Friday, April 30, 2010

Apple #453: Geographic Tongue

I have to tell you about my geographic tongue.

Last month I was pretty stressed out, more than I realized.  I went to the dentist for a regular check-up and when they do the thing where you have to stick out your tongue so they can pick it up and move it around, the dentist said, startled, "Oh! You have a geographic tongue!"

I had never heard of such a thing, let alone that I had one.  She said it's no big deal, some people have it and some people don't.  It doesn't mean anything except that sometimes it's more apparent when you're stressed out but it's really nothing to worry about.

The phrase was so intriguing, of course I had to look it up.  It's a pretty simple topic, actually, and I was going to let this one go by, but I've been sort of fascinated by the whole idea since I learned about it.  Every so often I check on my tongue, to see what's the latest geography.

  • A geographic tongue is one on which the papillae fall off in patches. 

The places where the tongue looks burned are places where the papillae have fallen off.   This is a typical amount of patchiness on my tongue on any given day.
(Photo from World Articles in Ear, Nose, and Throat. Unless you like being completely grossed out, you do not want to look at the other photos on that page.)

  • The tongue is covered with four types of papillae, or tiny protrusions.  Three of the four types of papillae hold taste buds.  The fourth kind that we're concerned with, called filiform papillae, do not have taste buds.  So the fact that these things fall off does not mean that your sense of taste is compromised.
  • Filiform papillae do have a function, though.  They are abrasive and give the tongue a rasping and cleaning capability.  These same things are on cats' tongues but much more prominently so. They are what makes cats' tongues so effective at cleaning their fur.

Filiform papillae have spiky tips that are actually coated in a fine layer of keratin, which is what makes them rough.  On cats, these papillae are longer and they stand up, where on humans, the filiform papillae are shorter and lie flatter on the tongue.
(Photo from Southern Illinois University's School of Medicine)

  • The papillae replace themselves about every week, but often more will fall off in another location, so it will appear that the bald patches move around.
  • They also regenerate themselves on the outer edges of the patches first, so it might look like there is a white or sometimes bright red bumpy line around the outer edges of each patch.  

Here the faint white lines at the edges of the patches are visible.
(Photo from DermNet NZ)

  • The official medical phrase for "geographic tongue" is "benign migratory glossitis."  That name is actually a better description of what's going on.
      • Benign = not harmful, no worries. 
      • Migratory = it moves around.  
      • Glossitis = swelling. The red patches are actually places where the tissue of the tongue has swollen, and that's what causes the papillae to fall off.
  • About 3% of the population have a geographic tongue.  It seems to be a genetic condition.
  • Within that 3%, it is almost twice as common among women than men. 
  • Many people who suffer from psoriasis also have a geographic tongue.  But a lot of the people who have a geographic tongue do not have psoriasis. 
  • People with eczema, asthma, or allergies -- some extra sensitivity to their environment in other words -- also seem to be more likely to have a geographic tongue. 
  • It's also fairly common among people who have diabetes.
  • But just because you have a geographic tongue does not mean you should worry that you have any of these other conditions.  It might be linked to those conditions, but chances are it isn't.
  • Women who take birth control may notice that it's more pronounced on day 17 of their cycle, a fact which leads doctors to surmise that it has something to do with hormones.
  • Other people think that deficiencies in the B vitamins might be a contributing factor but that, too, is currently only a theory.
  • The fact that it does seem to get more patchy when people are stressed out and immune levels are low seems to bolster the B-deficiency theory. 

When there are more patches or when they show up more obviously as they do on this woman's tongue, I'm pretty sure that's when I'm more stressed out.
(Photo from eMedicine)

  • Oddly, the condition is less common in people who smoke. 
  • Some people think that hot or spicy or acidic foods might make the patches appear.  
  • Or maybe drinking too much alcohol makes the tongue get patchy.  
  • As the multitude of conjectures suggests, doctors don't really know what causes it or why it happens.  It doesn't seem to affect anything, so there's really no reason for anybody to look for a treatment, so there isn't one.
  • Some people do say they experience a burning sensation where the patches appear, but most people with this condition don't sense any change.
  • If you do experience discomfort, try rinsing with an antiseptic mouthwash.  That's supposed to help cool the burn.

