An Overview of Transient Lingual Papillitis

Transient lingual papillitis, also called "lie bumps," is a common inflammatory condition that affects the tongue, specifically the fungiform papillae.

Fungiform papillae are flat, pink bumps located on the top and sides of the tongue, especially towards the tip. They contain taste buds and temperature-sensing receptors. When these papillae become irritated and inflamed, tongue pain and difficulty eating may occur.

Many different factors have been linked to transient lingual papillitis, including infection, chronic trauma, heat injury, or eating spicy or acidic foods. Doctors diagnose this condition by taking a medical history and performing an examination of the mouth. Rarely, a biopsy is performed

The treatment of transient lingual papillitis is supportive, meaning a doctor may recommend therapies—saltwater rinses, cold foods, or topical corticosteroids—that can soothe any tongue discomfort.

The symptoms of transient lingual papillitis vary based on the type:

This type of transient lingual papillitis refers to inflammation of one or several fungiform papillae within one area of the tongue, often the tip.

It manifests as single or multiple raised red or white/yellow painful bumps. The bump(s) often disappear within one to two days; although, less commonly, it may take up to several days.

Other symptoms associated with this type include:

• A burning, tingling, or itching sensation of the tongue
• Sensitivity to hot foods
• Difficulty with eating, especially spicy or high-acid foods
• Distorted taste (called dysgeusia)
• Dry mouth

This type usually affects children and causes a sudden whole-body illness. A child often has a fever and lymph node enlargement in the neck ("swollen glands"), in addition to painful bumps on the tip and sides of the tongue.

The illness lasts about one week on average but then may recur a couple of months later.

Besides pain, fever, and swollen glands, a child may produce excess saliva and have difficulty eating.

The papulokeratotic type causes several white to yellow bumps to form all over the tongue. The bumps are painless and may come and go or persist for long periods of time.

The precise cause behind transient lingual papillitis remains unknown. That said, experts suspect that it occurs as a result of one or more triggering factors, such as:

• Underlying infection, either viral or bacterial (this is commonly associated with eruptive lingual papillitis)
• Low-grade chronic irritation or trauma from sharp-edged/fractured teeth or wearing an orthodontic appliance
• Stress
• Sleep deprivation
• Poor nutrition
• Heat injury to the tongue
• Eating spicy or acidic foods (for example, foods containing cinnamon or capsaicin)
• Excessive smoking or alcohol intake
• Using certain oral hygiene products
• Hormone fluctuation (for example, during menstruation or menopause)
• It may also be associated with atopic disease (e.g., eczema).

Research suggests, as well, that transient lingual papillitis may be associated with a food allergy. It may also be seen with other underlying tongue conditions, such as geographic tongue.

When diagnosing transient lingual papillitis, your doctor will perform a medical history that explores potential triggers (e.g., trauma). Your doctor will also perform a physical examination that focuses on the mouth, tongue, lips, and neck area (to look for lymph node swelling).

Less commonly, a biopsy (when a tiny piece of tissue from your tongue is removed and examined under the microscope) will be performed to rule out alternative diagnoses.

Since this tongue condition usually resolves within hours to a couple of days, no treatment is often needed.

However, for symptom relief, a doctor may recommend the following therapies:

• Saltwater rinses
• Cold drinks and foods
• Anesthetic or antiseptic mouthwashes
• Topical steroids, such as triamcinolone acetonide 0.1% dental paste
• Avoiding irritating gums, candies, or oral hygiene products

Eliminating triggers to prevent recurrence of the condition may also be recommended.

Transient lingual papillitis is a common, often painful tongue condition. While you may feel uncomfortable, and your tongue may appear unsightly, rest assured that this condition is harmless and will resolve soon, usually within a day or two.

If you think you have transient lingual papillitis, or notice any new changes with your tongue, it's a good idea to make an appointment with your doctor, especially if it does not resolve within a couple of days.