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Gwen Cohen Brown, DDS, FAAOMP

Joined: 06/15/2011

Expert Profile:

Dr. Gwen Cohen Brown is an Associate Professor in the department of Dental Hygiene at the New York City College of Technology, and is a Fellow in the Academy of Oral and Maxillofacial Pathology. Dr. Brown graduated with a Doctor in Dental Surgery (D.D.S.) degree from The New York University College of Dentistry (NYUCD) in 1988 followed by an Advanced Education Program in General Practice Dentistry also at NYUCD. She completed a three-year residency program in Oral and Maxillo-Facial Pathology at the New York Hospital Medical Center of Queens and continued her education in a two-year sub-specialty fellowship in Oral and Maxillo-Facial Pathology at the Health Science Center S.U.N.Y. Brooklyn Downstate Medical College/Kings County Hospital Medical Facility.

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Reply: Yellow coat on tongue

Hi goolar, Sorry to hear that you have been concerned. Although...

Posted by Gwen Cohen Brown, DDS, FAAOMP

2 Replies | Reply | Watch This DiscussionReport This| Share this:Yellow coat on tongue Hi goolar, Sorry to hear that you have been concerned. Although...

Reply: Swollen Taste Buds and somewhat white tongue.

Hi joewithaproblem, Although I cannot diagnose on line the attached...

Posted by Gwen Cohen Brown, DDS, FAAOMP

Hi joewithaproblem,

Although I cannot diagnose on line the attached photo looks like a totally benign clinical condition known as Geographic Tongue. The red areas tend to look flat without the little hairlike papilla (the normal white hairlike projections kniwn as filliform papilla)and often have a slightly raised white border.

The reason it is called Geographic Tongue - or benign migratory glossitis - is that 90% of the time it occurs only on the tongue, usually the lateral (side) borders and the top of the tongue. It tends to be seen on the anterior third of the tongue (tip) but can occur anywhere.

This is a well known condition and is often hereditary and seen with another condition known as fissured tongue. So the next time you see your parents, siblings or children look in their mout and more likely than not someone else will have a similar looking tongue.

This is a variation of normal. It is not spreading on your tongue it is getting better in one place and developing in another. It is not contagious you did not get it from anyone and you cannot give it to anyone. It is not caused by a virus. It is not a canker sore, cold sore or yeast infection.

The reason it can be painful is that the little white hairlike papilla are composed of keratin like your skin hair and nails. We do not know why these papilla fall off with geographic tongue however we know that they do. Without this protection the papilla provide your tongue is naked in these areas and therefore may be uncomfortable with hot, spicy or acidic foods. The papilla will gow back, give it some time.

On a purely anecdotal level, and I have seen hundreds of patients with Geographic Tongue it does seem to become more active with stress. I suggest that you see your dentist to confirm the diagnosis. It is a clinical diagnosis and neither lab tests or biopsy is required. In general I do not treat geographic tongue unless it has become secondarily infected with yeast or bacteria however in my entire career as an oral pathologist I have probably only teated a handful of patients.

It is often misdiagnosed as an oral yeast infection. The anti fungal medication may provide some relief but it is really only treating a secondary yeast infection and the effect is mostly placebo. Yeast is a normal part of your oral flora and keeps your mouth balanced and healthy. If anyone tries to culture your tongue or do a scraping run for the door. if you need a diagnostic procedure you should have a biopsy. and for the record it is not suggestive of a systemic yeast infection, and it is not due to eating bread. If this is geographic tongue antibiotics are never an appropriate treatment, in fact antibiotics will probably make your tongue feel worse. It is not bacterial.

I have found that most people, once they have a diagnosis, are much less stressed about their tongue (with a diagnosis) which will actually make it hurt less. Stop looking at it, playing with it and worrying about it. If it continues to bother you I suggest seeing either a specialist in oral medicine or oral pathology.

If you are using a alcohol based mouth rinse stop it will give you a chemical burn on the unprotected areas of the tongue. In fact stop all mouth rinses and use the most bland old fashioned tooth paste you can find, stay away from the whitening products and look for a toothpaste without SLS. Your pharmacist can help you find one. Do not use hydrogen peroxide as that may also cause a chemical burn. Do not use "organic" toothpaste, many have volatile oils which can also cause a superficial chemical burn. I know it seems like it would be a good idea but in many cases it will make the burning feeling much worse.

Basically once you have confirmed the diagnosis it will be less of a concern, less stress and faster resolution.

I hope this helps.

Dr. Gwen Cohen BrownView Thread

Posted byGwen Cohen Brown, DDS, FAAOMP

8 Replies | Reply | Watch This DiscussionReport This| Share this:Swollen Taste Buds and somewhat white tongue. Hi joewithaproblem, Although I cannot diagnose on line the attached...

Reply: Had all my teeth pulled.

Hi pspoon2, I hope you are feeling better. The best advice I can...

Posted by Gwen Cohen Brown, DDS, FAAOMP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Had all my teeth pulled. Hi pspoon2, I hope you are feeling better. The best advice I can...

Reply: Bumps on each side of Tongue?

Hi God4me, No need for concern. What you are looking at is normal...

Posted by Gwen Cohen Brown, DDS, FAAOMP

2 Replies | Reply | Watch This DiscussionReport This| Share this:Bumps on each side of Tongue? Hi God4me, No need for concern. What you are looking at is normal...

Reply: White Coating and Bad Breath Issue

Hi dmogar, I believe that you should go directly and deal with the...

Posted by Gwen Cohen Brown, DDS, FAAOMP

6 Replies | Reply | Watch This DiscussionReport This| Share this:White Coating and Bad Breath Issue Hi dmogar, I believe that you should go directly and deal with the...

Reply: White Coating and Bad Breath Issue

Hi dmogar, Both alcohol and tobacco are extremely drying to the oral...

Posted by Gwen Cohen Brown, DDS, FAAOMP

6 Replies | Reply | Watch This DiscussionReport This| Share this:White Coating and Bad Breath Issue Hi dmogar, Both alcohol and tobacco are extremely drying to the oral...

Reply: Help my mouth and I

Hi TylerKurt, Unfortunately with out a face to face clinical consult...

Posted by Gwen Cohen Brown, DDS, FAAOMP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Help my mouth and I Hi TylerKurt, Unfortunately with out a face to face clinical consult...

Reply: Lip bleeds

Hi miniva100, I hope that your girlfriend is feeling better and that...

Posted by Gwen Cohen Brown, DDS, FAAOMP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Lip bleeds Hi miniva100, I hope that your girlfriend is feeling better and that...

Reply: Gum or teeth tighening

Hi Gabjac31, Hi again, sorry, the TMJ is the...

Posted by Gwen Cohen Brown, DDS, FAAOMP

4 Replies | Reply | Watch This DiscussionReport This| Share this:Gum or teeth tighening Hi Gabjac31, Hi again, sorry, the TMJ is the...

Reply: Can oral yeast infection be spread thru oral sex.

Hi An_247721, That is an excellent question without a simple answer....

Posted by Gwen Cohen Brown, DDS, FAAOMP

1 Reply | Reply | Watch This DiscussionReport This| Share this:Can oral yeast infection be spread thru oral sex. Hi An_247721, That is an excellent question without a simple answer....

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