NOTE TO COMMENTERS: I very much appreciate your comments and your interest in this topic.  But I am not a doctor.  I can't tell you whether what you have is a geographic tongue or not.  If your tongue hurts for some reason, I can't tell you why that is or what exactly will work for you.  All I can do is tell you about my own tongue and what I've found generally on the subject. 

If you still have questions, re-read this entry, or do some more reading elsewhere about the topic.  You were enterprising enough to find this page, surely you can find more information if you try (you could start with the sources listed below). Or better still, take what you've learned to your local friendly doctor and ask him or her for a diagnosis and advice.  Happy exploring!


Sources
International Geographic Tongue Support Group
Medline Plus, Geographic tongue
Robert D. Kelsh, DMD, Geographic Tongue, Medscape's eMedicine, October 6, 2009
Dr. Greene, Geographic Tongue
Maxillofacial Center for Education and Research, Migratory Glossitis (Geographic Tongue)
DermNet NZ, Geographic tongue (benign migratory glossitis)
WrongDiagnosis.com, Geographic Tongue and Filiform Papillae
Inner Body, Filiform Papillae

52 comments:

  1. Whoa! Just when you thought you knew all the things that can go wrong with the body. Do they hurt? www.satisfiedsole.com

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    1. No! I have a geographical and it does not hurt at all! It sometimes feels really bumpy though!

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    2. goog to know I am not the only one. My wife thinks I do not clean my mouth enoght. Now I can tell her it is not that and it is not a sick mouth. lol

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  2. Nope. Doesn't bother me a bit. Now that I know what it is, I'm kind of fascinated by it and even a bit proud of it. It's cool having this thing that changes its appearance regularly. In fact, I'm curious right now to know what it looks like today. I might go look to see what it's doing.

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  3. this is really interesting- I am a nurse and have never come across this before. It looks pretty nasty though- is it painful?http://caroline-greenliving.blogspot.com/

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  4. Phewf, i was worried i had mouth thrush. Thanks for clearing up my worry! and same here, stress related!

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  5. I apparently have this problem too; but it started . . . I'd say a few years back, and I've been wondering what it was since then - looks just like the pic. So, just to calm my worries, it's not something that a person is normally born with, but instead, it just pops up for no apparent reason? I had a doctor say thrush a while back, but it's obviously not that.

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  6. Yup, you're born with a geographic tongue and the patches will vary in intensity and location throughout your lifetime.

    According to other pages I've read, thrush patches are "creamy" and may even get bumpy like cottage cheese. Thrush patches are caused by the PRESENCE of yeast while geographic tongue patches are caused by the ABSENCE of cells. Thrush looks bumpy and raised like something's growing in your mouth (which is in fact what's happening), while geographic tongue looks like something's been scraped away.

    Thrush patches can be painful especially if you try to scrape them off, you could also possibly have a fever with them, and you could have similar patches elsewhere on your body. Geographic tongue patches are rarely painful.

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  7. I too have this and it is currently driving me mad as it is very sore at the moment. I thought I knew which foods made it worse but perhaps the stress thing is the key at the moment or maybe lack of sleep. Interesting about the b vitamins - I might look more into that.

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  8. I have had this since my daughter was born 2 1/2 years ago. It seems to pop up for me when my immune system is down, When I lack sleep, when hormones are out of whack, and when I am stressed out. There may be a food relation as I tend to try to limit my sugar intake during these bouts. It turns out my daughter gets this too! Hers seems to come around when she is getting sick; therefore, supporting the immune system theory. I have since began taking a great vitamin b that melts under your tongue but that does NOT change the geographic tongue. I recognize that this is genetic condition but I was wondering if it is at all contagious??

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  9. I tried most of the home remidies I have read about but nothing really worked so far. Tyopically I have a little pain when the shapes are on the tip of my tounge, things like pizza or bagles with a rough surface can irritate.

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  10. I noticed that my tongue felt weird yesterday, like there was some residue from something, but I didn't pay much attention. this morning it felt really weird and when I looked in my mouth and stuck out my tongue I was shocked. I rinsed my mouth with hot water, tried to brush it off.. (literally and figuratively) and no change. I tried to drink some hot tea and it burned in the middle of my tongue. the back of my tongue seems to have little red bumps that I think are always there but seem more pronounced.

