Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

ONGOING

geographic tongue

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reassurance

No treatment is generally given apart from patient reassurance as this is a benign condition.

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Consider – 

topical treatment

Additional treatment recommended for SOME patients in selected patient group

If the symptoms are significant, barrier agents such as topical hyaluronic acid-based preparations (e.g., Gelclair®), or over-the-counter topical analgesic/anti-inflammatory agents (e.g., benzydamine), may be helpful in providing short-term symptomatic relief.

Some clinicians prescribe topical corticosteroid preparations (one tablet dissolved in water and used as a mouthwash) or topical calcineurin inhibitors (e.g., tacrolimus); however, their effectiveness is not supported by current evidence.[26]​​

May use daily for 7 to 10 days for symptomatic relief.

fissured tongue

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reassurance + tongue brushing

If debris becomes lodged between the fissures and grooves, patients may be encouraged to brush the dorsal surface of the tongue.

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Consider – 

topical treatment

Additional treatment recommended for SOME patients in selected patient group

If the symptoms are significant, barrier agents such as topical hyaluronic acid-based preparations (e.g., Gelclair®), or over-the-counter topical analgesic/anti-inflammatory agents (e.g., benzydamine), may be helpful in providing short-term symptomatic relief.

hairy tongue

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reassurance + oral hygiene

Patients should avoid hot drinks and use a tongue scraper. Good oral hygiene practices should be encouraged. A toothbrush may be used for tongue brushing.

If possible, risk factors contributing to reduced keratin shedding (e.g., oral discomfort, poor oral hygiene, hyposalivation, or increased keratin growth of filiform papillae tips) should be modified.

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Choose a patient group to see our recommendations

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

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