Atrophic Glossitis: The Smooth, Sore Tongue and the Blood Tests Behind It

Table of Contents

1. What a Smooth Tongue Is
2. Burning and Soreness
3. How Often Studies Find It
4. Vitamins and Minerals Linked to It
5. Autoantibodies and Pernicious Anemia
6. Candida, Diabetes and Dry Mouth
7. Where Studies Found No Link
8. The Blood Tests Used and What They Found
9. Treatment Results Reported
10. How It Differs From Similar Conditions
11. What Is Not Known
12. Key Research Papers
13. Connections
14. Featured Videos

What a Smooth Tongue Is

The tiny bumps on the top of the tongue are called papillae. The most numerous kind, the filiform papillae, give the tongue its velvety, matte surface. A 2020 review from Taiwan defines atrophic glossitis as the partial or complete absence of these filiform papillae on the top surface of the tongue.

Researchers do not all draw the line in the same place, and that matters when comparing their numbers:

• A Norwegian survey of older people counted a tongue as atrophic only when papillae were missing from more than half of it.
• A 2022 study from Guangzhou, China, split 236 patients into partial and complete atrophy. Low vitamin B12 and anemia were both significantly more common in the complete group.
• A Japanese report notes the traditional sorting: a totally smooth tongue was put down to a shortage of vitamin B12, folic acid or iron, and a partly smooth one was called median rhomboid glossitis or geographic tongue. Its own findings, described below, added yeast infection to that list.

Atrophic glossitis is a description of how a tongue looks. It does not name a cause. Several different conditions can leave a tongue looking this way, and most of this page is about telling them apart.

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Burning and Soreness

Pain with eating recurs across these reports. All 40 patients in the Japanese series of atrophic tongue complained of tongue pain with spicy or hot food. A 2020 letter from Taiwan describes patients with pernicious anemia as usually having a complete or partial smooth tongue, sensitivity to spicy or hot food, burning and numbness of the tongue, and loss of taste, which can finally make eating or swallowing difficult.

Not everyone reports burning. In 64 patients whose mouth problems led to a diagnosis of low iron, 59% had atrophic glossitis and 28% had burning mouth.

The burning can also lead to the wrong label. A published case describes a 73-year-old woman with several months of tongue pain who was first diagnosed with burning mouth disorder. A later examination found a beefy, red, smooth tongue, and blood tests showed low vitamin B12 and enlarged red blood cells. The authors' final diagnosis was atrophic glossitis and tongue pain from vitamin B12 deficiency, most likely caused by pernicious anemia.

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How Often Studies Find It

No study found for this page counts atrophic glossitis across a general population of all ages. The available figures come from particular groups, and they vary a great deal.

• Older people in Norway. In a 2000 survey, atrophic glossitis affected 13.2% of men and 5.6% of women among 106 randomly selected older people living at home. Among 310 older people recently admitted to hospital, it affected 26.6% of men and 37% of women.
• Dental patients in India. Among 4,926 patients at an oral medicine department, 12.07% had a tongue lesion. A depapillated tongue accounted for 11.5%, a figure that can only sensibly be a share of those with lesions, since the overall rate was 12.07%.
• People with canker sores in Taiwan. Of 355 patients with recurrent mouth ulcers in one study, 160 also had atrophic glossitis.
• People with low iron. In the 64 patients described above, 59% had atrophic glossitis. These patients were selected because they had a sore mouth, so this is not a rate for iron deficiency in general.

The contrast between home and hospital in the Norwegian survey fits the authors' conclusion that atrophic glossitis is a marker of malnutrition and reduced muscle function in older age. Being ill in hospital and having a smooth tongue went together, but the survey cannot show which came first.

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Vitamins and Minerals Linked to It

The 2020 Taiwanese review lists riboflavin, niacin, pyridoxine, vitamin B12, folic acid, iron, zinc and vitamin E as nutrients whose shortage may show up as a smooth tongue. A 2010 review for primary care doctors names iron, folic acid, vitamin B12, riboflavin and niacin. Those are the lists. The blood studies below measured only some of these nutrients, chiefly iron, vitamin B12 and folate.

