Anemias Iron-deficiency anemia is mainly caused by blood loss, such as may occur during menses or gastrointestinal hemorrhage. This often results in a depapilled, atrophic<unk> , giving the tongue a bald and shiny appearance, along with pallor (paleness) of the lips and other mucous membranes a tendency towards recurrent oral ulceration, and cheilosis (swelling of the lips). The appearance of the tongue in iron deficiency anemia has been described as diffuse or patchy atrophy with tenderness or burning. One cause of iron deficiency anemia is sideropenic dysphagia (Plummer–Vinson or Paterson–Brown–Kelly syndrome) which is also characterized by esophageal webbing and dysphagia. Pernicious anemia is usually caused by autoimmune destruction of gastric parietal cells. Parietal cells secrete intrinsic factor which is required for the absorption of vitamin B12. Vitamin B12 deficiency results in megaloblastic anemia and may present as<unk> . The appearance of the tongue in vitamin B12 deficiency is described as "beefy" or "fiery red and sore". There may be linear or patchy red lesions. Vitamin B deficiencies Vitamin B1 deficiency (thiamine deficiency) can cause<unk> . Vitamin B2 deficiency (ariboflavinosis) can cause<unk> , along with angular cheilitis, cheilosis, peripheral neuropathy and other signs and symptoms. The<unk>  in vitamin B2 deficiency is described as magenta. Vitamin B3 deficiency (pellagra) can cause<unk> . Vitamin B6 deficiency (pyridoxine deficiency) can cause<unk> , along with angular cheilitis, cheilosis, peripheral neuropathy and seborrheic dermatitis. Folate deficiency (vitamin B9 deficiency) can cause<unk> , along with macrocytic anemia, thrombocytopenia, leukopenia, diarrhea, fatigue and possibly neurological signs. Apart from pernicious anemia discussed above, any other cause of vitamin B12 deficiency can cause<unk> , which tends to be painful, smooth and shiny. Infections Bacterial, viral or fungal infections can cause<unk> . Chronic Candida infections of the tongue can cause an atrophic<unk>  known as median rhomboid<unk> . Syphilis is now relatively rare, but the tertiary stage can cause diffuse<unk>  and atrophy of lingual papillae, termed "syphilitic<unk> ", "luetic<unk> " or "atrophic<unk>  of tertiary syphilis". It is caused by Treponema pallidum and is a sexually transmitted infection. Other causes Many conditions can cause<unk>  via malnutrition or malabsorption, which creates the nutritional deficiencies described above, although other mechanisms may be involved in some of those conditions listed. * Alcoholism * Sprue (celiac disease, or tropical sprue), secondary to nutritional deficiencies * Crohn’s disease * Whipple disease * Glucagonoma syndrome * Cowden disease * Acquired immunodeficiency syndrome (AIDS) * Carcinoid syndrome * Kwashiorkor amyloidosis * Veganism and other specialized diets, without B12 supplementation. *Poor hydration and low saliva in the mouth, which allows bacteria to grow more readily *Mechanical irritation or injury from burns, rough edges of teeth or dental appliances, or other trauma *Tongue piercing<unk>  can be caused by the constant irritation by the ornament and by colonization of Candida albicans in site and on the ornament *Exposure to irritants such as tobacco, alcohol, hot foods, or spices *Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in confectionery, plastic in dentures or retainers, or certain blood-pressure medications (ACE inhibitors) *Administration of ganglion blockers (e.g., Tubocurarine, Mecamylamine). *Oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris *Heredity *Albuterol (bronchodilator medicine) A painful tongue may be an indication of an underlying serious medical condition and nearly always merits assessment by a physician or dental surgeon.
Glossitis
Geographic tongue
Bursitis
Enthesitis
Facet joint arthrosis
Osteochondropathy
Jaccoud arthropathy
Compression arthralgia