Abstract
Patients: A 60-year-old female complained of pain in the anterior tongue tip. After clinical examination, geographic tongue was only found. Based on a thorough history and diagnostic test including blood tests and microbial tests, any local factors (candidiasis, herpes, hyposalivation, allergy, or mucosal lesions) or systemic factors (vitamin deficiencies, diabetes, hypothyroidism, medications such as ACE inhibitors, or autoimmune disorders), causes of symptoms were not found. Consequently, we diagnosed glossodynia with geographic tongue. Psychotherapy, topical pharmachological management (local anesthetic) and reassurance relieved her symptoms in several months.
Discussion: Burning mouth syndrome is chronic oral mucosal pain or discomfort, involving the anterior tongue in most cases, and sometimes also the lips, palate, and pharynx. If the symptoms are confined to the tongue only, it is called glossodynia. It has no identifiable causative lesions and is not caused by any other condition or disease. In this case, geographic tongue was found, but we didn't consider it as a cause of symptoms. If we could not find objective finding which explains the subjective symptoms, we should just explain the patients' clinical conditions and/or conservative treatment instead of invasive surgical treatment.
Conclusion: In this case, we could manage a patient by psychotherapy and using local anesthetic. Topical lidocaine may be useful for the management of glossodynia from the viewpoints based on efficacy, lack of systemic side effects and convenience of use as one of conservative treatment.