Serum iron and ferritin are different measures, so the iron column does not compare like with like. A fifth report, from Shanghai, found low vitamin B12 in 50 of 72 newly enrolled patients, and megaloblastic anemia or enlarged red cells in 97 of 213 patients (45.4%) seen over three decades. Those authors called vitamin B12 deficiency possibly the main cause of atrophic glossitis. The two large Taiwanese series, where iron shortage was more common than vitamin B12 shortage, point the other way. The abstracts do not explain the gap. The 2012 study used a vitamin B12 cutoff of 200 pg/mL; the cutoffs behind the other figures are not stated in the abstracts, and the patients were drawn from different places.

Vitamin B12. The Guangzhou authors concluded that atrophic glossitis could be an important sign of possible vitamin B12 deficiency, especially when more than half the tongue is affected or atrophy is complete. In the Taiwanese series, 56 of the 1,064 patients were short of vitamin B12. Among those 56, 53.6% had enlarged red cells, 64.3% had low hemoglobin and 89.3% had high homocysteine.

Iron. A small 1993 pilot in nine people with glossitis found laboratory evidence suggesting iron deficiency in five. In the Taiwanese series, 180 of the 1,064 patients had low serum iron, but low iron did not mean iron deficiency anemia. Of the 83 who were anemic, 40 had normocytic anemia, 30 had iron deficiency anemia, 9 had pernicious anemia and 4 had anemia from thalassemia trait.

Riboflavin and other B vitamins. Riboflavin (vitamin B2) and niacin appear on the reviews' lists, but none of the patient studies read for this page reported measuring them. Two older patients in a 1991 case report were tested far more widely by a specialist nutrition laboratory. Both had evidence of protein and calorie malnutrition and were deficient or marginally deficient in several vitamins and trace minerals. The authors said much work was still needed to learn how well physical signs like this predict low blood levels.

Calories and protein. The Norwegian survey tied atrophic glossitis to lower weight, body mass index, skinfold thickness, arm muscle, strength and daily-living ability. In its final statistical model, only cholesterol, muscle strength and daily-living ability remained linked to the tongue finding.

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Autoantibodies and Pernicious Anemia

Some people with a smooth tongue carry antibodies against their own tissues. The largest study measured three of them in 1,064 patients and 532 matched healthy people.

• Gastric parietal cell antibody, aimed at acid-making cells in the stomach: 26.7% of patients against 2.3% of healthy people.
• Thyroglobulin antibody, aimed at the thyroid: 28.4% against 2.1%.
• Thyroid microsomal antibody, also aimed at the thyroid: 29.8% against 2.6%.

About 55.3% of the patients had at least one of the three. Among 373 patients positive for a thyroid antibody whose thyroid-stimulating hormone was measured, 78.6% had a normal level, 8.0% a low level and 13.4% a high level. Most had a normal result.

The stomach antibody matters because of pernicious anemia, the autoimmune condition in which the stomach stops supporting vitamin B12 absorption. Patients with this antibody had significantly more enlarged red cells, low vitamin B12 and high homocysteine than patients without it. Among 63 anemic patients with the antibody, the commonest types were normocytic anemia (42.9%), pernicious anemia (34.9%) and iron deficiency anemia (15.9%). Higher antibody levels went with more problems: of 117 patients with a high level, 29.1% had low hemoglobin and 16.2% low vitamin B12, against 17.4% and 7.2% of 167 patients with a low level.

Pernicious anemia itself was uncommon in the series as a whole: 22 of 1,064 patients (2.1%). All 22 were among those with high homocysteine, and none were among the other 937. Among the 56 patients short of vitamin B12, 36 were anemic, and 22 of those 36 (61.1%) had pernicious anemia, the commonest type in that group.

The thyroid antibodies looked different. Comparing 304 patients positive only for thyroid antibodies with 476 who had none of the three, a 2019 study found no significant differences in anemia or in iron, folate or homocysteine, though low vitamin B12 was more frequent in the thyroid antibody group.

The Taiwanese authors write that some patients with the stomach antibody may go on to develop pernicious anemia, autoimmune atrophic gastritis or stomach cancer, and that some with thyroid antibodies may have thyroid dysfunction. They called for these patients to be referred to medical doctors for further care. Their study measured antibodies at one point and did not follow patients over time to count how many developed these conditions.

