Transient Lingual Papillitis: Symptoms, Causes, Treatment

 

Transient Lingual Papillitis is a common and painful inflammation that occurs on the tongue. It affects one or more small bumps called fungiform papillae. People often refer to this condition as "lie bumps." It may also be related to or the same as other tongue conditions known as eruptive (familial) lingual papillitis and fungiform papillary glossitis.

Overview:

Transient lingual papillitis is an inflammatory condition commonly known as "lie bumps". It involves the fungiform papillae on the tongue and causes pain. Transient lingual papillitis may be associated with other tongue conditions.

It is a temporary condition that causes small, painful bumps on the tongue. These bumps, which can be red or white, are believed to be caused by irritation or inflammation of the taste buds. Possible triggers include certain foods, tongue trauma, stress, hormonal changes, or viral infections. The condition usually resolves on its own within a few days or weeks without treatment. However, if symptoms persist or worsen, it is advisable to seek medical advice.

This article will provide you valuable insights into the causes and symptoms of transient lingual papillitis, making it a helpful resource for those seeking information on this condition. 

What are Fungiform Papillae?

Fungiform papillae are a specific type of bumps that can be found on the surface of the tongue. These papillae serve important functions, such as housing taste buds (especially for bitter taste), temperature receptors, and having a good blood supply. 

• They are scattered across the top and sides of the tongue, primarily towards the tip. Normally, they are not easily noticeable, appearing flat and pink. 
• The number and size of fungiform papillae can vary in different individuals.
• Females tend to have more fungiform papillae than males, and their numbers may increase even further after menopause.
• Nerve injuries can lead to a decrease in the number of fungiform papillae and a reduction in taste sensation.
• In certain conditions, such as scarlet fever, fungiform papillae can become more prominent, resulting in a "strawberry tongue" appearance. 

More recently, they have been recognized as the most common oral manifestation of COVID-19.

How common is Transient Lingual Papillitis?

Transient lingual papillitis is a relatively common condition, although its exact prevalence is not well-documented. It can affect people of all ages, including children and adults. While the frequency of occurrence is unknown.

Who Gets Transient Lingual Papillitis and Why?

The prevalence of the classic form of transient lingual papillitis is estimated to affect more than 50% of the population. It is more commonly observed in young women, but it can affect individuals of all age groups. The primary cause of this condition is believed to be local irritation or trauma to a fungiform papilla on the tongue. However, other factors such as stress, hormonal changes, gastrointestinal issues, and specific foods have also been suggested as possible triggers.

Eruptive (familial) lingual papillitis primarily affects young children and their families. It tends to be more prevalent during the spring season, although it can occur throughout the year. Children who have frequent contact with other children, such as those attending school, kindergarten, or daycare, are more likely to develop this condition. It is suspected to have a viral cause, similar to herpes simplex virus/cold sores, where the virus is acquired in childhood and can lead to recurrent episodes later in life, presenting as the classic form of transient lingual papillitis in adulthood.

Transient lingual papillitis has also been reported in patients with COVID-19. Additionally, there is a condition called fungiform papillary glossitis, which has been described in individuals with a history of eczema, asthma, or hay fever. Fungiform papillary glossitis may be another term for transient lingual papillitis. Some researchers suggest that this condition may be due to increased environmental sensitivity of the tongue, similar to the increased sensitivity of the skin, lungs, or nose that can result in eczema, asthma, or hay fever, respectively.

Transient Lingual Papillitis Pictures:

Clinical Features of Transient Linguam Papillitis:

1. Classic Form:

Transient lingual papillitis typically manifests as a solitary painful bump on the tongue, which can be red or white. It is commonly located towards the tip of the tongue. These bumps usually last for 1-2 days before disappearing, and they may reappear weeks, months, or even years later. There are usually no other accompanying symptoms or enlargement of lymph glands. In some cases, the lesions may be more numerous, resolve within hours persist for several days, and may be accompanied by a burning or tingling sensation. Occasionally, the bumps may not cause any noticeable symptoms. Some studies have suggested a potential association between transient lingual papillitis and geographic tongue or scalloped markings on the sides of the tongue.

2. Eruptive Lingual Papillitis:

Eruptive lingual papillitis is a systemic illness that is often accompanied by symptoms such as fever and enlargement of lymph glands. The onset of this condition is sudden. Affected children may exhibit a reluctance to eat and excessive production of saliva. The tongue shows enlarged and inflamed fungiform papillae primarily on the tip and sides, but not on the top. These enlarged papillae may resemble pustules. Angular cheilitis, a condition characterized by cracks or sores at the corners of the mouth, may also be observed.

The illness typically lasts for about one week, although it can range from 2 to 15 days. Recurrences of the condition have been reported to occur 1-2 months later, with the same clinical features. Family members, including parents and siblings, may develop symptoms approximately one week later, with a range of 1-15 days. In adults, the illness presents as a sudden and intense burning sensation on the tongue, which is exacerbated by consuming food. The clinical appearance of the tongue is similar to that observed in affected children.

3. Papulokeratotic Variant:

The papulokeratotic variant of transient lingual papillitis is characterized by the presence of multiple white bumps on the tongue. Unlike other forms of the condition, these bumps do not cause any noticeable symptoms. They may persist over time without resolving on their own.

