Tongue disease

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Tongue disease
Black tongue.jpg
A picture of black hairy tongue. A non serious tongue disease.
Specialty Gastroenterology   OOjs UI icon edit-ltr-progressive.svg

Tongue diseases can be congenital or acquired, and are multiple in number. Considered according to a surgical sieve, some example conditions which can involve the tongue are discussed below. Glossitis is a general term for tongue inflammation, which can have various etiologies, e.g. infection.

Contents

Congenital

Ankyloglossia Frenulum linguae.jpg
Ankyloglossia

Examples of congenital disorders which affect the tongue include:

Acquired

Vascular

Infective

Median rhomboid glossitis Glossitis.jpg
Median rhomboid glossitis

Traumatic

Autoimmune

Inflammatory

Neurological

Neoplastic

Oral cancer on the side of the tongue ZungenCa2a.jpg
Oral cancer on the side of the tongue

Degenerative

Environmental

Unknown

Geographic tongue (benign migratory glossitis) Landkartenzunge 005.jpg
Geographic tongue (benign migratory glossitis)

Iatrogenic

Epidemiology

Tongue lesions are very common. For example, in the United States one estimated point prevalence was 15.5% in adults. [10] Tongue lesions are more common in persons who wear dentures and tobacco users. [10] The most common tongue conditions are geographic tongue, followed by fissured tongue and hairy tongue. [10]

History

Hippocrates, Galen and others considered the tongue to be a "barometer" of health, and emphasized the diagnostic and prognostic importance of the tongue. [11] Assessment of the tongue has historically been an important part of a medical examination. [12] The shape and color of the tongue is examined and observed diagnostically in traditional Chinese medicine. For example, scalloping of the tongue is said to indicate qi vacuity. [13] Some modern medical sources still describe the tongue as "the mirror of physical health". [14] This is related to the high rate of turnover of the oral mucosa compared to the skin, which means that systemic conditions may manifest sooner in the mouth than the skin. Physical appearances such as cyanosis are also often more readily apparent in the mouth.

See also

Related Research Articles

Tongue Muscular organ in the mouth of most vertebrates

The tongue is a muscular organ in the mouth of a typical vertebrate. It manipulates food for mastication and swallowing as part of the digestive process, and is the primary organ of taste. The tongue's upper surface (dorsum) is covered by taste buds housed in numerous lingual papillae. It is sensitive and kept moist by saliva and is richly supplied with nerves and blood vessels. The tongue also serves as a natural means of cleaning the teeth. A major function of the tongue is the enabling of speech in humans and vocalization in other animals.

Mouth ulcer

A mouth ulcer is an ulcer that occurs on the mucous membrane of the oral cavity. Mouth ulcers are very common, occurring in association with many diseases and by many different mechanisms, but usually there is no serious underlying cause.

Bad breath Presence of unpleasant odors in exhaled breath

Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder.

Oral candidiasis Fungal infection

Oral candidiasis, also known as oral thrush among other names, is candidiasis that occurs in the mouth. That is, oral candidiasis is a mycosis of Candida species on the mucous membranes of the mouth.

Lichen planus human chronic inflammatory disease

Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, and is only named that because it looks like one. It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. Although there is a broad clinical range of LP manifestations, the skin and oral cavity remain as the major sites of involvement. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used in efforts to control the symptoms.

Xerostomia

Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause.

Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami. It is sometimes confused with anosmia – a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami, most of what is perceived as the sense of taste is actually derived from smell. True ageusia is relatively rare compared to hypogeusia – a partial loss of taste – and dysgeusia – a distortion or alteration of taste.

Macroglossia

Macroglossia is the medical term for an unusually large tongue. Severe enlargement of the tongue can cause cosmetic and functional difficulties in speaking, eating, swallowing and sleeping. Macroglossia is uncommon, and usually occurs in children. There are many causes. Treatment depends upon the exact cause.

Stomatitis

Stomatitis is inflammation of the mouth and lips. It refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration.

Glossitis

Glossitis can mean soreness of the tongue, or more usually inflammation with depapillation of the dorsal surface of the tongue, leaving a smooth and erythematous (reddened) surface,. In a wider sense, glossitis can mean inflammation of the tongue generally. Glossitis is often caused by nutritional deficiencies and may be painless or cause discomfort. Glossitis usually responds well to treatment if the cause is identified and corrected. Tongue soreness caused by glossitis is differentiated from burning mouth syndrome, where there is no identifiable change in the appearance of the tongue, and there are no identifiable causes.

Frenulum of tongue

The frenulum of tongue or tongue web is a small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue.

The oral mucosa is the mucous membrane lining the inside of the mouth. It comprises stratified squamous epithelium, termed "oral epithelium", and an underlying connective tissue termed lamina propria. The oral cavity has sometimes been described as a mirror that reflects the health of the individual. Changes indicative of disease are seen as alterations in the oral mucosa lining the mouth, which can reveal systemic conditions, such as diabetes or vitamin deficiency, or the local effects of chronic tobacco or alcohol use. The oral mucosa tends to heal faster and with less scar formation compared to the skin. The underlying mechanism remains unknown, but research suggests that extracellular vesicles might be involved.

