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Mouth Diseases

Tongue Problems!

03/12/2010

Question:

I have 2 white rings on my tongue and in the center of the rings my tongue is a deeper red than the rest of the tongue, and it really really really hurts!!!!!What do I have and how do I treat it?

Answer:

Based upon your description you probably have “Benign Migratory Glossitis” or “Geographic Tongue” (Erythema Migrans). The etiology of this condition is unknown but may be related to a contact hypersensitivity response or allergic reaction, adverse response to yeast (Candida albicans), a normal oral commensal organism, or possibly related to hormonal imbalances. As I said the cause is unknown and these possible causes are based upon associative observations.

The lesion usually occurs on the anterior 2/3rds of the dorsum of the tongue, but can also occur else where in the oral cavity. They appear as well-delineated areas of redness (erythema) with a white/yellow irregular border (in your case circles). The red, painful center portion is the result of loss of the protective covering provided by the filliform papilla. These lesion received their descriptive name as they resembled the “rugged coastline  of Maine” that is seen on maps. These lesions can be quite painful as you have lost the protective coating of the tongue, thus alcohol, salt, spices, hot temperature, all may illicit a painful response.

Treatment usually consists of palliative interventions such as topical local anesthetics, or mouth rinses, or baking soda or physiologic concentration of salt water (normal saline). In some cases a topical adhesive dressing may be utilized (Orabase). Most of the time these lesions resolve and no definitive treatment is required.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University