- What is known about the prevalence of the disease?
- What you need to know about the structure of the surface of the language?
- What functions does a healthy language perform?
- Why does glossitis occur?
- Features of infectious inflammation
- Why glossitis happens during pregnancy?
- General symptoms of glossitis
- How is infectious glossitis manifested and complicated?
- Species and features of non-infectious non-infectious glossitis
- What diagnostics is needed?
- Treatment of glossitis
- Video on topic
Glossitis is an inflammatory or dystrophic reaction from the mucous membrane of the tongue to a stimulus, an infection. The disease has been known since ancient times. This is the very "tippoo" that it was customary to wish a person to not say anything bad.
The disease occurs in isolation or reflects disorders that have occurred in other diseases. By changes in surface, color, size, we can assume pathology of the gastrointestinal tract, metabolism, immune system, blood disease.
Dryness of the tongue indicates dehydration of the human body. The course of glossitis is more often chronic. To cure the disease, it is necessary to identify the true cause of inflammation.
What is known about the prevalence of the disease?
Glossitis is more common in children and men after 40 years. The greatest distribution( the lesion is fixed in 50-65% of cases) glossitis of the tongue has as a concomitant disease: with allergies of various kinds, diseases of the gastrointestinal tract, stomatitis of the oral cavity.
In autoimmune systemic diseases of connective tissue( collagenoses, rheumatoid arthritis), various types of anemia, poisoning with salts of heavy metals, glossitis is recorded in 20-40% of patients.
What you need to know about the structure of the surface of the language?
The inflammatory process in the language affects the individual structures of the organ, the clinical manifestations depend on it. Therefore, we recall the anatomical structure. When examining the tongue of the patient, the doctor pays attention:
- on the back - the outer convex part;
- lower surface - shorter is due to the lower jaw;
- edge of the tongue.
Without the introduction of a special mirror, only the front area can be viewed. Back - it is turned to the pharynx. Along the tongue in the middle there is a dividing border groove. Select the following layers, which are discussed below.
Mucous - consists of a single-layered epithelium. Because there is no submucosal layer, it is closely fused with the fascia covering the lingual muscle. From below it passes into the "bridle" and forms wrinkles around it. On the back, too, there are three lingual-epiglottis folds.
Papillae - special growths on the mucosa of the back and edge zone, more in the anterior part. They are taste and tactile analyzers. Unlike other sites are covered with multilayer epithelium. In total, there are 6 types of papillae that perform different functions.
In the photo, the folded tongue of an adult male
Some of the epithelium is constantly changing, the old one is sloughing off( a white coating appears on the tongue with an intensified separation of the keratinized cells), others can be visually seen as folds. Each papilla distinguishes a certain taste.
Muscle - the muscle of the tongue is quite strong, the fibers have a different direction. It is covered with dense fascia. In the back of the back is one or two lingual tonsils. These are lymphatic formations that protect against pathogenic microorganisms in the period between meals.
What functions does a healthy language perform?
In the absence of signs of inflammation, the human language is actively involved:
- in chewing food arrived - stirs and crushes the products entering the oral cavity, pushes the lump into the esophagus, if the process is disturbed, the load on the stomach and intestines is significantly increased;
- analysis of taste - through primary analyzers the brain receives information about the quality of food, in response, hormones are produced that regulate the saturation process, the mood of a person;
- process of speech formation - certain movements along with air form sounds, so when glossitis is one of the symptoms is slurred speech in adult patients, and for a beginner to talk a child, the illness greatly delays learning.
Why does glossitis occur?
The causes of glossitis with isolated inflammation are:
- in direct exposure to the mucous membrane of the infection( bacteria, viruses, fungi) with stomatitis, gingivitis;
- mechanical injuries with sharp broken teeth, bones of fish and poultry, inconvenient prostheses or seals, bite of the tongue with epileptic seizures, burns of the oral cavity with hot drinks and dishes;
- repeated toxic effects of nicotine on smoking, alcohol, spicy foods;
- response allergic reaction to fresheners for the mouth, toothpaste, cud, candy, balm rinse;
- abnormal development of the language, congenital pathology - the newborn reveals a folded glossitis that changes the shape of the tongue, increases the size, makes it difficult to suck.
Common diseases in which glossitis becomes one of the symptoms or a complication include:
- infectious diseases - measles, scarlet fever, rubella, diphtheria, cutaneous infection, tuberculosis, syphilis, AIDS;
- allergic manifestations - diathesis, atopic dermatitis, urticaria;
- blood diseases - anemia( iron and B12-deficient), posthemorrhagic( against the background of significant blood loss);
- pathology of the digestive system - gastritis, peptic ulcer, hepatitis, colitis, dyskinesia, celiac disease, helminth and parasitic diseases, dysbacteriosis;
- autoimmune diseases - rheumatism, nodular periarthritis, collagenoses;
- hypovitaminosis - the mucous membrane of the tongue is affected by the lack of vitamins E, A, Group B, folic acid, C.
How do vitamins affect the condition of the tongue mucosa?
