First let me say the geographic tongue is not a cancer. And IF this particular diagnosis is correct, geographic tongue has not been shown to be a precancer. The tongue is covered on its dorsum (top side) with papilla, thousands of them. The tip of each individual papilla is cornified or hardened. When a person develops this condition, the hard tips are desqamified, or lost. But this does not happen to all the papilla uniformly on the tongue. The areas of focal, massive erythema where this is occurring contrast with the adjacent papilla which are not participating in the process (are normal), forming patterns on the tongue. Hence the name geographic tongue since it is rather map like when you look at it. The contrast between the two areas is intensified because a whitish or white yellow boarder develops around the edges of the process. As time passes, the papilla which have been effected regenerate the their tips, but at the same time other areas become affected, so the pattern is constantly changing. Some people call these wandering lesions or plaques.

The duration of the condition cannot be predicted. It can last for weeks, months, years, and then resolve suddenly, and possibly reoccur again. The causes of this condition (its etiology) are unknown, and none of the suggested causes (such as psychologic, neurohumoral or genetic) have clear-cut proof that they are the cause. There is no cure or treatment for this condition, except to treat the discomfort that is associated with it. Individuals who have geographic tongue need to remember that it is (while uncomfortable) a harmless condition and should not over treated with various medications that will offer no cure. Increased self-observations can lead to cancerphobia.

Obviously it is important that this diagnosis be made by a clinical oral pathologist least a more serious condition go undiagnosed. They need to be sure that it is not other things such as various forms of leukoplakias, and trophoneurologial changes to the surface of the tongue.

If this is indeed the correct diagnosis, the dentist who stressed everyone out regarding biopsy, has obviously had a limited exposure to this condition, though it is relatively common. On the other hand biopsy of something that has persisted for any length of time is prudent and hurts nothing. A biopsy of geographic tongue would probably show