Common Tongue Conditions in Primary Care.

Area of Science:

• Oral pathology
• Dermatology
• Infectious diseases

Background:

• Tongue conditions affect 15.5% of the US population.
• Common conditions include geographic tongue, fissured tongue, and black hairy tongue, typically asymptomatic.
• Less common conditions range from infections to inflammatory disorders and growths.

Purpose of the Study:

• To provide an overview of various tongue conditions.
• To discuss the etiology, presentation, and management of common and less common tongue conditions.
• To highlight the importance of differential diagnosis and appropriate referrals for certain oral lesions.

Main Methods:

• Literature review of common and less common tongue conditions.
• Summarization of diagnostic criteria and treatment modalities.
• Emphasis on differential diagnosis for tongue growths.

Main Results:

• Geographic tongue, fissured tongue, and black hairy tongue are common and usually asymptomatic.
• Median rhomboid glossitis may indicate candidiasis, treated with antifungals.
• Atrophic glossitis suggests nutritional deficiency; oral hairy leukoplakia is linked to Epstein-Barr virus in immunocompromised individuals.
• Tongue growths necessitate biopsy for differentiation between benign and malignant lesions.
• Burning mouth syndrome and oral lichen planus have specific treatment protocols involving medications and therapies.
• Ankyloglossia (tongue-tie) management, particularly frenotomy, may improve breastfeeding.

Conclusions:

• Many common tongue conditions are benign and require no intervention.
• Specific treatments exist for infectious, inflammatory, and deficiency-related tongue conditions.
• Biopsy and specialist referral are crucial for diagnosing and managing suspicious tongue lesions.
• Emerging evidence supports frenotomy for ankyloglossia to improve function.