Glossitis: Clinical Etiologies, Diagnostic Evaluation, and Multidisciplinary Management in Dental and Medical Practice

Abstract

Background: Glossitis, defined as inflammation of the tongue, is a common clinical presentation with a broad differential diagnosis. It manifests through symptoms like pain, burning, and changes in tongue morphology, such as depapillation, erythema, or swelling. The condition often serves as a visible indicator of underlying systemic disorders, making its evaluation a critical component of both dental and medical practice.

Aim: This review aims to synthesize the diverse etiologies, systematic diagnostic approach, and multidisciplinary management strategies for glossitis, emphasizing its role as a sentinel sign of local and systemic pathology.

Methods: A comprehensive analysis of the literature was conducted, integrating data on anatomy, pathophysiology, clinical classification, and evidence-based management. The diagnostic evaluation and therapeutic principles are drawn from both dental and medical perspectives.

Results: Glossitis has multifactorial etiologies, including nutritional deficiencies (iron, B vitamins), infections (Candida, viral), medication reactions, autoimmune diseases, and local irritants. Clinical patterns—such as atrophic, median rhomboid, geographic, and strawberry tongue—guide the diagnostic workup. Evaluation hinges on a detailed history and physical exam, supplemented by targeted laboratory tests (e.g., CBC, vitamin levels) and biopsy for persistent or suspicious lesions to rule out malignancy. Management is etiology-specific: correcting deficiencies, treating infections, removing offending medications, and providing symptomatic relief with topical therapies.

Conclusion: Glossitis requires a systematic, interdisciplinary diagnostic approach to identify its often-systemic cause. Successful management depends on accurate etiology determination and tailored treatment, ranging from simple nutritional supplementation to addressing complex autoimmune conditions.