Causes and Treatment of Transient Lingual Papillitis
Why You May Have "Lie Bumps" on Your Tongue
Medically reviewed by Edmund Khoo, DDS
Transient lingual papillitis, also called "lie bumps," is a common inflammatory condition that affects ie tongue, specifically your taste buds (known as fungiform papillae). Fungiform papillae are the flat, pink bumps on the top, sides, and tips of the tongue that sense taste and temperature. When these become irritated and inflamed, they can be painful and make it hard to eat.
Lie bumps get their name from the myth that you get them after telling a lie.
This article looks at the symptoms, types, and causes of transient lingual papillitis. It also explains how they are diagnosed and treated, and how to keep them from coming back.
Learn More: Surprising Anatomy of the Tongue
Martin Barraud / OJO Images / Getty Images
Types and Symptoms of Bumps on Tongue
There are four different types of transient lingual papillitis, each with its own set of symptoms. Transient lingual papillitis may occur on its own or with other tongue conditions like geographic tongue (a generally harmless condition in which "bald" patches develop on the tongue).
Classic or Localized Lingual Papillitis Type
In classic or localized transient lingual papillitis, the papillae are inflamed in just one area of the tongue, often the tip.
Symptoms include:
One or more painful and raised bumps ranging from a whitish-yellow to red
A burning, tingling, or itching tongue
Sensitivity to hot foods
Difficulty eating, especially spicy or acidic foods
Distorted taste (dysgeusia)
Dry mouth (xerostomia)
The bumps on your tongue typically last for between one day and several days. The possible causes of these are many and are sometimes unknown.
Eruptive Lingual Papillitis Type
Eruptive lingual papillitis is a systemic (whole-body) illness that usually affects children and sometimes adults.
The cause of eruptive lingual papillitis is unknown, but some believe that it may be due to a viral infection as it can sometimes spread through entire households. Others contend that it is an atopic (allergy-related) disorder that can also sometimes run through families.
Symptoms include:
Painful bumps on the tip and sides of the tongue that often look like pus-filled pimples
Fever
Excessive saliva
Difficulty eating
Cracks and redness on the corners of the mouth (angular cheilitis)
Eruptive lingual papillitis generally lasts for a week or two. However, it is prone to recurrence, often within a couple of months.
Papulokeratotic Lingual Papillitis Type
Papulokeratotic lingual papillitis is a persistent or frequently recurring type that does not cause symptoms other than whitish or yellow bumps all over the tongue. They do not interfere with eating or affect taste in any way.
Papulokeratotic lingual papillitis is often idiopathic (meaning of unknown origin).
U-Shaped Lingual Papillitis
U-shaped lingual papillitis has some key differences from the other types. Firstly, it doesn't involve bumps but rather small patches that look as if tissues have been peeled away.
Other symptoms may include:
Scattered pink spots
Tongue swelling
Burning sensations in the mouth
Canker sores (aphthous ulcers) on the cheeks, lips, and mouth
This type of papillitis is frequently noted in people with COVID-19 but is also seen in those with poor oral hygiene and who are on oxygen therapy.
COVID-19 and U-Shaped Lingual Papillitis
Studies suggest that roughly one in 10 people with COVID-19 experience U-shaped lingual papillitis, usually on the front portion of the tongue.
Causes of Lie Bumps
Researchers don't yet know the exact cause of transient lingual papillitis, although it is thought to be the result of one or more triggering factors, either localized or systemic.
Local triggers of transient lingual papillitis may include:
Eating overly spicy or acidic foods
Smoking cigarettes
Excessive alcohol use
Poor oral hygiene
Orthodontic appliances such as retainers
Systemic triggers may include:
Viral or bacterial infections (including COVID-19 and strep throat)
Stress
Sleep deprivation
Poor nutrition
Hormone fluctuation (such as menstruation or menopause)
Atopic conditions like eczema, food allergy, allergic rhinitis (hay fever), or asthma
Recurrent Childhood Infection
One theory is that transient lingual papillitis is the result of a prior childhood infection that recurs later in life, much in the same way as viruses like oral herpes (cold sores).
The theory is supported by the fact that children in contact with other children in daycare are far more likely to have transient lingual papillitis than those who are not.
Also supporting the theory are studies in which family outbreaks most often start with the youngest family member. According to research published in the Journal of Clinical and Experimental Dentistry, outbreaks of ulcerative lingual papillitis usually originate in children with a median age of 3.5 years before spreading to other family members.
Diagnosis of Bumps on the Tongue
Transient lingual papillitis can usually be diagnosed by its appearance alone. To this end, your healthcare provider will likely:
Ask about your symptoms
Inquire about any events leading up to the event (such as mouth trauma)
Do a physical examination of your mouth, tongue, and lips
Check your neck area for swollen lymph nodes
If there are any concerns that another, more serious condition is involved, your health provider may recommend a mucosal biopsy in which a punch-like device extracts a small sample of tongue tissue to examine under the microscope.
There are several conditions that mimic transient lingual papillitis that your healthcare provider may want to explore as part of the differential diagnosis (particularly if the condition is severe, recurrent, or accompanied by other symptoms):
Giant cell fibroma: A benign oral mass seen most commonly in White people
Pyogenic granuloma: A non-cancerous, raised tumor that is prone to bleeding
Scarlet fever: A bacterial illness that sometimes develops in people with strep throat
Treatment of Bumps on the Tongue
Some bumps on the tongue go away within hours to a few days and usually don't need medical treatment. However, to ease the pain and discomfort, your healthcare provider may suggest:
Rinsing with saltwater
Drinking cold drinks
Avoiding hot, spicy, or acidic foods
Using an anesthetic or antiseptic mouthwash
Applying a topical steroid, such as triamcinolone acetonide 0.1% dental paste
Avoiding gum, candy, or oral hygiene products that may irritate the tongue
Eruptive transient lingual papillitis may require antibiotics to treat an underlying bacterial infection. (Antibiotics are ineffective against viral infections.)
Do Not Pop
A bump on your tongue may look like a pimple (especially with eruptive lingual papillitis), but it is not a pimple. Do not pop or squeeze it as you may end up damaging the tissues and increasing the risk of infection.
Related: How to Safely Use Topical Steroids
Summary
Transient lingual papillitis, or lie bumps, are inflamed and sometimes painful taste buds. They come in several types, each with its own distinctive appearance and symptoms. Causes include infection, stress, poor nutrition, allergies, trauma to the tongue, smoking, and spicy or acidic food. In many cases, the cause is unknown.
Lie bumps are generally diagnosed based on their appearance. The bumps will likely go away within a few days without medical treatment. You can help relieve pain with saltwater rinses, anesthetic or antiseptic mouthwashes, and topical steroids.
Read the original article on Verywell Health.