Vitamins perform the function of coenzymes in the body. This means that without their presence, biochemical processes do not go on, protein synthesis and cell regeneration are violated, immunity decreases, and the vascular walls become fragile.
Raspberry-colored tongue is characteristic of B12-deficiency anemia
The lack of vitamin C is manifested by the development of scurvy. It is associated with edema and bleeding gums, infection of wounds, pronounced stomatitis and glossitis. Reducing the concentration of vitamins A and E in the blood contributes to the development of atrophic processes, slows down any restoration of tissues, disrupts local blood circulation.
Deficiency of vitamins B12 and folic acid causes the development of the same anemia followed by Hunter's glossitis. The entire group of B vitamins provides sufficient innervation, signal input through nerve fibers, nutrition of the language tissue. It is important in the formation of desquamative and atrophic glossitis.
Features of Infectious Inflammation
Under normal conditions, various microorganisms enter the surface of the tongue and nothing happens. To penetrate the infection and fungi into the cells of the mucosa, a sharp drop in human immunity is necessary.
This reason is typical for young children, the elderly, HIV-infected, patients with chronic diseases, taking antibacterial drugs, corticosteroids, cytostatics. Infection quickly joins the effects of trauma.
The most dangerous are the fungi of the genus Candida, staphylococci, streptococci, herpes viruses. Penetrating into the mucosa, they cause puffiness, vasodilation. The tongue becomes red, the papilla pattern is erased, a white-gray coating appears on the back.
Depending on the depth of infection and the spread of infection, the types of glossitis are distinguished:
- superficial is the easiest variant of inflammation;
- catarrhal - pronounced edema and redness of the tongue;
- deep - infection "leaves" deep into the papillae, abscesses are formed;
- ulcerative - under the coating on the surface appears a very painful wound;
- phlegmonous - inflammation covers the entire tongue, passes to the jaws, neck, multiple abscesses are formed.
Why glossitis happens during pregnancy?
Pregnancy does not protect a woman from all of the above reasons, making her even more vulnerable. In this physiological state, the mother organism bestows the best to the baby. Therefore, often pregnant women have signs of beriberi, anemia, functional disorders of the digestive system.
Hormonal surgery does not compensate for the costs of the mother, immunity decreases. Any kind of glossitis is possible. In this case, many medications are contraindicated because of the toxic effects on the fetus.
The problem of how to treat glossitis in a pregnant woman has to be coordinated with an obstetrician by a gynecologist observing a future mother
Common symptoms of glossitis
The disease has its own variations of the flow depending on the form. But common manifestations that require further diagnosis are:
- feeling of discomfort, burning, sometimes "foreign body" in the mouth, patients indicate that the tongue "interferes", bites;
- a noticeable increase in the mass of the tongue, redness, unusual patina on the surface;
- swelling of the tongue - most pronounced in case of allergic reaction, infectious glossitis, hormonal disorders( adrenal glands, thyroid gland), the patient speaks of "bursting" of the tongue;
- increased salivation;
- change in the form of the tongue - typical for prolonged traumatization, phlegmonous glossitis, the formation of abscesses in the muscle mass, is most pronounced with interstitial glossitis caused by syphilis;
- complex definition of taste right up to total loss, less perverted sensations;
- tenderness when eating;
- ulcers and rashes on the surface - under a grayish coating there is a bleeding ulcer, the rashes are multiple( viral and bacterial infections) or single( herpes), in appearance form spots, seals, abscesses, vesicles, plaques;
- slurred speech and pain when trying to speak - some sounds the patient does not utter;
- bad breath is felt by the surrounding and the patient himself, he happens with a purulent inflammation, is not eliminated by brushing his teeth.
How is infectious glossitis manifested and complicated?
Glossitis caused by a pathogenic infection is manifested by signs of acute inflammation( redness, swelling, local soreness).If there are confluent bubbles on the surface, then this is a sign of viruses. Opening up, they leave painful erosion.
With herpetic glossitis, delayed treatment and reduced immunity contribute to a rapid transition of inflammation to the oral cavity. Candidiasis glossitis is distinguished by a white coating, dense or loose on the background of edema and hyperemia.
On examination, attention is drawn to the impaired form, uneven increase in the area of the future abscess, swelling, tuberosity
With the development of phlegmon edema becomes more pronounced, the site with purulent tissue melting extends to the bottom of the mouth and neck. Pain syndrome is pronounced. Patients are forced to refuse food because of severe pain during chewing. Speech and breathing are difficult, choking attacks are possible.
There are symptoms of intoxication( fever, weakness, headache).It is possible to increase regional lymph nodes. Signs of intoxication are characteristic of ulcerative and phlegmonous glossitis. Toxins entering the blood can trigger the development of sepsis.
Species and features of non-infectious glossitis flow
Visual diagnostics of glossitis is performed by dentists. If necessary, they send for examination to other specialists to exclude general diseases. Atrophic glossitis - appears in chronic course, the absence of therapy. It is characterized by persistent, dense edema, mushroom-like growths on the mucous membrane.
