Transient Lingual Papillitis (TLP) is a common, benign condition affecting the tongue, characterized by small, often painful bumps. While usually harmless and self-resolving, TLP has gained attention due to observed connections with COVID-19. Understanding this temporary inflammation of the tongue’s papillae helps individuals recognize its presentation and manage symptoms. This article explores TLP and its relationship with COVID-19.
Understanding Transient Lingual Papillitis
Transient Lingual Papillitis is an inflammatory condition that impacts the fungiform papillae, which are the tiny bumps on the tongue’s surface containing taste buds. When these papillae become inflamed, they can appear as small, noticeable bumps that may be red, white, or yellow in color. These bumps commonly emerge on the tip or sides of the tongue, sometimes affecting an isolated area or both sides.
Individuals with TLP report symptoms such as soreness, burning, tingling, or itching on the tongue. Discomfort can range from mild to sharp pain, potentially making eating difficult or causing sensitivity to hot foods. While the exact cause of TLP is often unknown, non-COVID-related factors can trigger it. These include minor trauma from biting, stress, hormonal fluctuations, acidic or sugary foods, allergies, poor nutrition, and certain dental products.
The Connection Between TLP and COVID-19
An observed relationship exists between Transient Lingual Papillitis and COVID-19, where TLP can manifest as an oral symptom in some infected individuals. One specific type, U-shaped lingual papillitis, characterized by a swollen tongue with scattered red or pink spots, has been noted as more common in people with a COVID-19 infection. Studies have documented “COVID tongue” as a possible symptom, which can involve swelling, ulcers, and white patches on the tongue, often accompanied by a burning sensation or loss of taste.
The virus responsible for COVID-19, SARS-CoV-2, can invade human cells by interacting with angiotensin-converting enzyme 2 (ACE2) receptors, which are present in various organs, including the oral cavity. This viral entry can induce inflammatory responses in the affected tissues, potentially contributing to oral manifestations like TLP. Tongue swelling and irritated papillae in COVID-19 patients may result from direct inflammation of the oral mucosa by the virus, drying of the mucosa due to viral activity or oxygen therapy, or even compromised oral hygiene.
While TLP is not a universal symptom of COVID-19, it has been noted as an oral manifestation in studies. For instance, one study found transient U-shaped lingual papillitis in approximately 11.5% of hospitalized COVID-19 patients, with some also experiencing tongue swelling. Other oral findings in COVID-19 patients include glossitis with patchy depapillation, aphthous stomatitis, and a general burning sensation. These oral changes highlight the broader impact of viral infections on the body’s inflammatory responses.
Managing TLP Symptoms and Knowing When to Seek Help
Managing the symptoms of Transient Lingual Papillitis, whether associated with COVID-19 or not, primarily involves self-care measures to alleviate discomfort. Avoiding known irritants such as spicy, acidic, or sugary foods and drinks can help reduce irritation. Rinsing the mouth with warm salt water can also provide relief, and consuming cold foods or drinks, like ice chips or popsicles, may soothe inflammation.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage any pain. Maintaining good oral hygiene is also beneficial, which includes using a soft toothbrush and avoiding toothpastes or mouthwashes that seem to trigger irritation. It is important to avoid attempting to pop the bumps on the tongue, as this can lead to further pain or potential infection.
While TLP often resolves within a few days to a week, seek medical attention if symptoms are severe, persistent, or worsen, or if bumps do not disappear after two weeks. Also, if TLP symptoms are accompanied by fever, swollen lymph nodes, bleeding from the bumps, or difficulty swallowing or breathing, immediate medical evaluation is advised, especially if COVID-19 is suspected or confirmed.