From the Guidelines
The most effective treatment for glossitis involves maintaining good oral hygiene, using topical corticosteroids, and managing symptoms with pain relievers and antiseptic mouthwashes, as evidenced by the most recent guidelines 1. To manage glossitis, it is essential to identify and address the underlying cause. For mild cases, maintaining good oral hygiene, avoiding irritants like spicy foods, alcohol, and tobacco, and using over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage symptoms. Some key considerations for treatment include:
- Using antiseptic oral rinses twice daily to reduce bacterial colonization of the mucosa, with options including 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash 1.
- Applying a topical corticosteroid four times daily, such as betamethasone sodium phosphate 0.5 mg in 10 mL water as a 3-min rinse-and-spit preparation, or using a more potent preparation like clobetasol propionate 0.05% mixed in equal amounts with Orabase 1.
- Considering the use of a potent topical corticosteroid mouthwash, such as betamethasone sodium phosphate, four times a day, as recommended in the British Association of Dermatologists' guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people 1. It is crucial to evaluate severe or persistent glossitis by a healthcare provider, as it may indicate serious underlying conditions like autoimmune disorders that require specific treatments. Staying hydrated and using alcohol-free mouthwashes can provide additional comfort during recovery.
From the Research
Treatment for Glossitis
The treatment for glossitis depends on the underlying cause of the condition.
- For atrophic glossitis, which is often linked to an underlying nutritional deficiency of iron, folic acid, vitamin B12, riboflavin, or niacin, treatment involves correcting the underlying condition 2.
- Supplementations with vitamin BC capsules plus corresponding deficient hematinics for those AG patients with hematinic deficiencies can achieve complete remission of oral symptoms and AG in some AG patients 3.
- Median rhomboid glossitis is usually associated with a candidal infection and responds to topical antifungals 2.
- In cases of vitamin B12 deficiency, glossitis with linear lesions is considered an early clinical sign, and determination of vitamin B12 is recommended even in the absence of anemia 4.
Nutritional Deficiencies and Glossitis
Nutritional deficiencies play a significant role in the development of glossitis.
- Deficiencies of hemoglobin, iron, and vitamin B12, as well as high homocysteine levels, are significantly associated with atrophic glossitis 5.
- Younger atrophic glossitis patients have significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency compared to older patients 6.
- Correction of these deficiencies is essential for the treatment and management of glossitis 3, 2, 5, 4, 6.