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Candida, Diabetes and Dry Mouth

Candida yeast. The Japanese series of 40 patients is the clearest report. Candida grew from 72.5% of them, almost all of it Candida albicans. Blood tests were within reference levels in 29 of the 40 (72.5%), so most of these patients had no sign of anemia or diabetes. In a Chinese series of 124 patients, 79.03% had Candida infection, significantly more than among 53 healthy controls. Among the 64 patients with low iron and a sore mouth, 85% had Candida infection, which suggests the two problems can occur together. The site's oral thrush page covers the red form of thrush, which has no white coating.

Dry mouth. In the Chinese series, 41.94% of patients had dry mouth. A Japanese study of 231 patients who complained of dry mouth looked at what went with a smooth tongue. Two factors stood out: more Candida albicans and less saliva when saliva flow was stimulated. Other Candida species showed no such link. The authors describe those patients as having no systemic predisposing factors. The site's dry mouth page covers the wider topic.

Diabetes. The evidence here is older and thinner. A 1976 study of 175 diabetic outpatients in South Africa found atrophic tongue lesions in 26.9%, and 91.7% of those lesions were central papillary atrophy, a patch in the middle of the tongue, not a tongue smooth all over. How well the diabetes was controlled was not related to how often the patch appeared. In the Japanese Candida series, mild diabetes turned up in 4 of 40 patients (10.0%). The 2020 review lists diabetes among the causes.

Bacteria. The review also lists Helicobacter pylori, the stomach bacterium. In a Croatian study of tongue tissue from 268 patients, the bacterium was found in 16% of samples overall, and it was found significantly more often in atrophic glossitis than in geographic tongue. The authors suggested that the altered surface may simply make the tongue easier to colonize, so the finding does not show that the bacterium causes the smooth tongue. A sequencing study of saliva found lower bacterial and fungal diversity in atrophic glossitis patients than in healthy people, and proposed Lactobacillus and Saccharomycetales as possible markers. The abstract does not report testing this as a way to diagnose the condition.

Celiac disease. A 2007 letter titled "Atrophic glossitis leading to the diagnosis of celiac disease" reports this route to a diagnosis. It has no abstract, and a single letter gives no rate.

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Where Studies Found No Link

The textbook picture is that a smooth tongue means a shortage. These results do not fit it:

• Folate, repeatedly. In the 2012 Taiwanese study, low folate was no more common in 176 patients than in 176 matched controls. In the Qingdao series, folic acid levels did not differ significantly from controls, although the authors listed 11.29% of patients as deficient. The Norwegian survey found no relationship with folate. In Shanghai, patients short of vitamin B12 had raised folate levels.
• Zinc. The Norwegian survey found no relationship with zinc levels, although the 2020 review lists zinc among possible shortages.
• Vitamins A, E and B12 in hospitalized people with alcohol use disorder. In a small Brazilian study, 13 patients with papillary atrophy of the tongue, 8 with a normal tongue and 8 healthy volunteers had similar blood levels of all three. Those with the smooth tongue had lower body mass index and less body fat. The authors found the smooth tongue tied to poor overall nutrition without a vitamin shortage in the blood.
• Vitamin B12 after adjustment. In the Norwegian survey, vitamin B12 was related to atrophic glossitis at first, but did not remain in the final statistical model.
• No shortage at all. In the Japanese Candida series, 72.5% of patients had normal blood results. In a Taiwanese treatment study, 14 of 91 patients had no definite shortage.

A low or normal result in a study does not settle things for one person. It does show that a smooth tongue on its own cannot tell anyone which, if any, shortage is present.

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The Blood Tests Used and What They Found

The authors of the 2020 review argue that a complete blood count, serum vitamin and mineral levels, homocysteine and autoantibodies are all important to check before treatment starts. Here is what each of those tests reported in these studies.