    I've had a bad cold and cough and the physician prescribed an oral spray much like what they give to people with asthma. I'm wondering if it is from this and just looks like geographic tongue?

    It seems that others also have sensitivity to hot beverages. I haven't tried any spicy food today.

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  11. oh boy i just found out my 1 year old has that problem i thought it was i cant remember the name but i know babies get it there tongues get like a fungus. But no turned out to be a geographic tongue and i was like what the hell is that lol

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  12. I have it too. not painful. I thought I somehow bit my tongue but went to the dentist and they told me about geograghic tongue. I wish it would go away it is soooo ugly.

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  13. i have this! i've never known what it was. i thought it was because i didnt clean my mouth well enough. in high school my friends were grossed out by it, they must've thought the same thing.

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  14. I think this is what I have going on with my tongue. It looks similar to the picture. Only thing is the patch at the tip of my tongue tends to sting a bit. I thought I was scraping my tongue with my teeth and it was causing the sores. The dentist never says anything at all when I go in, and I was just in this week for a cleaning with full on patches. I seem to want to nibble at the swollen spots, which is very annoying.

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  15. I to have this.Daily morning if i do tongue clean i used to get blood from the tongue.what medicine i have to take and how that skin will form.

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  16. i think i may have this.....looks very similar to the pictures provided and have had it for as long as i can remember....every morning and night i brush and sometimes scrape my tongue and gets rid of about 60-70% of it but it will reappear within an hour or so, it has a greenish tint like in these pictures, i drink alot of milk and whey proteins could this be making it worse?

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  17. I have this, the pictures look just like my tongue. I've been worried that it's fungus.

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  18. here is a picture of my tongue...its not great quality but can someone please tell me if it looks like geographical tongue....thanks...

    http://s645.photobucket.com/albums/uu179/bigamzz09/?action=view&current=Image0084.jpg

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  19. i had this when i was younger. i dont think i ever really put much thought in it. i had these spots and they just kind of wandered around. the first time i want to the orthodontist he said the exact same thing.

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  20. wow i thought i had some disease or something and i was very worried!! this makes me feel so much better :)

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  21. I feel a lot better now, that is a normal thing

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  22. My geographic tongue is irritating to me.It's not painful but rather annoying.
    I recently had flu and or cold and it seemed to bring it on.

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  23. I have had this condition for 40 years. Have known what is was for about 30 years. I have had times that it hurt and then may go months and not notice it at all. Illness, foods, allergies, horomones, and stress all play a part. Best advise is moderation in all things and don't worry about something that will cause no harm. To many other things for us to be concerned about. good luck to all

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  24. Great post! I've been trying to figure out what the heck is wrong with me and this is probably at least a good starting point. Thanks for the information.

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  25. I have had geographic ever since I can
    remember and was diagnosed when I was in kindergarten. Unfortunately, I am one of the few who had pain associated with it. I don't always have the patches, but when I do they can be highly sensitive and certain foods can cause a whole lot of pain. Eggplant has proven to be the absolute worst, followed by things like limes, lemons, and raw tomatoes. So far, the only thing I have found to relieve the pain is, strangely enough, rubbing salt on the patches.
    It has a sort of numbing effect.

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  27. When I got this Geographic tongue about 2 years ago I was also under heavy stress, I went to the Doctor who said he will take a sample of my tongue and test it ,I didnt trust him so I went to another who convinced me to do the sample test and he cut my tongue and verified that it was Geographic tongue , And also he made sure that I visit him in order to get the results so he can charge for the visit. So I went to another Doctor witch I explained what I have been going through and his said to me that this is obviously geographic tongue and those Doctors were pigs for putting me through that stress and agony. Yes some times when Im under stress it will hurt and it will get a little worse what I have found to help me is Advil for that, Sometimes it will go away almost thinking thats its gone and then it will come right back as a small tiny patch . But in my situation its always been on the left side same side as my hurt in case you are looking in a mirror. And I can feel the outline that it creates as it grows or disappears. But I can not say that Im happy for having it causes me to think about it and worries me sometimes , Im not a smoker and not a drinker. I can say that I can go with out having a drink till an event comes along.

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  28. I believe I have this as well. Does smoking play a part in it or worsen the condition? I am not a chain smoker, I only enjoy an occasional pipe every now and then.

