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
tongueinflammation, which can have various
etiologies, e.g.
infection.
Aglossia - complete absence of the tongue at birth
Ankyloglossia (tongue tie) - where the
lingual frenum tethers the tongue to the floor of the mouth. If it interferes with oral hygiene and feeding,
frenectomy may be indicated.
Choristomata - For example, osseous
choristoma of the tongue, a very rare condition characterized by a nodule on the
dorsum of the tongue containing mature
lamellar bone without
osteoblastic or
osteoclastic activity.[1]: 808 Cartilaginous (chondroid),[2] and glial choristomas may also very rarely occur on the tongue.[3]
Cleft tongue (bifid tongue) - completely cleft tongue is a rare condition caused by a failure of the lateral lingual swellings to merge.[4] More common is an incompletely cleft tongue, appearing as midline fissure. This is normally classed as
fissured tongue.
Acquired
Vascular
Caviar tongue - the veins underneath the tongue can become dilated and prominent, giving the undersurface of the tongue a caviar like appearance.
The tongue may traumatized by mechanical, thermal, electrical or chemical means. A common scenario is where the tongue is bitten accidentally whilst a
local anestheticinferior alveolar nerve block is wearing off. The tongue may develop scalloping on the lateral margins, sometimes termed
crenated tongue. This appearance is the result of indentations of the teeth where the tongue is habitually pressed against the teeth ("tongue thrusting", and example of oral
parafunction). A lesion similar to
morsicatio buccarum can occur on the tongue (sometimes called morsicatio linguarum), caused by chronic chewing on the tongue. The ventral surface (under surface) of the tongue may also be traumatized during
oral sexual activity such as cunnilingus ("
cunnilingus tongue").[6]
The sides (lateral) and undersurface (ventral) of the tongue are high risk sites for the development of
oral cancer, most commonly
squamous cell carcinoma.
Degenerative
Motor neuron disease (Lou Gehrig's disease) can cause impaired control of tongue movement, affecting speech and swallowing.
Environmental
Poor diet can cause
malnutrition and
nutritional deficiencies. Deficiency of iron, B vitamins and folic acid are common causes for atrophic glossitis.
Black hairy tongue - some factors thought to cause black hairy tongue are environmental, such as eating a soft diet, poor oral hygiene, smoking and antibiotic use.
Unknown
Geographic tongue (benign migratory glossitis) - a common disorder which occasionally causes a burning sensation but is usually painless. Irregular patches of depapillation form on the tongue giving the appearance of a map. The cause is unknown.
Tongue coating - food debris, desquamated epithelial cells and bacteria often form a visible tongue coating.[7] This coating has been identified as a major contributing factor in bad breath (
halitosis),[7] which can be managed by brushing the tongue gently with a toothbrush or using special oral hygiene instruments such as tongue scrapers or mouth brushes.[8]
Burning mouth syndrome - this chronic pain disorder commonly involves the tongue. In reflection of this, some of the synonyms for the condition include tongue-specific terms such as "glossodynia" or "burning tongue syndrome". Burning mouth syndrome is characterized by chronic burning sensation on the tongue and other oral mucous membranes in the absences of any identifiable signs or causes.
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.
^James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier.
ISBN978-0-7216-2921-6.
^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.
PMID12627912.
^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.
PMID17972083.
S2CID29538827.
^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.
PMID16625641. (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}}.)
^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.
PMID18654938.