Geographic tongue -what does it mean?

What is geographic tongue?

Geographic tongue (GT) is a benign inflammatory condition affecting the superficial surface of the tongue. In most cases the aetiology is unknown.

How does it appear?

It appears as reddish areas characterised by denuded surfaces on the tongue (de-papillated tongue) surrounded by white borders.

The peculiarity of this lesion is, these denuded areas do not remain constant. They change their positions from time to time. Hence this condition is also called as benign migratory glossitis or erythema migrans.

geographic tongue

Symptoms of the geographic tongue?

Usually, GT is asymptomatic. But, in a few cases, it is associated with burning sensation and severe taste impairment.

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Patients usually are not aware of the presentation unless identified by an oral physician or others. The lesion regularly appears in elderly aged females.

Geographic tongue causes?

The aetiology of GT is unknown. But there are few risk factors, which might play key role in initiation of geographic tongue.

Few authors consider GT to be associated with psoriasis while other researches associate GT to a form of allergy.

Stress is often associated with GT but lacks sound support in the literature. Other risk factors include Vitamin deficiency, bacterial infections and autoimmune manifestations.

The association of GT with oral candidiasis cannot be declined as many types of research showed a significant association between GT, oral candidiasis and rampant caries.

How does geographic tongue start?

GT is asymptomatic and undiagnosed in most cases. Hence many patients lack a clear history of its origin.

Usually, it starts as small but multiple denuded areas (areas that appear as plain or bald with loss of papillations) on the surface of the tongue. The edges of these surfaces are marked by a compensatory increase of taste buds or papilla, which appears as a white border. Their positions change from week to week.

If these surfaces harbour food and encourage a secondary fungal infection, then the denuded surfaces become inflammatory and start producing a burning sensation.

How long does GT last?

The period of the presentation cannot be judged in GT. It may stay for a few months to years.

Geographic tongue treatment?

There is no specific treatment protocol for GT. But satisfactory results were achieved with topical steroids and vitamin A supplements.

As the aetiology is unknown, GT lacks a specific treatment methodology, which is often frustrating for the patients.

Auto-immune origin of GT was suggested by a few researchers, where they advocated the use of immune-modulators.

How to cure geographic tongue naturally?

There is no specific cure to the geographic tongue. But few changes in the lifestyle can bring improvement in patients’ quality of life.

Oral physicians consider a 5-step natural protocol in managing GT. They include

  • Good oral hygiene with calculus free teeth
  • Free from known allergic food
  • Regular hydration of oral cavity
  • Replacement of old metal restorations with biocompatible restorations
  • Daily multivitamin supplements

Does geographic tongue cause cancer?

Patients suffering from GT, have stressful lifestyle due to misconception regarding oral cancer. Many patients think of GT as a form of oral cancer.

GT has no association with oral cancer. It is a pure benign condition.

Geographic tongue picture?

geographic tongue
Geographic tongue

This is a classic image of GT. In the above picture, we can see multiple areas of de-papillated tongue. It appears as multiple red areas. Identify the borders around these red areas which appear as thick white borders. The presentation mimics a geography map.


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Dr. Kiran

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