What are Tongue Papillae?
Papillae are on everyone’s tongue. Most people do not have any issues with their papillae but some do. Papillae are circular bumps found on the tongue surface. These give the tongue its bumpy appearance. There are four different types of papillae on tongue. The function of tongue papillae is to taste different tastes. 
Image 1 – Tongue Anatomy Images and Tongue Anatomy Taste Buds 
Image 2 – Healthy tongue look like as above
What are Circumvallate Papillae?
Circumvallate papillae (CP) are bigger than other papillae and are arranged in a v-shaped way in the back of the tongue near the throat. Most people have from 6 to 12 circumvallate papillae.
These papillae are used to taste bitter. These sensors can make a person gag from bad tastes. CP are also called vallate papillae.
They are arranged in two rows and each of them has 1 to 2 mm projections of mucous membranes. These projections are connected at the base of the mucous membranes which is shaped as a circular depression. The edge of the circular depression forms a border called a vallum (wall).
Image 3: Circumvallate Papillae (Observe V Shape)
The papillae look like short cones and the base of the cone is attached to the tongue’s upper surface. At the circular depression, the ducts of Von Ebner’s glands (VEG) or lingual salivary glands clear out their serous secretions and act as a moat.
These secretions assist to wash out food debris from the circular depression and they help to catch fresh tastes. The glosso-pharyngeal nerve is the ninth cranial nerve and it provides nerve supply to the circumvallate papillae. It also helps to catch unique afferent taste perceptions. [3, 4]
Functions of Circumvallate Papillae
We can analyze any unpalatable taste due to presence of circumvallate papillae and these papillae also restrict swallowing of any poisonous substances due to the bad taste.
The activation of the sensation depends upon the number of taste buds one has. Normally 250 to 270 of bitter-responsive taste buds are present in each circumvallate papilla but these numbers are varied.
For example some people who have less numbers of circumvallate papillae enjoy the salty taste of cheese. Some people complain cheese has a bitter taste, as they have a higher number of bitter taste buds in circumvallate papillae.
With increasing age or with nicotine smoking these lessen the number of circumvallate papillae and taste buds. The number of circumvallate papillae and the sensitivity to bitter tastes are also dependent on gender, genetics and culture. Women tend to have more taste buds than men. 
Signs and Symptoms
These are certain signs of an unhealthy tongue:
- Pernicious Anemia: Tongue is bulky, reddish, tender with papillary atrophy
- Insufficiency of Vitamin B12 or Folic Acid: Swelling of the tongue with redness and tenderness, late features are papillary atrophy, sore tongue vitamin deficiency
- Pellagra: A black tongue occurs due to niacin deficiency, painful reddened beefy appearance
- Riboflavin Deficit: Indicated by a magenta coloration in the tongue, painful reddened beefy appearance, can also cause fissuring of the corners of the mouth
- Thrush: Indicated with snow-white fungal patches on the tongue with stomatitis (inflammation of the mucous membranes in the oral cavity), sore tongue with white coating
- Infection with Aspergillus Niger: Caused by chronic use of Penicillin. This can be characterized by a brownish or blackish tongue with “hairy” growth without any pain (papillae become long, they thicken and become amalgamated)
- Macroglossia: Tongue becomes elevated and bulging
What Causes Enlarged Circumvallate Papillae (Papillitis)
Image 4: Enlarged Papillae
Enlarged circumvallate papillae are caused by different reasons:
- Viral Infections or Throat Infections: These cause enlarged painful circumvallate papillae. It is not a complicated medical issue. Usually it is a self-treatable condition and the symptoms usually disappear within fifteen days. If it is accompanied with high fever, then people need to consult with a doctor because oral cancer also has similar types of symptoms.
- Oral Cancer: It can cause problems with the taste buds
- Stress: It can harm the body, cause canker sores and inflammation of the tongue, can cause sore papillae on tongue
- Thrush: Helps the attack of viruses / bacteria and can help lead to inflamed papillae
- Anticancer Medications: Methotrexate can cause tongue papillae inflammation
- Mouth Ulcers: Ulceration inside the mouth due to bacterial growth
- GI Tract Ailment: Ulcerative Colitis and Gastro-esophageal Reflex Disease (GERD) can cause changes of the PH level in the whole GI tract
- Hot, Salty and Spicy Foods: The tongue can become irritated from too much hot, salty or spicy food that contain acidic substances which can damage the papillae
- Accidental Trauma: Accidental biting or other injuries like from a toothbrush can increase irritation of the tongue
- Food Allergies: Some individuals have food allergies from different types of food that can cause irritation
- Smoking: Smoking can also cause enlarged circumvallate papillae due irritation of the tongue
- Consumption of Toxic Substances: Toxic substances like alcohol, poison and pesticides can also damage the circumvallate papillae
- Vitamin Deficiency: Vitamin deficiency can be associated with multiple vitamin insufficiency, which can result in enlargement of circumvallate papillae as well
How to Treat Enlarged Papillae ?
Usually enlargement of circumvallate papillae is self treatable but following certain measures can help to accelerate the healing of the condition:
- Licking ice cream or topical application of ice cubes can help to control pain and may also reduce enlargement
- Local administration of cold compression and drinking cold drinks can help to manage the discomfort
- Chewing mint leaves can help inflammation of the tongue
- In the case of throat infections that cause enlargement of circumvallate papillae, you can help it by gargling with salty lukewarm water
- A balanced diet with fruits and vegetables can provide essential vitamins, compensate the vitamin deficiency therefore help to reduce the symptoms
- Adequate water intake can help to flush toxic substances from the mouth and reduce irritation/enlargement of papillae on the tongue
- Antibiotics or antiviral drugs can treat mouth ulcers and viral infections. Topical application of antifungal drugs, analgesics and anti-inflammatory medications can reduce discomfort / decrease enlarged circumvallate papillae
- Multi-vitamin, mineral supplements and a diet rich in vitamin B12 / iron can also be useful in the case of enlarged circumvallate papillae caused by vitamin deficiency
- Different natural oil gurgling such as tea tree oil gurgle or sesame oil gurgle can also be beneficial for fungal and thrush infections
- Good oral hygiene and periodic visits to the dentist can reduce the chances of development of enlarged circumvallate papillae
- Do not bite the tongue, accidental biting or injuries can be treated with topical application of glycerin which helps to reduce the trauma
- Low fat dairy products including yogurt can provide considerable benefits for reduction of enlarged circumvallate papillae by treating thrush infections
- Stop smoking and avoid hot spicy foods for maintenance of good tongue health
- Well fitting dentures can help the tongue
- Drink soups made with ginger, garlic and pepper to help prevent oral infections
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What to read next?
- Wise Geek, Available from: http://www.wisegeek.org/what-is-the-circumvallate-papillae.htm
- Doctor Spiller, Available from: http://doctorspiller.com/circumvallate_papillae.htm
- Wikipedia, Available from: https://en.wikipedia.org/wiki/Lingual_papillae
- Live Strong, Available from: http://www.livestrong.com/article/325962-bumps-on-tongue-in-a-v-shape/
- National Center for Biotechnology Information, US National Library of Medicine, Available from: https://www.ncbi.nlm.nih.gov/books/NBK236/
- Medical Treasure, Available from: http://medicaltreasure.com/enlarged-papillae/
- Wealth for my Health, Available from: https://wealthformyhealth.com/what-is-circumvallate-papillae/
- Coordstudenti, Available from: http://coordstudenti.blogspot.com/2016/06/tongue-anatomy-human-with-label.html
- The Science of Eating, Available from: http://thescienceofeating.com/2015/06/23/secrets-your-tongue-holds-about-your-health/
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