Tongue lecture
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1. The document discusses various diseases and disorders that can affect the tongue, including burning mouth syndrome (glossodynia), glossitis, geographic tongue, hairy tongue, and cancers like squamous cell carcinoma. 2. It describes the clinical examination of the tongue involving inspection, palpation, and function evaluation. Common lesions seen on the tongue are also outlined. 3. Treatment depends on the specific condition but may include antibiotics for infections, tricyclic antidepressants for burning mouth syndrome, improved oral hygiene for hairy tongue, and biopsy or surgery for suspected cancers.
Tongue lecture
- 1. Tongue diseasesTongue diseases and disordersand disorders
- 4. B- PalpationB- Palpation BidigitalBidigital ConsistencyConsistency C- Function evaluationC- Function evaluation Tongue TieTongue deviation
- 5. Disorders of Tongue • Glossodynia (burning mouth syndrome)- spontaneous burning, discomfort, pain, irritation, or rawness of the tongue, has no identifiable etiology most of the time
- 6. Etiology of Glossodynia • Neurologic – Peripheral nerve damage – Diabetic neuropathy – Trigeminal neuralgia • psychiatric – Depression – Anxiety – Cancerophobia • Systemic disorders – Anemia (iron deficiency, pernicious) – Nutritional deficiency – Gastroesophageal reflux disease – Sjogren syndrome – Hypothyroidism – Acquired immunodeficiency syndrome
- 8. Disorders of Tongue… • Glossitis- presents as pain, irritation or burning, hypogeusia, or dysgeusia • Atrophic glossitis – Due to filiform de-papillation – Mild patchy erythema to a completely smooth, atrophic, beefy-red surface – Etiology - pernicious anemia, protein and other nutritional deficiencies, chemical irritants, drug reactions,, vesiculobullous diseases, oral candidiasis and systemic infections
- 9. Disorders of taste dysgeusia • Viral infections • Candidiasis • Malnutrition • Neoplasms • Xerostomia • Metabolic disturbance • Drugs • Radiation • Zinc deficiency
- 10. COMMON LESIONS
- 12. Varicosities
- 14. Foliate papillae
- 15. They are occasionally mistaken for tumors or inflammatory disease
- 17. Fissured tongue • normal variant seen in 5-11% individuals • Numerous small irregular fissures oriented laterally on the dorsal tongue • Also seen in - Melkersson- Rosenthal syndrome, psoriasis, Down syndrome, acromegaly, Sjogren syndrome
- 18. Macroglossia • Congenital or acquired process, tongue is disproportionately large relative to the patient’s jaw size • Difficulty with mastication and speech and accidental tongue biting are common • Differential- Down syndrome, hypothyroidism, haemangioma, neurofibromatosis, infection by mycobacteria, or deep fungus, amyloidosis………
- 20. Hairy tongue • Hypertrophy of filiform papillae resembling hair-like projections • Associated with - heavy tobacco use, mouth breathing, antibiotic therapy, poor oral hygiene, general debilitation, radiation therapy, chronic use of antacids. • White, yellow green, brown, or black color is due to chromogenic bacteria or staining from exogenous sources
- 22. Brown hairy tongue TREATMENT: Treatment consists of brushing the tongue with a soft bristle toothbrush . Surgical scraping.
- 23. 1. What is the clinical diagnosis 2. What are the predisposing factors? 3. What is the treatment?
- 24. Geographic tongue • Geographic tongue- benign inflammatory condition, due to loss of filiform papillae • Erythematous plaques with well demarcated white border • Etiology- idiopathic, psoriasis, Reiter syndrome, atopic dermatitis, idiopathic
- 27. Hemangioma of the lateral aspect of the tongue
- 29. Lingual thyroid
- 30. Other lesions
- 31. OraI hairy leukoplakia • Caused by Epstein-Barr virus. • Presents as asymptomatic, corrugated, white plaques with accentuation of vertical folds along the lateral borders of tongue • Predominantly seen in HIV infection, organ transplant recipients and patients on chemotherapy
- 32. OraI hairy leukoplakia, Diagnosis •DNA in situ hybridization •Biopsy
- 33. Candidiasis Pseudomembranous • Etiology • Predisposing factors • Classification • Treatment
- 34. Median rhomboid glossitis • Median rhomboid glossitis - atrophic disorder of the tongue secondary to chronic candidiasis
- 37. Squamous cell carcinoma • Early carcinoma may clinically appear as leukoplakia or erythroplasia. • The tongue and floor of the mouth are the most common areas • PROGNOSIS: The overall five year survival rate is about 50%. Early diagnosis increases the chance of survival.
- 38. Leukoplakia unilateral indurated white patch related to the lateral surface of the tongue.
- 39. EARLY SQUAMOUS-CELL CARCINOMA OF THE LATERAL BORDER OF THE TONGUE EARLY SQUAMOUS-CELL CARCINOMA OF THE FLOOR OF THE MOUTH
- 40. SQUAMOUS-CELL CARCINOMA PRESENTING AS EXOPHYTIC ULCERATED TUMOR OF THE LATERAL BORDER OF THE TONGUE. . LATE SQUAMOUS-CELL CARCINOMA ON THE DORSUM OF THE TONGUE.
- 42. • DIFFERENTIAL DIAGNOSIS: All ulcerations present for more than 2-3 weeks in which there is no apparent cause should be biopsied to rule out carcinoma, especially in adults whose lesions are in high risk areas.
- 43. Traumatic ulcer Source of trauma should be identified