Miscellaneous lesions of oral cavity and tongue

Lesions of tongue

1. Miscellaneous lesions of tongue & oral cavity S. GOKULPRABHU

2. Median Rhomboid Glossitis Geographic tongue Hairy tongue Fissured tongue Tongue tie Nicotine stomatitis

3. Median Rhomboid Glossitis It is red rhomboid area, devoid of papillae, seen on the dorsum of tongue in front of foramen caecum. It is a developmental anomaly that occurs due to persistence of tuberculum impar, which fails to invaginate. Recent studies reveal this condition to be due to chronic candida infection. The condition is asymptomatic and no treatment is necessary

4. Geographic tongue It is characterized by erythematous areas, devoid of papillae, surrounded by an irregular keratotic white outline. The lesions keep changing thei r shape and hence the condition is also called “migratory glossitis.” The condition is asymptomatic and may not require any treatment.

5. Hairy tongue Due to excessive formation of keratin, the filiform papillae on the dorsum of the tongue become elongated. Smoking seems to be one of the factors. Treatment consists of scraping the lesions with a tongue cleaner, application of half-strength hydrogen peroxide and improving the general nutritional status of the patient by vitamins.

6. Fissured tongue It may be congenital or seen in cases of syphilis, deficiency of vitamin B complex or anaemia. Congenital fissuring associated facial palsy is seen in Melkersson–Rosenthal syndrome.

7. Tongue tie True tongue tie which produces symptoms is uncommon. If tongue can be protruded beyond the lower incisors, it is unlikely to cause speech defects. A mobile tongue is important to maintain orodental hygiene—to clean the debris and prevent formation of dental plaques. Treatment of any significant tongue tie is transverse release and vertical closure.

8. Nicotine stomatitis This disorder is seen in smokers particularly those in the habit of reverse smoking. Palatal mucosa shows pin-point red spots in the centre of umbilicated papular lesions. They are due to inflammation of the minor salivary glands and their duct openings as a reaction to the heat of the smoke. Management is elimination of smoking.