• Complete blood count. This shows hemoglobin and red-cell size. Of 202 anemic patients in the Taiwanese series, those with and without the stomach antibody together, normocytic anemia, in which red cells are normal in size, was the most common type in both groups. That result fits neither of the two classic pictures, small red cells from low iron or large red cells from low vitamin B12.
• Serum vitamin B12. The 2012 study counted below 200 pg/mL as low. Reported rates ran from 5.3% to 68.22%.
• Serum folate. The 2012 study counted below 4 ng/mL as low. Rates in the two Taiwanese reports were 1.7% and 2.3%.
• Iron and ferritin. The 2012 study counted serum iron below 60 µg/dL as low. The Chinese studies used ferritin. Among 64 Taiwanese patients with low iron and a sore mouth, 22% were not anemic and 30% had normal-sized red cells, so a normal hemoglobin did not exclude low iron in that group.
• Homocysteine. High levels occurred in 21.6% of the 176 patients and 11.9% of the 1,064. A high result was most frequent among those short of vitamin B12 (89.3%), and it was found in only 16.1% of those short of iron.
• Gastric parietal cell and thyroid antibodies. These are the tests described in the section above. Thyroid-stimulating hormone was added for the thyroid group.

Enlarged red cells alone did not settle the diagnosis either. Among 60 people with mouth-lining disease and enlarged red cells, only 40.0% had low vitamin B12, and only 16.7% met the World Health Organization definition of pernicious anemia that study used.

The 64-patient low-iron series also reports something beyond the mouth. Two of those patients were found to have colorectal cancer, and the author wrote that the origin of iron deficiency anemia needs investigating because it may be the first sign of a more serious disease.

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Treatment Results Reported

The searches for this page found no randomized, placebo-controlled trial of treatment for atrophic glossitis, though one may exist that they missed. What exists is case reports and uncontrolled series, so improvement cannot be separated from the natural course of the condition or from placebo effects.

• Vitamin B12 injections in pernicious anemia. A 2020 letter from Taiwan shows two patients whose tongues returned to normal in photographs after intramuscular hydroxocobalamin, 2 mg every two days for two weeks. The authors write that symptoms usually disappeared after this treatment, and that these patients need monthly injections for life because they cannot absorb the vitamin normally.
• Oral vitamin B12 in one case. The 73-year-old woman described above took oral vitamin B12 for three months. Her blood level was only partly restored, and her symptoms improved modestly.
• Vitamin supplements in 91 Taiwanese patients. Patients short of vitamin B12 (39), folic acid (10), iron (9) or vitamin B12 plus iron (19) were given capsules the authors call vitamin BC plus whatever they lacked. The 14 with no definite shortage received the capsules alone. Treatment ran until all oral symptoms disappeared, a mean of 8.3 to 11.6 months depending on the group, and homocysteine fell significantly in every group. There was no untreated group, and the months-long timescale contrasts sharply with the two-week letter above.
• Guangzhou 2022. The abstract says patients short of vitamin B12 responded well to supplements, but gives no figures.
• Antifungal treatment. In the Japanese series of 40, tongue pain disappeared or markedly improved in 80% after antifungal treatment, and the authors saw signs of the papillae growing back. They noted that a long duration and no benefit from topical steroids were clues to a Candida cause. There was no comparison group.
• Iron plus antifungal. The author of the 64-patient series reports that all mouth changes improved with iron treatment, plus antifungals when Candida was present. The abstract gives no counts for this.
• A B-vitamin tablet in a school outbreak. In a 2024 record review from a boarding school in Bhutan, 97 students were treated for glossitis with a vitamin B complex tablet of 32.5 mg, two doses daily for 15 days. About 80% reported feeling better. The authors could not establish the cause. These students had glossitis, and the abstract does not say that it was atrophic.

The 2020 review sums up by saying that supplements can achieve complete remission of symptoms and tongue atrophy in some patients. It does not say all. Questions about any individual treatment are ones for a clinician who has the blood results.

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How It Differs From Similar Conditions

Three other conditions come up most often in these studies. The table below shows how similar their blood tests can look. All three studies come from the same Taiwanese group and measure the same things.

The burning mouth and lichen planus papers report the first six rates as significantly higher than in healthy controls. The atrophic glossitis papers report the same for the blood findings, in patients with and without the stomach antibody. So a blood result alone does not sort these conditions. What sets them apart is what the mouth looks like.

