Geographic tongue, a benign condition affecting the surface of the tongue, has recently drawn increased attention due to its reported association with COVID-19. This article explores its characteristics and connection with the novel coronavirus. Understanding this link can provide valuable insights for individuals experiencing such oral changes.
Understanding Geographic Tongue
Geographic tongue, also known as benign migratory glossitis, is an inflammatory condition affecting the tongue’s surface, giving it a distinctive map-like appearance. It is characterized by smooth, red patches lacking the tiny, finger-like projections called papillae. These red areas are often surrounded by slightly raised, white or yellowish borders.
The patches can change in size, shape, and location over days or weeks, appearing to “migrate” across the tongue. While many individuals experience no symptoms, some report sensitivity, discomfort, or a burning sensation, particularly when consuming hot, spicy, or acidic foods. This condition is not contagious and is harmless, often resolving on its own. Its exact cause remains unknown, though it has been linked to factors such as genetics, stress, allergies, and certain underlying conditions like psoriasis.
Geographic Tongue and COVID-19
During the COVID-19 pandemic, observations emerged linking geographic tongue, sometimes referred to as “COVID tongue,” to SARS-CoV-2 infection. Studies and case reports indicated that oral changes, including those to the tongue, were present in some COVID-19 patients. Some individuals reported a swollen tongue with bumps, ulcers, white patches, or a burning sensation.
Research suggests that SARS-CoV-2 enters human cells through ACE2 receptors, which are present in significant numbers on the tongue’s surface. This high concentration of receptors may contribute to the tongue-related symptoms observed in some infected individuals. While prevalence varies, a 2020 study reported oral symptoms in 11.7% of COVID-19 patients, with red bumps and white patches among the noted changes. Geographic tongue can occur at different stages of infection, sometimes alongside other common COVID-19 symptoms or as an initial sign.
The connection between COVID-19 and geographic tongue is still under investigation, with theories suggesting it could be a direct effect of the virus on oral tissues or an immune response. The inflammatory nature of geographic tongue lesions aligns with the body’s broader inflammatory response to the virus. While observed in COVID-19 cases, it is not a primary symptom, and other factors may contribute to its manifestation.
Care and Outlook
For individuals experiencing geographic tongue, whether associated with COVID-19 or not, management primarily focuses on alleviating discomfort. Since the condition is benign and often resolves spontaneously, specific medical treatment is often not required. Avoiding irritants is an important self-care strategy; this includes abstaining from hot, spicy, acidic foods, alcohol, and certain toothpastes that can exacerbate symptoms.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage any discomfort or burning sensations. In cases of more significant irritation, a healthcare provider might suggest topical anesthetic gels, antihistamine mouthwashes, or corticosteroid rinses to reduce inflammation. While these symptomatic treatments can provide relief, their long-term benefit for geographic tongue is not extensively studied, as the condition tends to come and go on its own.
Geographic tongue typically has a good outlook, with lesions often resolving within days, weeks, or months, though they can recur. It does not lead to cancer or other major long-term health complications. However, if tongue changes persist for more than 10 days, or if there are concerns about severe swelling, difficulty breathing, speaking, or swallowing, consulting a healthcare provider is advisable to rule out other conditions.