4. Transient U-Shaped Lingual Papillitis:

Transient U-shaped lingual papillitis, which is often accompanied by tongue swelling, has been identified as the most frequently observed oral mucosal change in patients with COVID-19. This occurrence could be attributed to direct infection of the mucosa by the SARS-CoV-2 virus or secondary factors such as inadequate oral hygiene or the use of oxygen therapy.

What are the Symptoms of Transient Lingual Papillitis?

The symptoms of transient lingual papillitis, include the appearance of

• Small, painful bumps 
• Sores on the surface of the tongue
• Bumps can be red or white (causing discomfort or sensitivity while eating, drinking, or speaking)
• Tingling or burning sensation on the tongue,
• Increased saliva production
• A metallic taste in the mouth

It's important to note that these symptoms are usually temporary and the condition typically resolves on its own within a few days or weeks without any specific treatment.

What causes Transient Lingual Papillitis?

The exact cause of transient lingual papillitis is not fully understood. However, it is believed to be related to irritation or inflammation of the taste buds on the tongue. There are several possible triggers for this condition, including

• Certain foods such as acidic or spicy foods
• Tongue trauma
• Injury
• Stress
• Hormonal changes
• Viral infections

It's important to note that while these factors may contribute to the development of transient lingual papillitis, the condition is generally harmless and resolves on its own within a few days or weeks without any specific treatment.

How is Transient Lingual Papillitis Diagnosed?

Transient lingual papillitis and eruptive lingual papillitis are typically diagnosed based on their characteristic clinical presentation, and a mucosal biopsy is usually not required. However, if a biopsy is performed, it may reveal inflammation and swelling of a fungiform papilla. Special stains used in the biopsy process are generally unable to detect viral, fungal, or bacterial infections. In the case of the papulokeratotic variant, a biopsy would show severe hyperparakeratosis (abnormal thickening of the outer layer of the skin) and mild chronic inflammation.

How Transient Lingual Papillitis is Treated?

Transient lingual papillitis, also known as "lie bumps," typically resolves on its own without any specific treatment. However, there are a few self-care measures that can help alleviate discomfort and promote healing. These include

• Practicing good oral hygiene by gently brushing the tongue with a soft-bristled toothbrush,
• Avoiding irritating or spicy foods, and rinsing the mouth with warm saltwater
• Over-the-counter pain relievers, such as acetaminophen or ibuprofen. 

If the symptoms persist or worsen, it is adivisable to consult a healthcare professional for further evaluation and guidance. They may recommend topical medication or provide additional treatment options on the individual's specific condition. 

How Long does Transient Lingual Papillitis Last?

The duration of transient lingual papillitis, also known as "lie bumps," can vary from person to person. In most cases, the condition lasts for a few days to a couple of weeks. The bumps typically resolve on their own without any specific treatment. However, if the symptoms persist for an extended period or worsen, it is advisable to consult a healthcare professional for further evaluation and guidance. They can provide a more accurate assessment based on the individual's specific condition and recommend appropriate measures if necessary.

Home Remedies for Transient Lingual Papillitis:

While transient lingual papillitis, commonly known as "lie bumps," typically resolves on its own without treatment, there are some home remedies that may help alleviate discomfort and promote healing. Here are a few suggestions:

1. Maintain good oral hygiene: Gently brush your tongue with a soft-bristled toothbrush to remove any debris and maintain oral hygiene.

2. Saltwater rinse: Rinse your mouth with warm saltwater (dissolve 1/2 teaspoon of salt in 8 ounces of warm water) several times a day to reduce inflammation and promote healing.

3. Avoid irritating foods: Steer clear of spicy, acidic, or rough-textured foods that may further irritate the tongue.

4. Over-the-counter pain relievers: Non-prescription pain relievers like acetaminophen or ibuprofen can help manage any pain or discomfort associated with the condition. Follow the recommended dosage instructions.

5. Ice or cold compress: Applying a cold compress or sucking on ice chips can help numb the area and provide temporary relief.

It's important to remember that these home remedies are intended to provide temporary relief and promote comfort. If your symptoms persist or worsen, or if you have any concerns, it is advisable to consult a healthcare professional for further evaluation and guidance.

FAQs:

Q. What is Lingual Papillitis on the back of the tongue?

A. Transient lingual papillitis, or lie bumps, are inflamed taste buds. They come in several types, each with its distinctive pattern, appearance, and other symptoms. Causes may include infection, stress, poor nutrition, allergies, trauma to the tongue, spicy foods, smoking, and some oral hygiene products.

Q. How do you treat inflamed papillae at home? 

A. Swollen taste buds are inconvenient at best. They're not dangerous, but they can lead to pain and irritation. Home remedies, like sucking on ice or rinsing with warm salt water, can ease your symptoms most of the time. But if you have swollen taste buds that last for two weeks or more, talk to your healthcare provider.

Q. What is the best Treatment for Papillitis?

A. If spontaneous remission does not occur in people with papillitis it is usually treated with the corticosteroid drugs prednisone or methylprednisolone. Other treatment is symptomatic and supportive.

Q. Can Lingual Papillitis spread?

A. This condition lasts for about 1 week on average. Recurrence around 1 to 2 months, later on, in common with the same kind of symptoms. Eruptive lingual papillitis is contagious and spreads among family members and especially among siblings.