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Geographic Tongue Reassurance — MFDS Part 1 MCQ

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EasyOral MedicineGeographic Tongue ReassuranceMFDS Part 1

A 35-year-old patient has asymptomatic, well-demarcated erythematous depapillated patches with pale serpiginous borders on the dorsal tongue. The patches change position over several days. There is no induration or persistent ulceration. What is the most appropriate advice?

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Correct answer: C — It is not premalignant, and treatment is needed only if symptoms occur

The correct answer is C. Migrating erythematous depapillated patches with pale serpiginous borders are characteristic of geographic tongue (benign migratory glossitis). It is a benign condition with no association with oral cancer, so an asymptomatic patient generally requires explanation and reassurance rather than treatment. Symptomatic soreness or burning may be managed with avoidance of provoking foods and appropriate symptomatic relief. Biopsy is unnecessary when the history and appearance are typical, although an atypical, indurated or persistent lesion should be investigated. Antifungal treatment is not routinely indicated because geographic tongue is not caused by Candida, although separately diagnosed candidosis may require treatment. It is neither contagious nor expected to cause permanent taste loss.

Reference: Ashford and St Peter's Hospitals NHS Foundation Trust, Oral Surgery Leaflet: Geographic Tongue, reviewed March 2026, updated April 2026. https://www.asph.nhs.uk/leaflets/3558-oral-surgery-leaflet-geographic-tongue