What's with the map tongue? Do you need interventional therapy?

A 3-year-old boy with a map tongue on the front 2/3 and the side of his tongue.

The child had no pain or other discomfort, but oral examination showed that 5 1, 6 1, 74 and 84 teeth all had dental caries. In view of the fact that map tongue is a self-limited disease and the child is asymptomatic, the doctor advises the child to treat dental caries, maintain oral hygiene and drink plenty of water.

Case 2

4-year-old girl's map tongue changing with time

During the dental examination, the doctor found that both the left and right mandibular second deciduous molars had dental caries. The child was diagnosed as reversible pulpitis by apical X-ray examination, and it is suggested that stainless steel crown be used to repair the pulp after treatment.

In addition, after further oral examination, the doctor found that pink patches could be seen on the back or side of the tongue, the nipple in the affected area shrank and disappeared, and the tongue surface was smooth. The yellow edges of these patches are slightly higher than the tongue surface, and they are diagnosed as map tongue (Figure 2). Children only have a slight burning sensation in their tongues when they eat spicy food, and there are no symptoms at other times.

The girl's parents don't have these tongue changes. The doctor told the child to take multivitamin syrup and use tongue cleaner to relieve the symptoms. After 7 days, the tongue area of the original map was improved, but a pink map tongue appeared in the center of the tongue surface, and the nipple of the tongue shrank. After 2 weeks, the pink tongue surface is clearly visible, and there are prominent red tongue papillae (Figure 3).

1, prevalence rate

The clinical manifestations of oral and perioral soft tissue lesions in children are varied. Map tongue and cracked tongue are common tongue diseases. Among them, the overall prevalence of map tongue in the general population is about 1%-2.5%.

Figure 7. Changes of the map tongue of 6-year-old boys: 1 year ago, at the time of initial diagnosis (left), at the time of return visit without topical tacrolimus (middle), and at the time of follow-up after topical tacrolimus (right) [9].