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Glossitis
Inflammation of the tongue with loss of filiform papillae leads to glossitis
May be secondary to nutritional deficiencies (eg, niacin, riboflavin, iron, or vitamin E), drug reactions, dehydration, irritants, food and liquids, and possibly autoimmune reactions or psoriasis
Glossodynia
Burning and pain of the tongue; it may occur with or without glossitis
In the absence of clinical findings of glossitis, it has been termed "the burning mouth syndrome"
Glossodynia has been associated with diabetes mellitus, drugs (eg, diuretics), tobacco, xerostomia, and candidiasis as well as the causes of glossitis
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Rarely painful
Glossitis: red, smooth-surfaced tongue
Glossodynia: Consider imaging of the brain, brainstem, and skull base with MRI when
Symptoms are unilateral
Symptoms cannot be related to a specific medication
Symptoms and signs involve regions supplied by other cranial nerves, suggesting neuropathology
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Glossitis
Glossodynia
Reassurance that there is no infection or tumor
Anxiolytic medications and evaluation of possible psychological status may be useful
Treating possible underlying causes, changing long-term medications to alternative ones, and smoking cessation may resolve symptoms
Effective treatments for burning mouth syndrome include alpha-lipoic acid and clonazepam
Clonazepam is most effective as a rapid dissolving tablet placed on the tongue in doses from 0.25 mg to 0.5 mg every 8–12 hours
Behavioral therapy has also been shown to be effective for burning mouth syndrome