Bumps on the Tongue: Causes of Transient Lingual Papillitis (2024)

Transient lingual papillitis, also called "lie bumps" or "liar's tongue," is a painful condition that causes small bumps all along the tongue. It is not serious and usually goes away in a few days.

Lie bumps get their name from the myth that you develop bumps on your tongue if you tell a lie. The real cause of transient lingual papillitis is something irritating your taste buds (known as fungiform papillae).

The bumps, which are very common, cause significant pain, especially when you try to eat.

While transient lingual papillitis clears up on its own, you may need help managing the discomfort and can talk to your healthcare provider about ways to prevent them from coming back.

Types and Symptoms of Lie Bumps

There are four different types of transient lingual papillitis, each with its own set of symptoms. Each of these types may occur on their own or with other tongue conditions like geographic tongue (a generally harmless condition in which "bald" patches develop on the tongue).

Classic or Localized Lingual Papillitis Type

With classic or localized transient lingual papillitis, the papillae are inflamed in just one area of the tongue, often the tip.

Symptoms include:

• One or more painful and raised bumps ranging from a whitish-yellow to red
• A burning, tingling, or itching tongue
• Sensitivity to hot foods
• Difficulty eating, especially spicy or acidic foods
• Distorted taste (dysgeusia)
• Dry mouth (xerostomia)
  

Eruptive Lingual Papillitis Type

Eruptive lingual papillitis is a systemic (whole-body) illness that affects usually children and sometimes adults.

Symptoms include:

• Painful bumps on the tip and sides of the tongue that often look like pus-filled pimples
• Fever
• Swollen lymph nodes
• Excessive saliva
• Difficulty eating
• Cracks and redness on the corners of the mouth (angular cheilitis)

Eruptive lingual papillitis generally lasts for a week or two. However, it is prone to recurrence, often within a couple of months.

Papulokeratotic Lingual Papillitis Type

Papulokeratotic lingual papillitis is a persistent or frequently recurring type that does not cause symptoms other than whitish or yellow bumps all over the tongue. The bumps do not interfere with eating or affect taste in any way.

U-Shaped Lingual Papillitis

U-shaped lingual papillitis has some key differences from the other types. Firstly, it doesn't involve bumps but rather small patches that look as if tissues have been peeled away.

Other symptoms may include:

• Scattered pink spots
• Tongue swelling
• Burning sensations in the mouth
• Canker sores (aphthous ulcers) on the cheeks, lips, and mouth
  

Causes and Risk Factors

Transient lingual papillitis is often idiopathic (meaning of unknown origin). While the original cause is unknown, researchers believe that one or more triggering factors, either localized or systemic, can turn on the inflammation.

Local triggers of transient lingual papillitis may include:

• A burn on the tongue
• Eating overly spicy or acidic foods
• Smoking cigarettes
• Excessive alcohol use
• Poor oral hygiene
• Orthodontic appliances such as retainers
• Biting your tongue or other trauma
• Oxygen therapy
  

Systemic triggers may include:

• Viral or bacterial infections (including COVID-19 and strep throat)
• Stress
• Sleep deprivation
• Poor nutrition
• Hormone fluctuation (such as menstruation or menopause)
• Atopic conditions like eczema, food allergy, allergic rhinitis (hay fever), or asthma
  

Recurrent Viral Infection

Some researchers hypothesize that transient lingual papillitis can result from a prior infection recurring later in life, similar to how oral herpes (cold sores) recur.

It's unclear which viruses may cause transient lingual papillitis. One study showed the herpes simplex virus (HSV) type 1 virus in a test of transient lingual papillitis, but more research is needed.

Other Risk Factors

The classic form of transient lingual papillitis is very common. All people and age groups may be vulnerable as it affects over 50% of the population. However, it does appear to be most common in young women.

Eruptive lingual papillitis is most common in children who are in close contact with many other children (at school or daycare, especially). Frequently, in a household, this papillitis starts with the younger children. According to research, outbreaks originate in children with a median age of 3.5 years before spreading to other family members.

Diagnosis of Bumps on the Tongue

Transient lingual papillitis can usually be diagnosed by its appearance alone. To this end, your healthcare provider will likely:

• Ask about your symptoms
• Inquire about any events leading up to the event (such as mouth trauma)
• Do a physical examination of your mouth, tongue, and lips
• Check your neck area for swollen lymph nodes

If there are any concerns that another, more serious condition is involved, your health provider may recommend a mucosal biopsy. A punch-like device extracts a small sample of tongue tissue to examine under the microscope.

There are several conditions that mimic transient lingual papillitis.

Your healthcare provider may want to explore the following conditions as part of a differential diagnosis:

• Giant cell fibroma: a benign oral mass seen most commonly in White people
• Pyogenic granuloma: a non-cancerous, raised tumor that is prone to bleeding
• Scarlet fever: a bacterial illness that sometimes develops in people with strep throat

Treatment of Bumps on the Tongue

Some bumps on the tongue go away within hours to a few days and usually don't need medical treatment. However, to ease the pain and discomfort, your healthcare provider may suggest:

• Rinsing with saltwater
• Drinking cold drinks
• Avoiding hot, spicy, or acidic foods
• Using an anesthetic or antiseptic mouthwash
• Taking an over-the-counter pain reliever such as non-steroid anti-inflammatory drugs
• Applying a topical steroid, such as triamcinolone acetonide 0.1% dental paste
• Avoiding gum, candy, or oral hygiene products that may irritate the tongue

Eruptive transient lingual papillitis may require antibiotics to treat an underlying bacterial infection. (Antibiotics are ineffective against viral infections.)

Summary

Transient lingual papillitis, or lie bumps, are inflamed and sometimes painful taste buds. They come in several types, each with its own appearance and symptoms.

Triggers of transient lingual papillitis include infection, stress, poor nutrition, allergies, trauma to the tongue, smoking, and spicy or acidic food. In many cases, the underlying cause is unknown.

Lie bumps are generally diagnosed based on their appearance. The bumps will likely go away within a few days without medical treatment. You can help relieve pain with rinses, oral medication, and topical steroids.