Recurrent Lingual Papillae Inflammation in a Young Adult
Case at a Glance
A 26-year-old female presents with recurrent painful tongue lesions affecting taste buds, occurring intermittently over the past 12 months with suspected dietary triggers.
Patient's Story
The patient reports experiencing recurring sore and inflamed taste buds on her tongue for approximately one year. She initially suspected acidic foods as triggers, including citrus fruits, sour candies, and salt and vinegar flavored snacks. The lesions typically begin with discomfort and itching sensation on the lateral, anterior, and dorsal aspects of the tongue, accompanied by an urge to rub the affected area against her teeth, which subsequently becomes painful. The patient has been self-treating with hydrogen peroxide, salt water, and baking soda rinses, noting that while these treatments cause initial burning sensation, they appear to accelerate the healing process.
Initial Assessment
Physical examination revealed localized inflammation of fungiform papillae on the tongue surface. The patient provided photographic documentation of the lesions showing characteristic raised, erythematous areas consistent with inflamed taste buds.
The Diagnostic Journey
Given the recurrent nature and suspected dietary triggers, differential diagnosis included transient lingual papillitis (lie bumps), chemical irritation from acidic foods, nutritional deficiencies, or possible allergic reactions. The pattern of occurrence following consumption of acidic foods suggested a reactive inflammatory process.
Final Diagnosis
Recurrent transient lingual papillitis secondary to dietary irritants, commonly known as 'lie bumps' or inflamed taste buds.
Treatment Plan
- Dietary modification to avoid known triggers (acidic and highly seasoned foods)
- Gentle oral hygiene with mild antiseptic rinses
- Topical treatments during flare-ups including dilute hydrogen peroxide rinses
- Recommendation to avoid mechanical irritation (rubbing against teeth)
- Consider elimination diet to identify specific triggers
Outcome and Follow-up
Patient advised to continue current home management strategies while implementing dietary modifications. Follow-up recommended if symptoms persist, worsen, or if new concerning features develop. Patient education provided regarding trigger avoidance and proper oral hygiene techniques.