|Classification and external resources|
Tongue diseases can be congenital or acquired, and are multiple in number. Glossitis is a general term for tongue inflammation, which can be caused by various etiologies, e.g. infection. Considered according to a surgical sieve, some example conditions which can involve the tongue are discussed below.
Examples of congenital disorders which affect the tongue include:
- 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.
- Hypoglossia - congenitally short tongue
- Macroglossia - an abnormally large tongue, seen in some disorders such as Down syndrome (although macroglossia can be an acquired condition as well).
- Caviar tongue - the veins underneath the tongue can become dilated and prominent, giving the undersurface of the tongue a caviar like appearance.
- Glossitis - some types of glossitis are caused by infections, e.g. median rhomboid glossitis (Candida species), "strawberry tongue" (seen in scarlet fever), and syphlitic glossitis (seen in tertiary syphilis).
- Oral hairy leukoplakia (seen in people with immunosuppression, caused by Epstein-Barr virus)
- Oral candidiasis can affect the tongue. Risk factors for oral candidiasis include antibiotic and corticosteroid use, and immunodeficiency (e.g. HIV), or diabetes mellitus).
- The tongue may traumatized by mechanical, thermal, electrical or chemical means. A common scenario is where the tongue is bitten accidentally whilst a local anesthetic inferior 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 (oral parafunction). A lesion similar to morsicatio buccarum can occur on the tongue (sometimes called morsicatio linguarum), caused by chronic chewing on the tongue.
- Oral lichen planus
- Hypoglossal nerve weakness can cause atrophy and fasciculation of the tongue.
- Melkersson–Rosenthal syndrome - a neurological disorder characterized by fissured tongue, facial palsy and orofacial swelling.
- The sides (lateral) and undersurface (ventral) of the tongue are high risk sites for the development of oral cancer, most commonly squamous cell carcinoma.
- Motor neuron disease (Lou Gehrig's disease) can cause impaired control of tongue movement, affecting speech and swallowing.
- 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.
- 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.
- Leukoplakia - can affect the tongue
Society and culture
Hippocrates, Galen and others considered the tongue to be a "barometer" of health, and emphasized the diagnostic and prognostic importance of the tongue. Assessment of the tongue has historically been an important part of a medical examination. 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. Some modern medical sources still describe the tongue as "the mirror of physical health".
- Hodgson TA, Greenspan D, Greenspan JS (April 2006). "Oral lesions of HIV disease and HAART in industrialized countries". Adv Dent Res 19 (1): 57–62. PMID 16672551.
- "Odd Tongues: The Prevalence of Lingual Disease". The Maxillofacial Center for Diagnostics & Research. Retrieved 11 September 2013.
- Haller JS (September 1982). "The foul tongue: a 19th century index of disease". West. J. Med. 137 (3): 258–64. PMC 1274095. PMID 6755914.
- Marnae C. Ergil, Kevin V. Ergil (Editors) (2009). Pocket Atlas of Chinese Medicine. Thieme. ISBN 9783131416117.
- Kostka, E; Wittekindt, C; Guntinas-Lichius, O (2008 Aug). "[Tongue coating, mouth odor, gustatory sense disorder - earlier and new treatment options by means of tongue scraper].". Laryngo- rhino- otologie 87 (8): 546–50. PMID 18654938.