Tongue is one of the vital sensory organs which plays an important role from eating to speaking. The tongue provides a nidus for food debris, bacteria, and contaminants. When it is not cleaned properly it leads to problems such as bad breath, tooth decay, lesions on the tongue, which in turn will affect the function of the tongue.
A healthy tongue is pink in colour and has nodules on it called papillae. Any deviation from the normal appearance of tongue or pain could be a matter of concern. Let’s look into some common and some not so common diseases which the tongue can show.
White lesions on tongue can present itself in various clinical forms.
White coating of the tongue
- Oral Thrush: Also known as Candidiasis. It is caused by a yeast called Candida Albicans. White layer over the tongue resembling a cottage cheese. Most commonly seen in infants, denture wearers and people with weak immunity. May also be seen with patients with diabetes, or who are under steroid treatment. Long term antibiotic use also causes Oral Thrush
- Leukoplakia: In this condition, there is a white patch on tongue that cannot be scraped off. It is a precancerous lesion. Advanced forms may develop red patches and then are a matter of clinical concern.
- Oral hairy Leukoplakia: It presents as a corrugated hairy white lesion on sides of the tongue caused by Epstein Barr Virus. It is commonly seen in HIV positive patients with weaker immunity
- Oral Lichen Planus: It presents an interlacing network of raised white lines on the tongue. Clinically it is not of much significance and should be kept under observation only
Red Tongue, usually associated with burning mouth
- Vitamin Deficiency: Folic acid and Vit B12 deficiency cause red lesions on the tongue. Screening by blood test will help determine their levels.
- Geographic tongue: It is an inflammatory disorder. The affected tongue presents as a bald, reddish area that is surrounded by an irregular white border. The appearance results from loss of papilla. Causes: Stress, psychological factors, habits, allergies, diabetes, hormonal disturbances.
- Scarlet Fever: It is an infection of the tongue which gives a strawberry-like appearance. It is caused by bacteria known as Streptococcus pyrogens. Antibiotics are helpful in treating the infection.
Kawasaki Disease: It is seen in children under the age of 5 years. It is a condition in which the tongue presents with a strawberry-like an appearance.
Hypothyroidism: Enlarged tongue with an indentation on the lateral surface is indicative of a thyroid gland dysfunction.
Ulcerations: Most commonly are due to a tongue bite. An ulcer should heal within 2 weeks. If any ulcer remains for greater than 2 weeks then a further investigation is needed.
Tongue Piercing: More common in certain cultures. It leads to greater wear and tear of the natural tooth. There is a higher chance of tooth breakage.
Conclusion to Tongue and Oral health