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Red Smooth Tongue

Atrophic tongue, Smooth Tongue, or Glossitis

  • In this condition, the papillae (tiny, red, raised areas), which normally cover the surface of the tongue, shrink or disappear and the tongue (a muscle) wastes away -- giving the tongue a thin, shiny appearance (smooth).  The tongue may also show patches of redness and inflammation (swelling, irritation, and pain).

  • Red patches on the tongue
  • Red, swollen, painful tongue
  • Sensitivity to spicy foods
  • Bad Breath
  • There may be ulcers (open sores) on the tongue or mouth
  • Other signs depending on the underlying cause

  • Diseases:
    1. Streptococcus (bacteria) infection
    2. HIV (virus) infection
    3. Candidiasis -- infection caused by a fungus
    4. Herpes (Virus) infection
    5. Cancer of the tongue, trauma (burns, irritating chemicals)
  • Nutritional deficiency:
    1. Vitamin B12 -- pernicious anemia
    2. Iron Deficiency Anemia
    3. Folic Acid -- pernicious anemia
    4. Riboflavin Deficiency
    5. Niacin Deficiency known as pellegra (fiery red)

  • History of symptoms, medications, illnesses, allergies, habits, nutritional habits
  • Medical exam may reveal abnormality in tongue or other areas within the mouth and signs of underlying disease.
  • Referral may be made to a dentist or oral (mouth) surgeon for further evaluation.
  • Biopsy or taking a piece of the area involved may be necessary.
  • Blood tests may be done which include tests for anemia and vitamin levels.
  • Cultures (using KOH, a dye that can pick up candida and other fungi) or scraping the tongue may reveal an infection

  • Nutritional deficiencies
  • Poor areas with inadequate nutrition such as third world countries
  • Smoking
  • Chewing tobacco
  • Alcohol
  • Excessive use of mouth wash, tooth paste
  • Hot foods
  • Spicy foods
  • Burns
  • Dentures
  • Poor oral hygiene
  • Weakened immune system (natural body defenses) as in AIDS and cancer
  • Chemotherapy (cancer-killing drugs) and other toxic medications

  • Treat underlying cause (i.e., use vitamin therapy for particular deficiencies)
  • Pain may be treated with anesthetic (numbing) mouth rinses, such as viscous Lidocaine, Benadryl solution Orabase, and even Sodium bicarbonate.
  • Nystatin suspensions can be used as a rinse for treatment of candidiasis.
  • Antifungal (Diflucan) or antibiotic (penicillin) pills may be necessary if more severe fungi or bacteria infections are involved.
  • Avoid alcohol or tobacco.
  • Use mild toothpaste or mouth washes without alcohol.

  • Speak to your dentist or doctor as soon as convenient.  If severe tongue swelling, difficulty breathing, or rash appear rapidly (over several minutes or within one hour) call 911.

  • See causes

more about Red Smooth Tongue

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