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Median Rhomboid Glossitis: Occurrence, Symptoms, And Treatment

Published date field Last Updated:

Medically Reviewed By Colgate Global Scientific Communications

If you have an abnormally smooth, dark pink, or red flat area on your tongue, you may have a condition called median rhomboid glossitis (MRG). The name may sound serious, but unless you have any additional fungal infections along with this condition, you probably won't require treatment. We'll break down the potential causes of your MRG and the occasions when you should seek diagnosis and treatment so you can ensure your oral health keeps you smiling.

What Is Median Rhomboid Glossitis (MRG)?

Think median rhomboid glossitis is a complicated name to remember? Try throwing its other names into the mix – central papillary atrophy and glossal central papillary atrophy. Don't worry. For this article, we'll stick with calling it MRG.

According to the American Academy of Oral Medicine, MRG occurs more often in men, ages 30 to 50. However, anyone can have it, and around 1 percent of the total population is affected. MRG is a smooth, dark pink or red, flat area near the back of your tongue. Your tongue gets this appearance when it's missing filiform papillae, small bumps formed by mucous membrane cells that make up your tongue's surface. Filiform papillae are the only papillae that don't have taste buds, so this shouldn't affect your ability to enjoy food. The shape this condition takes is usually abstract and asymmetrical.

What Are the Symptoms of Median Rhomboid Glossitis?

Median rhomboid glossitis is often asymptomatic, meaning you may not notice you have it at all until a dental professional diagnoses you during a routine care assessment. There is rarely soreness or pain associated with this condition, and it's not contagious. However, some people experience a burning sensation when they eat.

What Are the Causes and Risk Factors for Median Rhomboid Glossitis?

According to a review published by the Journal of Patient-Centered Research and Reviews, about 100 identified fungi species can be found in the human mouth. Most of them don’t cause problems unless there are irregularities.

MRG is believed to be caused by a chronic fungal infection related to the candida group of microorganisms. The fungus Candida lives in most people’s mouths and digestive systems of healthy individuals in low numbers, but it can cause fungal infections when they multiply.

According to the National Health Service (NHS), MRG occurs more often in the following types of patients:

  • People with diabetes and people with another immunocompromising disease
  • Smokers
  • People undergoing antibiotic, steroid, or chemotherapy treatments
  • Denture wearers, especially if they don't take their dentures out before bedtime
  • People with dry mouth
  • Individuals with low levels of iron, B12, or folate
  • People who eat a high-sugar diet

How Do You Treat Median Rhomboid Glossitis?

Because symptoms and pain don't usually accompany MRG, there isn't usually a recommended treatment for the condition. A doctor may recommend adjustments in lifestyle to rid yourself of risk factors, like:

  • Quitting smoking
  • Taking dentures out before bedtime
  • Taking vitamin or mineral supplements
  • Reducing sugar in your diet
  • Drinking more water and taking other steps to improve dry mouth

According to a study cited in the Journal of the American Dental Association, more than 500 medications cause dry mouth. If your medication is causing dry mouth, your dental professionals may be able to recommend alternatives that will have less of an impact on your oral health.

Your doctor may recommend a culture or lab biopsy to be safe and determine if medication is necessary. If they notice any additional aggressive fungal conditions are accompanying your MRG, they may recommend an antifungal rinse or tablet to kill the organisms and reduce symptoms you may experience.

Practicing good oral hygiene is always recommended and can help reduce the risk of additional microorganism growth in your mouth. Brush at least twice a day, and don't forget to brush your tongue. Clean between your teeth with interdental brushes or water flossers at least once a day. Consider using other helpful products like an antimicrobial mouthrinse and a tongue scraper. And see your dental professional for regular checkups so they can catch any developing conditions early.

If you notice any abnormal changes in your oral health, it's always a good idea to visit your dental professional to be safe and ensure that it won't develop into anything more severe. When you work with your dental professional, you're best positioned to maintain a level of oral health you can smile about.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider. 

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