• Burning mouth syndrome. The Taiwanese authors define it as a burning sensation of the mouth lining with no visible change in the lining. Atrophic glossitis is the reverse: the change is visible by definition, and burning may or may not come with it. Dry mouth (48.1%), numbness (30.7%) and altered taste (16.7%) were common among the 884 burning mouth patients.
• Geographic tongue. Also called benign migratory glossitis. A 2023 meta-analysis puts it at about 3%, roughly one adult in 30, with phases of flare and remission. A Jordanian clinic survey of 2,000 patients found it in 4.8%, with symptoms in 28% of those affected. A primary care review describes it as one of the most common tongue problems and says it needs no treatment. Helicobacter pylori was found significantly less often in this condition than in atrophic glossitis in the Croatian study.
• Oral lichen planus. An inflammatory disease in which immune cells attack the deepest layer of the lining, described on the site's lichen planus page. It affects more than the tongue, including the cheeks and gums. Its blood profile in the table is close to that of atrophic glossitis, so tests alone would not separate them.
• Median rhomboid glossitis. A primary care review says this is usually associated with Candida and responds to antifungal treatment applied to the area. The Japanese report classes it among the partial forms of a smooth tongue.

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What Is Not Known

• The true cause in most patients. Taiwanese authors write that atrophic glossitis itself is a significant factor causing anemia and shortages. Case-control studies cannot show that. Other authors call vitamin B12 shortage a possible cause of the tongue change. Either could be true, or a third factor could cause both.
• Why the numbers disagree so much. The roughly 13-fold gap in low vitamin B12 between series has no explanation in the abstracts. Different cutoffs, diets, tests and ways of choosing patients are all possible.
• How independent the evidence is. Many of the largest numbers on this page come from one research group in Taiwan and several reanalyses of the same 1,064 patients. They are not separate confirmations.
• How well treatment works. No controlled trial surfaced in the searches for this page, and the treatment reports differ widely on how long healing took.
• Riboflavin, niacin, pyridoxine and vitamin E. They are listed in reviews, but none of the patient studies read here reported them, so how often they are involved cannot be stated from these sources.
• The long-term outlook. A case-control study of US adults aged 65 or older, using Medicare records, found inflammatory tongue conditions in 6.0% of 2,534 people with cancer of the oral tongue and 0.6% of controls (adjusted odds ratio 5.8). Diagnoses recorded as glossitis accounted for much of that link (odds ratio 5.6), and the associations remained strong more than five years before the cancer. The study groups several conditions together and does not report a separate result for atrophic glossitis. It shows a link, not that glossitis causes cancer. The authors called for increased clinical surveillance. The site's oral cancer page covers that disease.
• Traditional and food reports. No traditional or food-based report that could be checked against a source was found for this page, so none is included.

