Transient Lingual Papillitis: Types, Symptoms, Causes

Transient Lingual Papillitis: Types, Symptoms, Causes

Transient lingual papillitis (TLP), or “lie bumps,” is a common inflammatory condition that affects the fungiform papillae— the tiny bumps on your tongue’s surface that contain taste buds. When they become inflamed, these small bumps can appear red, white, or yellow in color and cause pain, discomfort, and tingling sensations that make eating difficult. 

While the exact cause of TLP remains unknown, it’s a temporary condition that typically resolves within a few days. 

There are four types of transient lingual papillitis—all of which have different symptoms. These include:

  • Classic (localized) lingual papillitis: Occurs when inflammation affects one or more papillae on one area of your tongue—usually the tip or sides. The bumps may appear red or white and cause pain or discomfort when eating and sensitivity to hot foods. This is the most common type of TLP and typically resolves within a few days. 
  • Eruptive lingual papillitis: Involves multiple red, yellow, or white-colored bumps on the tip and sides of the tongue. This type primarily affects children but can also occur in adults. The condition spreads through families, suggesting a viral infection may trigger eruptive lingual papillitis.
  • U-shaped lingual papillitis: Causes a swollen tongue (known as macroglossia) with scattered red or pink spots that form on the tip and front sides of the tongue. This type is most common in people with a COVID-19 infection. This type of TLP may cause a burning sensation in the mouth and can also occur alongside canker sores on the lips, mouth, and cheeks. 
  • Paupulokeratotic lingual papillitis: Develops yellow or white-colored bumps all over the tongue that do not cause pain or discomfort. This type is more likely to be chronic (long-lasting) or recurrent than other types of transient lingual papillitis.

The symptoms of transient lingual papillitis vary depending on the type of TLP you have. While every type affects your tongue and causes inflammation, other symptoms can occur alongside each TLP type.

Classic (Localized) Lingual Papillitis Symptoms

Classic lingual papillitis causes a few red, whitish, or yellow-colored raised bumps on one area of the tongue—typically on the tip or sides. Symptoms usually clear up within one to five days and can include: 

  • Mild to moderate pain or discomfort at the site of the bump(s) 
  • Burning, tingling, or itching sensations on or around the bumps 
  • Sensitivity to hot foods
  • Difficulty eating spicy or acidic foods 
  • Dry mouth
  • Distorted taste 

Eruptive Lingual Papillitis Symptoms 

Eruptive lingual papillitis is associated with multiple painful bumps that develop on the tip and sides of the tongue. Usually, the inflamed bumps can last up to a week but often recur in some people. The bumps may appear red, yellow, or white—mimicking the look of pus-filled pimples. Other symptoms of eruptive lingual papillitis may include: 

U-shaped Lingual Papillitis Symptoms 

U-shaped lingual papillitis causes small, scattered red or dark pink patches on the tongue. Other symptoms may include:

  • Swollen tongue 
  • Burning sensation in the mouth 
  • Canker sores (ulcers) in the mouth 
  • White tongue 
  • Distorted taste 

Papulokeratotic Lingual Papillitis Symptoms 

Unlike other forms of transient lingual papillitis, the papulokeratotic type causes white or yellow rough bumps that do not cause pain or discomfort. This type, however, is more likely to cause inflammation for longer periods.

Transient lingual papillitis occurs when the fungiform papillae, the mushroom-shaped structures on the surface of the front two-thirds of the tongue, become inflamed. Inflammation can affect the appearance and function of the fungiform papillae and the taste buds they contain.

What causes this inflammation and leads to transient lingual papillitis is unknown, but research suggests several factors may contribute to its development: 

  • Biting or burning the tongue 
  • Eating acidic or spicy foods 
  • Hormonal fluctuations (e.g., menstruation, menopause
  • Stress
  • Poor oral hygiene 
  • Excessive alcohol use 
  • Smoking 
  • Poor nutrition
  • Inadequate sleep 
  • Allergies to foods or oral hygiene products (e.g., toothpaste, mouthwash) 
  • Viral infections
  • Irritation from orthodontic appliances, such as a retainer

Risk Factors

While anyone can develop TLP, some groups may be more affected. For example: 

  • People assigned female at birth
  • Individuals who have a family history of TLP
  • Those who live with allergies to certain foods or environmental irritants

Diagnosing transient lingual papillitis is usually straightforward and requires a visual examination by a healthcare provider. Your healthcare provider will examine your tongue to assess the appearance, location, and size of the bumps. They will also review your medical history and ask about your symptoms. You can also expect them to ask whether you had recent dietary changes or exposure to potential oral (mouth) irritants. 

In most cases, these steps are sufficient for diagnosis. If you have other symptoms or recurrent transient lingual papillitis, your healthcare provider may order diagnostic tests to rule out other conditions that may cause similar symptoms. These tests may include: 

  • Oral swab: Uses a long cotton swab or small spatula to scrap cells from the tongue or the inside of your cheek to rule out fungal, bacterial, or viral infections affecting the tongue 
  • BiopsyTakes a small tissue sample from the affected area on the tongue and examines it under a microscope to help confirm a transient lingual papillitis diagnosis and rule out other conditions 

Transient lingual papillitis usually resolves without treatment for a few hours or days, though it can sometimes last for a week. If your symptoms are causing significant discomfort, your healthcare provider may recommend self-care strategies to ease your pain. Common treatment options include the following:

  • Avoid foods or beverages that can irritate your mouth, such as hot food, spicy or acidic foods, alcohol, and citrus juices
  • Maintain good oral hygiene
  • Rinse your mouth with an oral saline solution (warm salt water) to reduce inflammation 
  • Suck on ice or popsicles to soothe burning sensations on the tongue 
  • Avoid smoking
  • Take over-the-counter (OTC) pain relievers, such as Tylenol (acetaminophen) or Advil (ibuprofen) to reduce pain and inflammation
  • Try topical analgesics (pain relievers) such as mouth rinses, sprays, or gels applied directly to your tongue

If your symptoms are moderate to severe and interfere with your ability to eat and drink normally, your healthcare provider may prescribe a topical corticosteroid, such as Kenalog (triamcinolone acetonide), to relieve pain.

Preventing TLP is not always possible, but certain lifestyle habits may lower your risk of inflammation. These include the following: 

  • Brush your teeth twice daily with a soft-bristled toothbrush 
  • Floss at least once a day
  • Limit alcohol and tobacco use
  • Eat a well-balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins
  • Manage stress with techniques like meditation, regular exercise, or breathing techniques  

Transient lingual papillitis is a temporary condition that usually clears up within a few hours to a week. However, if it causes severe discomfort, it can affect your ability to eat or drink. This may increase your risk of developing malnutrition or dehydration. To avoid these complications, sip cool beverages throughout the day to stay hydrated and eat bland foods until the pain goes away. 

It’s important not to pick the bumps, even if they appear raised and white or pus-filled like a pimple. Breaking the tissues on your tongue can create an opening for bacteria and other infectious microbes to enter, leading to a more severe infection.

Transient lingual papillitis, commonly known as “lie bumps,” is a common inflammatory condition that causes small, red, white, or yellowish bumps on your tongue. Irritation and inflammation can lead to transient lingual papillitis, which causes pain and discomfort when consuming hot, spicy, or acidic foods.

Most cases of transient lingual papillitis clear up without treatment within a few days to a week. Self-care methods like rinsing your mouth with salt water, drinking cool beverages, and taking over-the-counter pain relievers may ease your discomfort.

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