Geographic Tongue – Red Patches on the Tongue

Patches on your tongue may be due to an inflammatory condition called benign migratory glossitis (BMG). This condition has many names, the most common one being ‘geographic tongue’, but medical practitioners may also refer to it as ‘erythema migrans’ or ‘migratory stomatitis’

What Does Geographic Tongue Look Like?

This is a harmless, chronic and benign condition. People will often notice red patches on the tongue’s top and side surfaces. These patches are caused because the tongue loses its papillae, also known as “taste buds”. The borders around the red patches might be yellow or white, both are completely normal. Sometimes, you may even notice a fissured tongue, which means that the top of the tongue has grooved. Sometimes, the patches can cause a tingling sensation, but in most cases, it’s painless and patients don’t even feel its presence.

geographic tongue treatment

How Does Geographic Tongue Differ From Other Tongue Conditions?

If you have geographic tongue, then the red patches on your tongue may move from one area to another every couple of days, or even disappear completely. Sometimes, you can have this condition for months or years, where the patches come and go at different times.

In the majority of cases, these patches are painless and often go unnoticed. However, a few patients have reported a tingling sensation when eating spicy or hot foods. Regardless, the patches caused by geographic tongue are harmless.

How Common is Geographic Tongue?

This is a very common oral mucosal lesion, and it affects 1-3% of the population. It is slightly more common in males, and a wide range of ages may be affected.

What Causes Geographic Tongue?

The causes of geographic tongue are unknown. It may be associated with a type of skin condition called psoriasis, though this is unconfirmed. Some individuals may also have a history of atopy, asthma, eczema, hayfever, or food allergies. However, some researches believe that genetics, family history and environmental factors may play a role.

Does Geographic Tongue Need Treatment?

In most cases, geographic tongue does not need treatment. The condition is completely harmless, and often painless. Plus, there is no risk of cancer.

In cases where patients develop symptoms (ie. discomfort, pain, burning sensation), then the use of steroid containing mouthwashes or topical anaesthetics may help, though other possible causes of the symptoms must be excluded. If this condition needs management, it should be under the guidance of a qualified professional.

When Should You See a Doctor/Dentist?

You should immediately see a dentist if you have patches in your mouth that are uncomfortable or painful. However, if you have patches on your tongue that aren’t uncomfortable, it’s still wise to see your dentist and have it noted in your file. It’s likely that the dentist will do a visual exam, and take a medical history. Your dentist will then ask you to monitor these patches at home. In the monitoring period, it’s important for you to note down if the patches move around on your tongue, change in size or completely disappear. If 3 – 4 weeks pass and the patch(es) are still present, and they haven’t changed location or size, then your dentist will most likely consider an oral medicine specialist referral.

geographic tongue, see a doctor

Take-Home Message

Geographic tongue is a harmless condition where you notice patches on your tongue. It is diagnosed by taking a medical history and doing a visual exam. Followed by monitoring of the patches for 2-3 weeks. Fortunately, geographic tongue rarely requires treatment.

Amanda Phoon Nguyen

Hi, I’m Amanda, an Oral Medicine specialist in Australia (Western Australia and the Northern Territory). My clinical and research interests include oral mucosal disease, orofacial pain, temporomandibular disorders, dental sleep medicine and pediatric oral medicine. Moreover, I run several oral medicine interest pages, including Spoonful of Oral Medicine on Facebook and @oralmedicineoralpathology on Instagram.

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Geographic Tongue – Red Patches on the Tongue
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