The different types of lie bumps: Transient lingual papillitis, fungiform papillae, and other forms
Dr. Angel Rivera
Transient lingual papillitis is a condition where there are transient swellings on your tongue called lie bumps. They can be caused by something as simple as eating spicy foods, but they can also signal the presence of other more serious conditions like cancer. There are many different types of lie bumps and each one has its own specific symptoms, diagnosis, and treatment options available to you. We’ll discuss transient lingual papillitis in depth so that you know how to spot it before it causes any problems for you.
What is transient lingual papillitis?
Transient lingual papillitis (TLP), also known as lie bumps or oral hairy leukoplakia is a transient condition where small white or red, sometimes painful tongue lesions appear on the tongue. Transient lingual papillitis usually appears as multiple transient papules on the back of the tongue which are smooth surfaced, round or oval, and white-yellow or red in color. These are caused by inflammation of the filiform papillae which can be due to a viral infection or autoimmune disease. Lie bumps are more common in children but can affect adults, too and can appear at any age after three years old. The condition can cause no pain at all or cause pain on the tongue–it varies from case to case. The origin of the name "lie bumps" comes from the old myth that they would appear on someone's tongue after telling a lie.
What are the symptoms of lie bumps?
The symptoms of lie bumps are minor and usually only last several days. Typically you will have red or white bumps on your tongue. These bumps can be very painful although they can also be painless. Pain can occur both from irritation, such as eating, drinking, or rubbing your lie bumps, but it isn't always necessary as they can also hurt on their own. Occasionally, lie bumps will be accompanied by a burning, itching, tingling sensation, but not all the time. The bumps are usually caused by an infection of transient lingual papillitis that results in the swelling of tiny, raised bumps on your tongue. Please note that the symptoms of red and white bumps on the tongue are very similar to eruptive lingual papillitis, which may be caused by a virus and may be contagious. Eruptive lingual papillitis usually is accompanied by swollen glands and fever and the symptoms can last as long as several days up to a couple of weeks.
What are fungiform papillae?
Fungiform papillae are red or pink small bumps found at the base of your taste buds and situated along their top side, also called the dorsal surface. They contain many taste buds and are the most common type of papillae to be found on your tongue. Fungiform papillae are seen on the anterior two-thirds of the tongue surface which consists of small conical, mushroom-looking, projections that contain taste buds. These structures can become enlarged for a transient period of time especially when there is an irritation to the tongue such as with transient lingual papillitis. This transient enlargement is known as fungiform papillae or lie bumps. The fungiform papillae are often the part of the tongue affected the most by lie bumps.
What causes lie bumps?
What causes lie bumps are not known, but there are several factors that have been linked to transient lingual papillitis.
Stress and anxiety
Stress and anxiety may cause your body to release cortisol which can weaken the immune system’s ability to fight infection. This could lead you to be more likely to develop lie bumps after an injury or trauma to your mouth.
Cold sores are caused by the herpes simplex virus (HSV) which can be spread to others through kissing or sharing objects such as utensils, lipsticks, towels, etc. HSV is a cause for transient lingual papillitis that may result in lie bumps on the sides of your tongue.
Viruses causing fevers
There are several viruses that can cause transient lingual papillitis including COVID-19. These conditions may result in lie bumps on the sides of your tongue and become swollen, tender, or painful. The bumps will then typically go away within two weeks.
Food allergies can cause lie bumps to appear on the tongue. It is recommended you stop eating whatever food is triggering your allergy to foods.
Carcinoma of the mouth and throat
Certain medical conditions may cause lie bumps. Lumps under your tongue or on its surface, which may be transient lingual papillitis can also result from carcinomas in these areas. If this is the case, transient lingual papillitis may result in lie bumps that don’t go away after two weeks, and your doctor will likely recommend a biopsy to determine if cancer is present.
Spicy foods or acidic foods
It is thought spicy and acidic foods can cause lie bumps because they can irritate the tongue with their spice levels or acidity. Eating these irritating foods can turn into lie bumps.
Biting or burning the tongue
As with spicy foods, it is thought that the chronic irritation caused by biting or burning your tongue with hot foods or drinks can also lead to lie bumps. When you bite your tongue it also causes it to swell which can lead to more bites and further irritation from teeth.
There are several other factors but these are the most common.
What are the different forms of lie bumps?
There are several transient lingual papillitis "forms" that you should know about. This is because each one has its own specific symptoms, diagnosis, and treatment options available to you. Below is a breakdown of the different forms lie bumps may take.
The form most common is a single red or white bump, usually toward the tip of the tongue. These usually are gone within several days and can recur throughout your life, sometimes years later.
The papulokeratotic form occurs when you have continuing white bumps on your tongue that do not cause pain.
Eruptive lingual papillitis
This form is associated with fevers and swollen glands and may take up to two weeks for your body to recover. The bumps affect the tip of your tongue and sides but not the top of it.
Transient U-shaped lingual papillitis
Transient U-shaped lingual papillitis is a form of TLP affecting the tongue that causes it to be swollen and has been associated as a symptom of COVID-19. It is uncertain, but believed, this is caused by an infection of the mucosa, or membrane that lines the surface of your tongue.
How do you diagnose lie bumps?
Most lie bumps will not need medical treatment, but in the rare case you need to see your doctor or dentist they will typically diagnose them by doing an initial examination of the area. In rare instances, the doctor or dentist may need to do a biopsy to properly diagnose you. The biopsy would involve removing all or part of the bump and then doing a clinical examination.
How do you treat lie bumps?
Most lie bumps do not require any treatment at all and should go away on their own in several days. If they persist, there are many over-the-counter and home treatments you can do to help your condition, these include:
- Gargling with warm salt water
- Practicing good oral hygiene by brushing twice daily, flossing, and using antiseptic mouthwash to kill bacteria
- Avoiding eating food that may irritate your lie bumps, especially spicy foods
- Using over-the-counter topical treatments that help isolate the lie bumps from irritation
If your lie bumps still persist, please see your doctor or dentist to determine the best course of treatment for you.
Is there a way to prevent lie bumps?
Due to there being no cause for most lie bumps there aren't any sure ways to prevent it. There is a belief that it can be helpful to avoid chewing on the same side of your mouth for prolonged periods of time. Some people believe that transient lingual papillitis can be caused by poor oral hygiene, so it may help to brush and floss more often. Avoiding biting your nails or picking your skin might be helpful as well, although none of these are proven.
Transient lingual papillitis also called TPL or lie bumps, are bumps that form on your tongue and typically go away on their own in several days. Not much is known of the cause, but stress, anxiety, spicy foods, and other reasons are thought to promote them. There are several different forms of lie bumps, including classic, papulokeratotic variant, eruptive lingual papillitis, and transient U-shaped papillitis. Doctors and dentists typically diagnose lie bumps by observing and examining the affected area. In rare cases, a biopsy may need to be done. To treat lie bumps, you can do many at-home or over-the-counter treatments including gargling with warm salt water, practicing good oral hygiene, not irritating the lie bumps, and using over-the-counter medications to treat them and prevent further irritation. There is no known way to prevent lie bumps but we recommend using oral hygiene products and practicing good oral hygiene. Should you have any further questions, please consult your healthcare provider.