closing 
• Difficulty breathing

Mild allergic reactions may resolve independently. However, if you have severe symptoms, seek medical care immediately.

Vitamin Deficiencies

Glossitis may occur when you’re not getting the nutrients you need. A nutritional deficiency usually causes a loss of papillae on the tongue, known as atrophic glossitis.

The condition can indicate anemia, which happens when your body isn’t getting enough oxygen-rich blood.⁴ Anemia often results from a deficiency of iron or Vitamin B12. You’ll likely also feel tired and weak.

Other deficiencies that might cause glossitis include:²

• Zinc
• Riboflavin
• Niacin
• Folic acid
• Vitamin E

Studies show a high prevalence of nutritional deficiencies in the US. For example, 84% of the American population gets an inadequate amount of vitamin E.⁶

Dry Mouth

Dry mouth occurs when the salivary glands in your mouth don’t produce sufficient saliva. It makes your mouth and tongue dry and may cause a scratchy throat. It can also cause glossitis.

Many different issues can cause dry mouth. You must consult a doctor to determine the underlying condition and treatment.

Infection

Various types of infection can cause glossitis, including:

• Viral infections — Herpes simplex is the most common virus to cause glossitis. It typically also forms cold sores around the mouth.
• Parasitic infections — Malaria and syphilis may present with the symptom of glossitis.
• Bacterial infections — Bacterial infections that cause glossitis are more common in people with an immune system disorder.¹
• Fungal infections — Infection by the yeast Candida, also called oral thrush, can trigger glossitis. People with cancer, diabetes, HIV/AIDS, dentures, or those taking certain medications are most at risk for developing oral thrush.⁵

Hormonal Factors

Hormones may play a role in developing glossitis. Burning tongue syndrome is also called menopausal glossitis, as it’s commonly seen in menopausal women.

Hormonal factors may also increase your risk for a geographic tongue, though the connection remains unclear.

Injury

A mouth injury can cause tongue inflammation. Cuts or burns can make your tongue swollen, as can irritation from dental appliances like braces.

Medications

Certain medications may cause glossitis as a side effect, including:¹

• Oral contraceptive pills
• Albuterol
• ACE inhibitors
• Antimicrobial drugs

Always speak to your doctor if symptoms such as tongue inflammation occur after starting a new medication.

Other Factors

• Psychological factors (neurological disorders and anxiety)
• Exposure to irritants (alcohol, spicy food, and tobacco)
• Normal familial variants (fissured tongue and geographic tongue)
• Down syndrome
• Psoriasis and other autoimmune conditions
• Burning mouth syndrome
• Iron-deficiency anemia
• Pernicious anemia

How is Glossitis Diagnosed?

Diagnosing glossitis involves an oral exam by a dentist or doctor. They’ll take a medical history.

They’ll also physically examine your tongue and the soft tissues of your mouth. Saliva or blood tests might also be used to determine the cause.

According to Dr. Nandita Lilly, New Mouth’s in-house resident dentist, “Glossitis has numerous potential causes, and while most are benign, some can be of a serious systemic underlying condition.” 

How is Glossitis Treated?

The treatment for glossitis depends on the cause and can include:

Medications

Your doctor may prescribe medication to treat the medical condition causing your symptoms, such as:

• Antibiotics and antivirals for infections
• Antihistamines for allergies
• Vitamin supplements for nutrient deficiencies
• Hormone replacement therapy during menopause
• Topical treatments to soothe symptoms

Oral Care

You can improve your oral health and alleviate symptoms by practicing good oral hygiene.

Daily brushing and flossing, tongue scraping, and using an alcohol-free mouthwash can help relieve symptoms and improve oral health.

Lifestyle Changes

Some lifestyle changes may relieve your symptoms and reduce your chances of developing a condition that causes tongue swelling, such as:

• Dietary changes
• Taking over-the-counter vitamin supplements
• Eliminating tobacco and alcohol
• Avoiding hot or spicy foods

Which Antibiotic is Best for Glossitis?

Your doctor can recommend the best antibiotic for glossitis based on your underlying cause. A common antibiotic for treating oral thrush is fluconazole.

Tips for Preventing Glossitis

You can’t always prevent glossitis, but some tips that might help stop it from developing include:

• Eating a healthy diet that provides balanced nutrient sources
• Practicing good oral hygiene
• Avoiding irritants like spicy or acidic foods
• Eliminating or reducing tobacco or alcohol use
• Regularly visiting your dentist

What is the Outlook for Glossitis?

Glossitis typically goes away when you treat the underlying cause. How long it takes to heal depends on how quickly you get treatment and your condition.

Summary

Glossitis is the swelling and inflammation of the tongue. It’s typically the symptom of an underlying condition, such as infections, nutritional deficiencies, or allergic reactions.

You may notice a loss of papillae on your tongue and a change in the color of your tongue. Consult with a doctor if you notice any of these changes. A dentist or doctor can perform an oral exam to diagnose and treat the root cause.

Treatment includes medications, oral care, and lifestyle changes. Avoiding triggers like tobacco and spicy foods may help soothe your symptoms and prevent glossitis.