Geographic tongue

Geographic tongue, also known by several other terms, is a condition of the mucous membrane of the tongue, usually on the dorsal surface. It is a common condition, affecting approximately 2–3% of the general population. It is characterized by areas of smooth, red depapillation which migrate over time. The name comes from the map-like appearance of the tongue, with the patches resembling the islands of an archipelago. The cause is unknown, but the condition is entirely benign, and there is no curative treatment. Uncommonly, geographic tongue may cause a burning sensation on the tongue, for which various treatments have been described with little formal evidence of efficacy.

Angular cheilitis Cheilitis characterized by inflammation of one or both of the corners of the mouth

Angular cheilitis (AC) is inflammation of one or both corners of the mouth. Often the corners are red with skin breakdown and crusting. It can also be itchy or painful. The condition can last for days to years. Angular cheilitis is a type of cheilitis.

Burning mouth syndrome (BMS) is a burning sensation in the mouth with no underlying known dental or medical cause. No related signs of disease are found in the mouth. People with burning mouth syndrome may also have a subjective xerostomia, paraesthesia, or an altered sense of taste or smell.

White sponge nevus

White sponge nevus WSN, is an autosomal dominant condition of the oral mucosa. It is caused by a mutations in certain genes coding for keratin, which causes a defect in the normal process of keratinization of the mucosa. This results in lesions which are thick, white and velvety on the inside of the cheeks within the mouth. Usually, these lesions are present from birth or develop during childhood. The condition is entirely harmless, and no treatment is required.

Oral and maxillofacial pathology refers to the diseases of the mouth, jaws and related structures such as salivary glands, temporomandibular joints, facial muscles and perioral skin. The mouth is an important organ with many different functions. It is also prone to a variety of medical and dental disorders.

Mouth assessment

A mouth assessment is performed as part of a patient's health assessment. The mouth is the beginning of the digestive system and a substantial part of the respiratory tract. Before an assessment of the mouth, patient is sometimes advised to remove any dentures. The assessment begins with a dental-health questionnaire, including questions about toothache, hoarseness, dysphagia(difficulty swallowing), altered taste or a frequent sore throat, current and previous tobacco use and alcohol consumption and any sores, lesions or bleeding of the gums.

Morsicatio buccarum is a condition characterized by chronic irritation or injury to the buccal mucosa, caused by repetitive chewing, biting or nibbling.

Crenated tongue

Crenated tongue is a descriptive term for the appearance of the tongue when there are indentations along the lateral borders, as the result of compression of the tongue against the adjacent teeth.

References

  1. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN   978-0-7216-2921-6.
  2. Yaqoob, N; Ahmed, Z; Muzaffar, S (Dec 2002). "Chondroid choristoma of tongue--a rare entity". The Journal of the Pakistan Medical Association. 52 (12): 584–5. PMID   12627912.
  3. Fan, SQ; Ou, YM; Liang, QC (Apr 2008). "Glial choristoma of the tongue: report of a case and review of the literature". Pediatric Surgery International. 24 (4): 515–9. doi:10.1007/s00383-007-2061-0. PMID   17972083. S2CID   29538827.
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  8. Outhouse, TL; Al-Alawi, R; Fedorowicz, Z; Keenan, JV (Apr 19, 2006). Outhouse, Trent L (ed.). "Tongue scraping for treating halitosis". The Cochrane Database of Systematic Reviews (2): CD005519. doi:10.1002/14651858.CD005519.pub2. PMID   16625641. (Retracted, see doi:10.1002/14651858.cd005519.pub3. If this is an intentional citation to a retracted paper, please replace {{ Retracted }} with {{ Retracted |intentional=yes}}.)
  9. Segura-Sampedro JJ, Sampedro-Abascal C, Parra-López L, Muñoz-Rodríguez JC (2015). "Intraoral paratrichosis after autograft". Cir y Cir. 83 (4): 309–11. doi: 10.1016/j.circir.2015.05.017 . PMID   26118782.
  10. 1 2 3 Reamy, BV; Derby, R; Bunt, CW (Mar 1, 2010). "Common tongue conditions in primary care". American Family Physician. 81 (5): 627–34. PMID   20187599.
  11. "Odd Tongues: The Prevalence of Lingual Disease". The Maxillofacial Center for Diagnostics & Research. Retrieved 11 September 2013.
  12. Haller JS (September 1982). "The foul tongue: a 19th century index of disease". West. J. Med. 137 (3): 258–64. PMC   1274095 . PMID   6755914.
  13. Marnae C. Ergil; Kevin V. Ergil, eds. (2009). Pocket Atlas of Chinese Medicine. Thieme. ISBN   9783131416117.
  14. Kostka, E; Wittekindt, C; Guntinas-Lichius, O (August 2008). "[Tongue coating, mouth odor, gustatory sense disorder - earlier and new treatment options by means of tongue scraper]". Laryngo- Rhino- Otologie. 87 (8): 546–50. doi:10.1055/s-2007-995614. PMID   18654938.
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