Swollen tongue

The common symptoms of glossitis are as follows:

• The tongue becomes pale dark red or bright red colour
• Difficulty and pain while chewing or difficulty in swallowing
• The tongue appears smooth as no papillae or taste buds are visible on the surface
• The tongue is tender and sore 
• The tongue may appear slightly swollen

These symptoms can be temporary but sometimes they may indicate an underlying life-threatening condition. If these symptoms start getting worse, the person may need to seek medical help immediately. Serious symptoms involve the following:

• Excessive swelling of the tongue leading to blockage of the airway
• Difficulty in breathing
• The feeling of choking leading to laboured breathing
• Losing consciousness
• Swelling of face, lips and tongue
• Bluish discolouration of the face and lips

There can be several causes of glossitis, as it can either be due to less severe reasons such as vitamin deficiency or it can be due to a serious condition such as an autoimmune disorder.

The possible causes of glossitis are:

• Hot and spicy food and beverages burning the tongue
• The habit of biting your tongue
• Sharp edges of the tooth creating continuous trauma to the tongue
• Allergy to any food item or any new drug
• Allergy to any oral hygiene product or appliance such as toothpaste, mouthwash and night guards
• Excessive alcohol consumption
• A bacterial infection caused by streptococcus bacteria 
• Herpes simplex virus infection
• Syphilis (a sexually transmitted disease)
• Yeast or fungal infection (for instance, thrush or oral candidiasis)
• Deficiency of folic acid (vitamin B9 deficiency)
• Iron deficiency anaemia
• Lichen planus (an oral lesion which causes a burning sensation in the mouth and presents as a white lesion)

The serious causes of glossitis are:

• Pernicious anaemia: In pernicious anaemia, the body's red blood cell count decreases due to the inability to absorb vitamin B12.
• Pemphigus vulgaris: Pemphigus vulgaris is an autoimmune disorder marked by painful blisters in the mouth, nose, throat, eyes, lungs and genitals.
• Sjögren’s syndrome: Sjögren’s syndrome is an autoimmune disease in which the body presents with three classic symptoms: dry mouth (xerostomia), dry eyes (keratoconjunctivitis) and rheumatoid arthritis.

The following people are at a higher risk of developing glossitis:

• People with poor oral hygiene
• People dealing with dry mouth
• Undernourished people (malnutrition) 
• People consuming any form of tobacco (chewable or smoked)
• People consuming excessive alcohol
• People with a weak immune system
• People using an ill-fitted dental appliance

There are certain things that can help you prevent glossitis, such as: 

• Not eating spicy and hot food
• Avoiding extremely hot beverages that can burn your tongue
• Reducing the intake of alcohol as it causes dry mouth
• Making sure that any oral appliance you are using fits properly in your mouth and does not cut or irritate your mouth
• Maintaining good oral hygiene; this includes brushing regularly, cleaning your tongue and getting regular dental checkups
• If you have been dealing with dry mouth for a long time, consume a small amount of water every few minutes. You may also get lozenges which help in stimulating saliva.
• Quit smoking and chewing tobacco as it can lead to oral lesions such as lichen planus.

Glossitis has distinct features which can be diagnosed by your dentists very easily. Swollen tongue with the absence of finger-like bumps on the surface (papillae) is a classic sign of glossitis. Your dentist may also ask a number of questions regarding your habits and lifestyle to find out the cause behind the problem. 

Your dentist may also recommend a blood test, to check if anaemia is the cause for glossitis.

The treatment of glossitis depends upon the cause. For instance, if the cause is eating hot and spicy foods, then it can be relieved by avoiding such food and beverages. However, if the underlying cause is a disease, then the person will have to undergo proper medical treatment. The treatment of glossitis includes:

• Use of anaesthetic agent such as viscous lidocaine (Xylocaine) which can be present either in gel form or swishing form to relieve the burning sensation in the mouth.
• Your dentist may prescribe an antihistamine mouth rinse such as diphenhydramine to treat any allergic reaction.
• Antibiotic tablets and corticosteroid mouth rinses such as dexamethasone can be prescribed by the doctor to treat the infectious causes of glossitis.
• To relieve pain, the doctor may prescribe you some nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or Naprosyn.
• The doctor would prescribe you a specific diet rich in vitamins and minerals along with nutritional supplements to treat anaemia and other nutritional deficiencies.