Glossodynia in patients with nutritional deficiencies

Various types of nutritional deficiencies can produce glossodynia and associated signs of inflammation. Changes such as swelling of the tongue, papillary atrophy, and surface ulceration are possible in most of the deficiency states. To further complicate the clinical picture, the patient commonly will suffer from multiple nutritional deficiencies. Therefore, it is not advisable to diagnose a specific nutritional deficiency on clinical impression alone. To establish iron, folate, or vitamin-B₁₂ deficiency, a hematologic screening that includes complete blood count, red-cell, serum iron, B₁₂, and folate levels should be performed. Although they are rarely required, specific tests for suspected niacin, pyridoxine, and riboflavin deficiency are available. Although glossodynia related to nutritional deficiency is statistically uncommon, it is easily curable with replacement therapy. Identification of a vitamin deficiency through early oral symptoms can forestall development of serious and irreversible systemic and neurologic damage.