Geographic Tongue: A Real Pain in the Mouth

Even in my earliest memories about food, I can remember the terrible consequences that would follow when I ate any meal which combined tomatoes and citrus together. Most often it happened if I drank orange juice and ate something with ketchup on it–within minutes, my tongue felt as if it had raised, painful ridges on it, red ridges which itched and burned like crazy and would not be soothed with drinking anything. Ice relief lasted only as long as the ice lasted in my mouth, and then the aggravating itch and burn would be back. Sometimes I resorted to scraping my tongue with my teeth or fingernails, which didn’t really help but made me feel a little less powerless against this until it finally went away (it usually took about an hour).

My mother always called this condition “geographic tongue,” and I learned that members of both sides of my family had experienced this reaction to certain foods or combinations of foods. For my immediate family, we quickly learned to avoid the tomato/citrus combination for my sake, and I became more aware of what I was about to eat. But sometimes it snuck up on me, or I forgot about it until it was too late–like the time I ate a slice of cheese pizza slathered in tomato sauce along with a citrusy drink for school lunch. (Let’s just say getting through third block was VERY interesting…)

However, while doing a bit of casual Googling and Wikipedia-ing about this topic, I noticed that there is more to “geographic tongue” than a simple, silly-sounding temporary food reaction. In fact, this is a medical condition, one that explains far more about my own gustatory habits.

What Exactly IS Geographic Tongue? (Warning, Picture Ahead)

Geographic tongue, aka “benign migratory glossitis” or “erythema migrans,” is a harmless mouth condition that affects about 3 percent of adults around the world. (Yay, I feel special now, LOL.) It seems to be more common in middle-aged and older adults than children, and more common in women than men. Upon eating foods with high acid content or strong flavors (it varies among sufferers), the tongue burns, stings, and/or itches. And, if you look at a geographic tongue, you’ll see patches of red and white all over it in map-like formations which give the condition its name.

As an example: my own tongue.

tongue As you can see, my tongue looks pretty strange–it has always looked patchy like this, even in my childhood. (Bonus: not only do I have strange patterns all over it, but I also have deep fissures in my tongue, which often appear in people with geographic tongue–you can see a big one running right down the center of my tongue in this pic, and there are other smaller ones as well. These fissures tend to exacerbate geographic tongue, producing swelling when already irritating foods get down into the fissures.)

The reason all these weird patches show up is because my tongue is missing papillae (the things that contain taste buds) on the redder parts of my tongue, while the lighter parts have papillae in abundance. The areas of darker and lighter red can change places at random, so you can never tell exactly what my tongue is going to look like (LOL). This “missing papillae” phenomenon doesn’t sound like much, but apparently it’s really important when it comes to processing strong flavors or acidic foods. People still don’t really know why it happens.

Is It Contagious/Dangerous?

If you’re one of the 3% of human beings who has this, do not fret: this is NOT a precancerous/cancerous condition, but rather a “minor annoyance” condition, at least as doctors classify it. (Ha, it doesn’t FEEL minor when it’s happening and you can’t do squat about it!) Also, it seems to have nothing to do with oral hygiene, though a lack of said hygiene can make geographic tongue worse in some cases. If you develop very painful sores or swelling on your tongue that keeps you from breathing correctly, however, get to a doctor ASAP.

Geographic tongue is not contagious; it appears to be purely hereditary, and the same people who have geographic tongue often have allergies, asthma, eczema, and/or are more susceptible to hay fever. There are also suspected links to anemia and psoriasis as well. (Yep, all this is in my family, too. [sarcasm] YAY. [/sarcasm]) Lastly, there may be a connection between geographic tongue and celiac disease, though more research needs to be done.

What Can Cause Geographic Tongue to Flare Up?

Foods/Drinks

Oral Products

Other Triggers

  • Spicy foods (esp. chilies, chili powder/chili sauce)
  • Citrus fruits, especially pineapple
  • Sour foods
  • Oregano
  • Walnuts & pecans
  • Raw spinach
  • Chard
  • Tomatoes
  • Eggplants
  • Really strong cheeses (like bleu cheese)
  • Strongly-flavored candy (esp. peppermint, chocolate, and cinnamon)
  • Alcohol
  • Mouthwashes (esp. with strong flavors)
  • Whitening toothpastes
  • Tobacco (esp. chewing tobacco)
  • Environmental sensitivity (see previous section on heredity)
  • Stress (possibly)
  • Diets high in sugar or processed foods (possibly; needs more research)
  • Vitamin B deficiency
  • Psoriasis flare-up
  • Hormonal changes
  • What Can Help Soothe/Keep Down Geographic Tongue?

    • Vitamin B supplements
    • Zinc supplements
    • Toothpaste for sensitive teeth with no additives
    • Ice (temporarily)
    • Anesthetic mouth rinses
    • Mint gum/lozenges (supposedly)

    (If constantly painful, a doctor can treat geographic tongue with certain topical ointments, antifungal products, or even corticosteroid treatments.)

    Living With Geographic Tongue

    For me, the list of “trigger foods” surprises me; most if not all of those are on my “do-not-eat” list. I never have been able to enjoy cinnamon-flavored gum or candy, for instance, and I’ve always been very particular about the kind of orange juice I get–it’s got to be “Low Acid.” And though I love sweets, too much chocolate with nothing to drink with it leaves me with a burning, “coated”-feeling tongue and throat.

    In light of this condition, my picky eating makes a little more sense, since I’ve been avoiding many foods possibly based on how they make my mouth feel rather than the taste. And it also sheds light on why my tongue often feels so irritated after I brush my teeth, too, since I use a lot of whitening agents and special mouth rinses.

    I don’t know whether adding Vitamin B or zinc would help me, nor am I sure if my geographic tongue might be connected to stress, allergies, psoriasis, etc. But these sure help give clues as to what I can try!

    For Further Reading/Reference

    NIH.gov Article on Geographic Tongue
    Foods that Cause Geographic Tongue
    WebMD.com’s Guide to Geographic Tongue
    Geographic Tongue: Top 10 Causes and Cures
    Geographic Tongue: Wikipedia Article
    Fissured Tongue: Wikipedia Article

    51 thoughts on “Geographic Tongue: A Real Pain in the Mouth”

    1. I have had Geographic tongue for my entire life and I did not know that I even had it until 2 years ago (I am 12). I though that pineapple just had a lot of acid so it made everybodys tongue hurt and I had never tried eggplant before (thats the worse one for me) the way I found out is my mom was talking about how her tongue hurt when she ate different foods and I realized it is not normal to have your tongue constantly hurt (I ate a lot of pineapple and tomatos)

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