It may be primary, where there is no underlying cause, or secondary where it is a sign or symptom of another condition. It can be acute or chronic. Generally speaking, there are several clinical patterns of glossitis, some more common than others. Atrophic glossitis
Atrophic glossitis, also known as bald tongue, smooth tongue, Hunter glossitis, Moeller glossitis, or Möller-Hunter glossitis, is a condition characterized by a smooth glossy tongue that is often tender/painful, caused by complete atrophy of the lingual papillae (depapillation). The dorsal tongue surface may be affected totally, or in patches, and may be associated with a burning sensation, pain and/or erythema. Atrophic glossitis is a non-specific finding, and has a great many causes, usually related to iron-deficiency anemia, pernicious anemia, B vitamin complex deficiencies, unrecognized and untreated celiac disease (which often presents without gastrointestinal symptoms), or other factors such as xerostomia (dry mouth). Although the terms Möller and Hunter glossitis were originally used to refer to specifically the glossitis that occurs in vitamin B12 deficiency secondary to pernicious anemia, they are now used as synonyms for atrophic glossitis generally. In this article, the term glossitis, unless otherwise specified, refers to atrophic glossitis. Candidiasis may be a concurrent finding or an alternative cause of erythema, burning, and atrophy. Median rhomboid glossitis
This condition is characterized by a persistent erythematous, rhomboidal depapillated lesion in the central area of the dorsum of the tongue, just in front of the circumvallate papillae. Median rhomboid glossitis is a type of oral candidiasis, and rarely causes any symptoms.
Infections
Bacterial, viral or fungal infections can cause glossitis. Chronic Candida infections of the tongue can cause an atrophic glossitis known as median rhomboid glossitis.Syphilis is now relatively rare, but the tertiary stage can cause diffuse glossitis and atrophy of lingual papillae, termed "syphilitic glossitis", "luetic glossitis" or "atrophic glossitis of tertiary syphilis". It is caused by Treponema pallidum and is a sexually transmitted infection. Other causes
Many conditions can cause glossitis via malnutrition or malabsorption, which creates the nutritional deficiencies described above, although other mechanisms may be involved in some of those conditions listed. Alcoholism
Sprue (celiac disease, or tropical sprue), secondary to nutritional deficiencies
Crohn’s disease
Whipple disease
Glucagonoma syndrome
Cowden disease
Acquired immunodeficiency syndrome (AIDS)
Carcinoid syndrome
Kwashiorkor amyloidosis
Veganism and other specialized diets, without B12 supplementation. Poor hydration and low saliva in the mouth, which allows bacteria to grow more readily
Mechanical irritation or injury from burns, rough edges of teeth or dental appliances, or other trauma
Tongue piercing Glossitis can be caused by the constant irritation by the ornament and by colonization of Candida albicans in site and on the ornament
Exposure to irritants such as tobacco, alcohol, hot foods, or spices
Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in confectionery, plastic in dentures or retainers, or certain blood-pressure medications (ACE inhibitors)
Administration of ganglion blockers (e.g., Tubocurarine, Mecamylamine). Oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris
Heredity
Albuterol (bronchodilator medicine)A painful tongue may be an indication of an underlying serious medical condition and nearly always merits assessment by a physician or dental surgeon. Diagnosis
Classification
Glossitis could be classified as a group of tongue diseases or gastrointestinal diseases.