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Key Research Papers

1. Chiang CP, Chang JY, Wang YP, Wu YH, Wu YC, Sun A. Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. J Formos Med Assoc. 2020;119(4):774-780. PubMed PMID: 31076315
2. Sun A, Lin HP, Wang YP, Chiang CP. Significant association of deficiency of hemoglobin, iron and vitamin B12, high homocysteine level, and gastric parietal cell antibody positivity with atrophic glossitis. J Oral Pathol Med. 2012;41(6):500-4. PubMed PMID: 22188475
3. Chen GY, Tang ZQ, Bao ZX. Vitamin B12 deficiency may play an etiological role in atrophic glossitis and its grading: A clinical case-control study. BMC Oral Health. 2022;22(1):456. PubMed PMID: 36307840
4. Wu YC, Wu YH, Chang JY, Wang YP, Kuo YS, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with vitamin B12 deficiency. J Formos Med Assoc. 2020;119(3):720-727. PubMed PMID: 31630933
5. Chiang CP, Wu YC, Chang JY, Wang YP, Wu YH, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with iron deficiency. J Formos Med Assoc. 2020;119(2):587-594. PubMed PMID: 31607629
6. Chiang CP, Wu YC, Chang JY, Wang YP, Wu YH, Sun A. Anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in atrophic glossitis patients with or without hyperhomocysteinemia. J Formos Med Assoc. 2020;119(1 Pt 3):544-552. PubMed PMID: 31444017
7. Chiang CP, Chang JY, Wang YP, Wu YH, Wu YC, Sun A. Gastric parietal cell and thyroid autoantibodies in patients with atrophic glossitis. J Formos Med Assoc. 2019;118(6):973-978. PubMed PMID: 30736997
8. Chiang CP, Chang JY, Wang YP, Wu YH, Wu YC, Sun A. Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative atrophic glossitis patients. J Formos Med Assoc. 2019;118(2):565-571. PubMed PMID: 30581105
9. Chiang CP, Wu YH, Chang JY, Wang YP, Wu YC, Sun A. Does serum gastric parietal cell antibody titer have influence on anemia and vitamin B12 deficiency in atrophic glossitis patients? J Formos Med Assoc. 2020;119(1 Pt 2):377-383. PubMed PMID: 31277918
10. Kuo YS, Wu YH, Chang JY, Wang YP, Wu YC, Sun A. Blood profile of atrophic glossitis patients with thyroglobulin antibody/thyroid microsomal antibody positivity but without gastric parietal cell antibody positivity. J Formos Med Assoc. 2019;118(8):1218-1224. PubMed PMID: 31005374
11. Chang JY, Wang YP, Wu YC, Cheng SJ, Chen HM, Sun A. Hematinic deficiencies and pernicious anemia in oral mucosal disease patients with macrocytosis. J Formos Med Assoc. 2015;114(8):736-41. PubMed PMID: 25935499
12. Wu YC, Wu YH, Wang YP, Chang JY, Chen HM, Sun A. Hematinic deficiencies and anemia statuses in recurrent aphthous stomatitis patients with or without atrophic glossitis. J Formos Med Assoc. 2016;115(12):1061-1068. PubMed PMID: 27839675
13. Du HX, Wei CL, Zhang H, Deng J, Guo YQ, Zheng WP, Yuan CQ. [Related factors of atrophic glossitis in 124 consecutive cases]. Shanghai Kou Qiang Yi Xue. 2020;29(4):423-426. PubMed PMID: 33089295
14. Zhu JC, Wang YF, Sheng J, Chen FX, Tang GY. [Atrophic glossitis is attributed to cobalamin deficiency]. Shanghai Kou Qiang Yi Xue. 2013;22(1):58-62. PubMed PMID: 23552783
15. Bøhmer T, Mowé M. The association between atrophic glossitis and protein-calorie malnutrition in old age. Age Ageing. 2000;29(1):47-50. PubMed PMID: 10690695
16. Enwald CV, Drinka PJ, Swortz C, Langer EH, Voeks SK. Iron status in atrophic glossitis: a pilot study. Wis Med J. 1993;92(10):570-3. PubMed PMID: 8266715
17. Drinka PJ, Langer E, Scott L, Morrow F. Laboratory measurements of nutritional status as correlates of atrophic glossitis. J Gen Intern Med. 1991;6(2):137-40. PubMed PMID: 1902511
18. Cunha SF, Melo DA, Braga CB, Vannucchi H, Cunha DF. Papillary atrophy of the tongue and nutritional status of hospitalized alcoholics. An Bras Dermatol. 2012;87(1):84-9. PubMed PMID: 22481655
19. Terai H, Shimahara M. Atrophic tongue associated with Candida. J Oral Pathol Med. 2005;34(7):397-400. PubMed PMID: 16011607