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  29. As noted in the entry, "Oddly, the condition is less common in people who smoke." But that doesn't mean that people who smoke _won't_ get it.

    I would guess that there could be a connection between the fact that smoking depletes your body of all sorts of vitamins & good stuff, and the appearance of the patches on your tongue. But that's only a guess by someone who is not a doctor.

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  30. i first noticed this in '95 when i 17. went to the doctor and they had me take a HIV/AIDS test...imagine my fear considering i had no sexual activity at that time...needless to say..i have taken many test and i do not have HIV/AIDS, diabetes or any other disorder...for those that think they may have this..do your own research and find out exactly because you dont want the shock i got as a 17yr old kid...its not bad just really annoying at times...

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  31. I have this f***in problem since I was 14 and now im 28 and im really tired it hurts when you drink sodas or eat hot/spicy food, but i noticed that when i drink (clamato tomato cocktail) mixed with beer and some lime the next day the figures disappear at all or at least a 70% must be some vitamins in tomato. try it and let me know.
    Good luck!!!

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  32. I have a geographic tongue..the only time I notice it doing anything is when I have had a cold or the flu. When I start to get better, my tongue goes from white to pink patches of sensitivity. As I get better, the patches grow to cover my whole tongue, then voila, the whole tongue clears into pink perfection.

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  33. Thanks for sharing. You may have solved my dilemma.
    M

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  34. I also have geographic tongue. It feels like it's stress and/or hormone related. I have endometriosis and that's when the patches on my tongue appeared. Chewing mint gum seems to help a little....

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  35. Finally im not stress about this any more im only 17 and had it for a couple years now!!!!

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  36. looks just likr my tounge hehehe guess i dont have some crazy form of cancer then.
    Thanks for clearing that up

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  37. So why does the back part of the tongue look covered and kinda creamy?

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  38. hmmm im 12 ive had it since i was in Pre-K, thanks for explaining this it helps so much!!! and for me, drinking soda/fruity juices and eating candy irritates it more. Usually i dont feel it but sometimes i get the ''burning sensation'' as mentioned above. i feel weird when people ask me about it, but i know everything going on. thnx Daily Apple!!! :)

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  39. I've had this condition for 60 + years. I can't tell you how many times I've had health care practioners say, "Do you know you have geographic tongue?"

    I am a speech pathologist and when we studied oral anomalies in school I was the center display for the geographic tongue demo. As a SP I often have clients look in my mouth as I demonstrate the tongue positioning and movement for articulation. Quite often a client will ask why my tongue looks so funny. They get a straight forward answer and a brief demo to resolve their worry and curiosity.

    It's just part of me and I live with it. it cause no problems, but has lead to some funny discussions at work.

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  40. ive only had it for a few months now but i have noticed when im drinking soda is when it bothers me and causes to make my tounge fell like its scorched but other than that its no big deal im just glad to know i dont have some kinda mouth cancer

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  41. ive had these spots on my tongue for years its nice to know what it is. does any body know a cure for this

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  42. this is a relief I thought I had some sort of disease . thank you soooo much

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  43. OMG thanks, A relief i though i had some untreatable dangerous virus, disease or something!!

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  44. This is a yeast infection, candida. Doctors will neer help anyone with it and best not really. The patches are due to issues with your organs.. you tongue is a map of them. Id say by the first images that is kidney issues.. you need a cleanse! My tongue was identical to this when i had candida overgrowth for 4 years...due to antibiotics and suffering with low blood sugar levels and have a high sugar diet.. It should be pink.. nothing else

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  45. No, Dinkytoes Baby, you are incorrect. You apparently have not read the entry. I'm sorry you had candida, but what you had and what I have are two different things.

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  46. Thank you for this blog. It gives me comfort to know what's going on with my tongue. I actually had a great laugh now, thinking of the term: "I have a geographical tongue." 😜

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  47. Yap.. thats me lol
    i thought it happens cuz of my upset stomic

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  48. I'm 44 and I've been fighting off some horrid illness the past couple days, then at 1am a stranger walked into my house. He left without incident, but it was traumatizing and I couldn't sleep. My tongue had started hurting enough yesterday for me to mention it, but today I looked at it and was all "WHAT?". Before heading to Urgent Care I looked online, and what do you know? Looks like I had a Geographic Tongue just waiting to happen. And today is Christmas Eve.

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