Understanding Tongue Disorders: Ankyloglossia, Black Hairy Tongue, Geographic Tongue
Ankyloglossia, also known as tongue-tied, is a congenital anomaly affecting tongue mobility. Black hairy tongue is the lengthening of papillae on the tongue surface, often temporary and resolve without treatment. Geographic tongue presents as white patches and is usually asymptomatic. Treatment options vary, with surgical intervention sometimes necessary for ankyloglossia.
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TONGUE DISORDERS Ankyloglossia Black Hairy Tongue Geographic tongue Presented by Anastasiya Smirnova DEN 1114/Section 8216
ANKYLOGLOSSIA DEFINITION Ankyloglossia also known as tongue-tied, is rare congenital tongue anomaly, that decrease mobility of the tongue tipand affect speech and feeding problems in infants.
CAUSES Ankyloglossia caused by an unusually short thick attachment of lingual frenulum that extends to the tongue apex. Lingual Frenulum is a membrane that connects the underside(base) of tongue to the floor of the mouth.
PROGNOSIS Lingual frenulum usually stretches with time. Orofacial myofunctional therapy (OMT) may be needed before surgery is considered. In many cases surgery is the best option.
BLACK HAIRY TONGUE DEFINITION Black hairy tongueis the lengthening of papillae on the dorsal tongue surface. Normal shedding of epithelium of filiform papillae does not occur which result in thick layer of dead cells and keratin build up on tongue surface. The build up of cells that is left can become extrinsically stained by tobacco, medications, food, bacteria, fungal overgrowth or radiation and become yellow, brown or black.
PROGNOSIS Black hairy tongue is temporary, painless condition which usually resolves without medical treatment. Brushing of tongue twice a day is recommended to promote shedding of epithelium and remove debris.
GEOGRAPHIC TONGUE DEFINITION Geographic tongue is a lesion of dorsal surface of tongue resulting in white patches of tongue. These lesions are missing tongue papillae that appear as smooth, red islands. Geographic tongue doesn't cause health problems and isn't associated with infection or cancer.
PROGNOSIS The condition is usually asymptomatic and insignificant. If pain and discomfort present patients may be given antihistamines. Tobacco and alcohol should be avoided until lesions healed. Changing to toothpaste made for sensitive teeth has also shown to be helpful in decreasing symptoms. The lesions often heal in one area and then migrate to a different part of tongue.
ROLE OF DENTAL TEAM Rule out if any lesions you find are not associated with more serious tongue diseases. Educate patients about their tongue conditions. Refer patients with ankyloglossia to specialist. Encourage patients to maintain better oral health by brushing teeth and tongue twice a day. Work in team with patient after surgery (ankyloglossia) as more oral health required and must be obtained.
REFERENCES Illustrated Dental Embryology, Histology, and Anatomy, Third Edition. Mary Bath-Balogh and Margaret J. Fehrenbach. 2010 http://www.webmd.com/skin-problems-and-treatments/picture- of-geographic-tongue http://www.mayoclinic.com/health/