20. Nakamura S, Okamoto MR, Yamamoto K, Tsurumoto A, Yoshino Y, Iwabuchi H, Saito I, Maeda N, Nakagawa Y. The Candida species that are important for the development of atrophic glossitis in xerostomia patients. BMC Oral Health. 2017;17(1):153. PubMed PMID: 29246167
21. Lu SY. Perception of iron deficiency from oral mucosa alterations that show a high prevalence of Candida infection. J Formos Med Assoc. 2016;115(8):619-27. PubMed PMID: 27133388
22. Farman AG. Atrophic lesions of the tongue: a prevalence study among 175 diabetic patients. J Oral Pathol. 1976;5(5):255-64. PubMed PMID: 824423
23. Gall-Troselj K, Mravak-Stipetić M, Jurak I, Ragland WL, Pavelić J. Helicobacter pylori colonization of tongue mucosa--increased incidence in atrophic glossitis and burning mouth syndrome (BMS). J Oral Pathol Med. 2001;30(9):560-3. PubMed PMID: 11555160
24. Li H, Sun J, Wang X, Shi J. Oral microbial diversity analysis among atrophic glossitis patients and healthy individuals. J Oral Microbiol. 2021;13(1):1984063. PubMed PMID: 34676060
25. Pastore L, Lo Muzio L, Serpico R. Atrophic glossitis leading to the diagnosis of celiac disease. N Engl J Med. 2007;356(24):2547. PubMed PMID: 17568041
26. Sun A, Wang YP, Lin HP, Chen HM, Cheng SJ, Chiang CP. Significant reduction of homocysteine level with multiple B vitamins in atrophic glossitis patients. Oral Dis. 2013;19(5):519-24. PubMed PMID: 23130817
27. Wu YH, Hwang MJ, Lee YP, Chiang CP. Atrophic glossitis in pernicious anemia patients can be treated to normal in two weeks by intramuscular injection of vitamin B12. J Dent Sci. 2020;15(4):558-559. PubMed PMID: 33505632
28. Lehman JS, Bruce AJ, Rogers RS. Atrophic glossitis from vitamin B12 deficiency: a case misdiagnosed as burning mouth disorder. J Periodontol. 2006;77(12):2090-2. PubMed PMID: 17209796
29. Nepal TN, Gyaltshen D. Outbreak of glossitis in a boarding school, diagnostic challenges and the outcome after treatment with Vitamin B Complex tablets: A retrospective descriptive study. SAGE Open Med. 2024;12:20503121241241215. PubMed PMID: 38545234
30. Chiang CP, Wu YH, Wu YC, Chang JY, Wang YP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in 884 patients with burning mouth syndrome. J Formos Med Assoc. 2020;119(4):813-820. PubMed PMID: 31679908
31. Wu YH, Yu-Fong Chang J, Lee YP, Wang YP, Sun A, Chiang CP. Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in 588 patients with oral lichen planus. J Dent Sci. 2025;20(1):660-666. PubMed PMID: 39873037
32. Pereira RDPL, de Oliveira JMD, Pauletto P, Munhoz EA, Silva Guerra EN, Massignan C, De Luca Canto G. Worldwide prevalence of geographic tongue in adults: A systematic review and meta-analysis. Oral Dis. 2023;29(8):3091-3100. PubMed PMID: 36208129
33. Patil S, Kaswan S, Rahman F, Doni B. Prevalence of tongue lesions in the Indian population. J Clin Exp Dent. 2013;5(3):e128-32. PubMed PMID: 24455067
34. Darwazeh AM, Almelaih AA. Tongue lesions in a Jordanian population. Prevalence, symptoms, subject's knowledge and treatment provided. Med Oral Patol Oral Cir Bucal. 2011;16(6):e745-9. PubMed PMID: 21196841
35. Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. 2010;81(5):627-34. PubMed PMID: 20187599
36. Tota JE, Engels EA, Lingen MW, Agrawal N, Kerr AR, Zumsteg ZS, Cheung LC, Katki HA, Abnet CC, Chaturvedi AK. Inflammatory Tongue Conditions and Risk of Oral Tongue Cancer Among the US Elderly Individuals. J Clin Oncol. 2024;42(15):1745-1753. PubMed PMID: 38033283

PubMed Topic Searches

1. PubMed: Atrophic glossitis
2. PubMed: Atrophic glossitis with vitamin B12 and iron
3. PubMed: Atrophic glossitis and Candida
4. PubMed: Atrophic glossitis and gastric parietal cell antibody

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Connections

• Dentistry
• Folate Deficiency: Mouth Sores and Sore Tongue
• Vitamin B12 Deficiency: Sore Tongue and Mouth
• Vitamin B2 Deficiency: Sore Throat and Swollen Tongue
• Pernicious Anemia
• Iron Deficiency
• Oral Thrush
• Dry Mouth
• Lichen Planus

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