The desquamative species is also called "geographical language".Development is associated with trophic disorders in the mucous layer. Part of the papillae( filiform) exfoliate prematurely. The process is called desquamation. In their place remain bright red spots with uneven edges.
Because of the stratification of such areas, the color varies from white to pink and red. The language really looks like a geographic map. It is characteristic for pregnancy, patients with chronic diseases of the stomach and intestines, blood diseases, metabolism, parasitic invasion.
Rhomboid or medial glossitis - more common in patients with hypoacid gastritis. In the root area there is a thickening of the epithelial tissue in the form of diamond-shaped sections of bright red or cyanotic color. Possible flat, tubercular or warty surface of diamonds. This form is prone to chronic flow, frequent relapses.
The nasal appearance is manifested by overgrowth and cornification of the threadlike papillae. They resemble villi. Appears with prolonged trauma, candidiasis, in smokers as a result of taking certain medications.
Interstitial glossitis - accompanied by the transition of a part of the muscle tissue into the cicatricial. The tongue resembles a quilted blanket, the fate of the muscle tissue rises. The symptom is a part of the symptoms of syphilis in the Tertiary period. Patients need specific antisyphilitic treatment. The disease refers to precancerous conditions.
When desquamation, tenderness is usually mild, worsens burning sensation
Hunters' glossitis - considered a symptom of B12- and folate-deficient anemia, belongs to a variety of atrophic process. Papillae are so atrophied that the surface of the tongue looks like a polished, shiny, bright crimson color.
What kind of diagnostics is needed?
For the purpose of proper treatment of glossitis and treatment of the tongue, dentists often have a characteristic appearance. To determine the depth and cause of inflammation, bacteriological planting on pathogenic flora, cytological methods, and enzyme immunoassay are used.
Smear microscopy and the absence of pale treponema, test-RPR, help to eliminate syphilitic nature. The presence of viruses is confirmed by the polymerase chain reaction method. To diagnose primary diseases, doctors use all the hardware capabilities, the results of biochemical blood tests. The necessity of consultation of an otolaryngologist, hematologist, gastroenterologist and other specialists is not excluded.
Treatment of glossitis
Treatment of glossitis of the tongue necessarily starts with elimination of the main cause, correction of disorders caused by the underlying disease. To reduce the pain when eating, a gentle diet is recommended: mashed soups, boiled liquid porridge, vegetable puree. At the expressed pains suggest to do nutritious cocktails from eggs, sugar, milk and to drink them through a tube.
The doctor of any specialty
can meet with different types of glossitis. Local procedures:
- several times during the day, before and after meals, mouthwashes are appointed with disinfectant solutions( furacilin, potassium permanganate, chlorhexidine);
- with severe pain shows applications with anesthetics( Trimekaine, Pyromecaine, Lidocaine);
- if the mucosa is dry, then the surface is lubricated with a glycerin mixture with Anestezine;
- for the removal of plaque fibrin and necrotic epithelium use cotton swabs soaked in solution with proteolytic enzymes( Trypsin or Chymotrypsin), with painful erosions and ulcers they are used in applications.
After each procedure, the oral cavity is treated with a solution of antiseptic, hydrogen peroxide to prevent re-infection and complication. To accelerate healing, gel-like dental equipment is used( Vinisol, Solcoseryl, Retinol oil solution).They activate the process of tissue regeneration. The composition includes vitamin A, little rose hips, peach.
Depending on the type of glossitis, antifungals, antibiotics, antiviral( Acyclovir, Cycloferon) and anthelmintic treatment are prescribed. Of immunomoduljatorov widely used drugs that increase local immunity( Imudon in absorbable tablets under the tongue, drops of lysozyme).Dosage is selected by the doctor individually.
In allergic and auto-allergic processes, courses of corticosteroids in the form of ointments are shown. It is dangerous to apply them independently, as they can cause atrophy of the mucous membrane of the tongue. Surgical treatment may be needed in case of complication of infectious glossitis( abscess, phlegmon), villous form. The removal of the cornified part of the mucosa is carried out, the abscesses are opened.
What can I do at home?
Inpatient treatment is recommended in cases of advanced or complicated glossitis. Most patients are treated on an outpatient basis with the advice of a doctor. It is necessary to conduct regular rinses, treatment of affected areas, drink tablets of antibacterial or antifungal drugs.
For rinses, recommend special dental kits from extracts of medicinal plants( Stomatophyte, Rotokan)
It is necessary to observe the time after the procedure before meals - at least two hours. Folk remedies can only be used after consultation with a doctor. The greatest bactericidal effect and healing effect are:
- raspberry leaves;
- flowers of chamomile and calendula;
- laurel leaves;
- Oak bark.
For the surface treatment, eucalyptus and tea tree oil is effective. Healers offer a way to rinse the mouth with freshly squeezed potato juice. Glossitis is a painful disease. To prevent it, you must fulfill all the requirements of oral hygiene, in time to treat carious teeth, to quit smoking and spicy food. Respect for one's own organism will help to avoid many problems.