Pathology of Tonge-BASIC PATHOLOGY

2. BASIC PATHOLOGY
SUBMITTED TO : MA’AM AMREEN RAHEEM
DISCIPLINE : SPEECH LANGUAGE AND PATHOLOGY
SEMESTER : 3rd

3. MEMBERS NAME
HOORIA FATIMA (70138321)
HARAM DURANI (70138244)
NOOR FATIMA (70126160)

5. WHAT IS TONGUE?
The tongue is a muscular organ in the mouth.
The tongue is covered with moist, pink tissue called MUCOSA.
Tiny bumps called PAPILLAE give the tongue its rough texture.
Thousands of TASTE BUDS cover the surfaces of the papillae. Taste buds are collections of
nerve-like cells that connect to nerves running into the brain.
The tether holding down the front of the tongue is called the FRENUM.
LOCATION
Your tongue runs from your hyoid bone (located in the middle of your neck) to the floor of
your mouth.

6. FUNCTONS
• The tongue is vital for chewing and swallowing food, as well as for speech.
• The four common tastes are sweet, sour, bitter, and salty.

7. PATHOLOGIES OF TONGUE
The Pathologies of tongue are as following:
1) Oral thrush
2) Median rhomboid glossitis
3) Fissured tongue
4) Atrophic glossitis
5) Geographic tongue
6) Hairy tongue
7) Leukoplakia
8) Burning tongue
9) Macroglossia

8. ORAL THRUSH
• Oral thrush is a fungal infection of the mouth
• It's also called oral candidosis (or candiasis) because it's
caused by a group of yeasts called Candida.
• commonly affects newborns and younger children, but it
may also affect adults with weakened immune systems,
such as those living with human immunodeficiency virus
(HIV).
• Oral thrush tends to cause white lesions on the tongue and
cheek that may appear to look like cottage cheese.

9. Symptoms
Loss of ability to taste
Redness and soreness inside and on the corners of the mouth
A cottony feeling inside of the mouth
Treatment
Antifungal medications
Antifungal mouthwash
Salt water

10. MEDIAN RHOMBOID GLOSSITIS
• Median rhomboid glossitis is the term used to describe a smooth, red, flat or raised nodular
area on the top part (dorsum) of the middle or back of the tongue.
• This condition is considered a chronic fungal infection.
• It typically presents as an ovoid area about 2 – 3 centimeters long in its longest dimension
• about 1% of the population and most often affects men between the ages of 30 – 50 years of
age.
CAUSES
 Smoking
 Denture wearing
 Diabetes mellitus
 Candidal infections

11. TREATMENT
 In general, no treatment is necessary for median rhomboid glossitis
 For those with symptoms (pain or burning sensation), an antifungal medication may be
prescribed to kill the yeast and thereby reduce the symptoms.
 dentist may recommend a biopsy

12. FISSURED TONGUE
• The term fissured tongue describes the finding of multiple small furrows or grooves
on the dorsal (top) surface of the tongue. These fissures can be shallow or deep, single
or multiple.
• Fissured tongue is not contagious and is harmless. A dentist is most likely to discover
the condition
• CAUSES
• Researchers haven’t yet pinpointed the precise cause of fissured tongue.
• The condition may be genetic, as it’s often seen in higher concentrations within
families.
TREATMENT
 Fissured tongue generally doesn’t require treatment.
 It’s important to maintain proper oral and dental care, such as brushing the top surface
of the tongue to remove food debris and clean the tongue.
 Bacteria and plaque can collect in the fissures, leading to bad breath and an increased
potential for tooth decay.
A

13. ATROPHIC GLOSSITIS
Atrophic glossitis (AG) is characterized by the partial or complete absence of filiform papillae on
the dorsal surface of the tongue.
CAUSES
 AG may reflect the significant deficiencies of some major nutrients including riboflavin, niacin,
pyridoxine, vitamin B12, folic acid, iron, zinc, and vitamin E.
 Treatment with radiation aimed at the head or neck region
 Certain infections caused by bacteria, viruses or fungi, including thrush and geographic tongue
SYMPTOMS
 A smooth, thin, red tongue with a reduced number of papillae
 Loss of taste sensation
 Burning or soreness in the mouth
 Difficulty eating and speaking.

14. TYPES
Primary atrophic glossitis: This type is caused by nutritional deficiencies or
other metabolic disorders such as diabetes or anaemia. It is characterised by a smooth, red
tongue without any visible papillae.
Secondary atrophic glossitis: This type is caused by certain medications or medical
conditions that affect the tongue’s ability to produce papillae. These can include autoimmune
diseases such as lupus syndrome, chemotherapy drugs, radiation therapy to the head and neck
area, and HIV/AIDS medications.
Tertiary atrophic glossitis: This type is caused by chronic irritation from dental
appliances such as dentures or braces that rub against the tongue for long periods of time. It
causes pain and burning sensations on the tongue and can lead to permanent damage if left
untreated for too long.

15. GEOGRAPHIC TONGUE
• Geographic tongue is an inflammatory disorder that usually appears on the top and
sides of the tongue.
• Typically, affected tongues have a bald, red area of varying sizes that is surrounded, at
least in part, by an irregular white border (see Right).
• The appearance of the affected portion of the tongue results from loss of the papilla
CAUSES
 The cause of geographic tongue is unknown.
 A relationship between geographic tongue and psoriasis (a skin disease) has been
reported. Geographic tongue was found to be more frequent in patients with psoriasis.
TREATMENT
 In most cases, there is no need for treatment of this condition.
 Occasionally geographic tongue may cause a burning or smarting sensation of the
tongue. In this situation, topical anesthetics can be used for surface numbing.
 Anti-inflammatory drugs also may be prescribed to help control discomfort.

16. HAIRY TONGUE
• The term hairy tongue is used to describe an abnormal coating on the top (dorsal) surface of
the tongue. It is a relatively common, temporary, and harmless condition that occurs in as much
as 13% of the population.
• Hairy tongue occurs due to lack of stimulation / abrasion to the top of the tongue. The result is
a buildup of a protein known as keratin (the same protein that makes up the hair on your head).
In severe cases, the length of these papillae can become quite long, giving a hair-like
appearance to the top of the tongue
• Also, when the papillae don’t properly shed, food, bacteria, and sometimes yeast can
accumulate in the hair-like mesh. These accumulations result in various colors to the surface of
the tongue.
• Certain types of bacteria and yeast can even give the tongue a black appearance, referred to as
“black hairy tongue”.

17. CAUSES
 It can occur from poor oral hygiene (mouth cleaning), the use of
medications, chronic or extensive use of antibiotics, radiation treatment
to the head and neck area, excessive coffee or tea drinking, or tobacco
use.
 It may also develop in persons with no teeth because their soft food diet
does not aid in the normal shedding of the papillae.
TREATMENT
 May be treated with medical or surgical treatments
 In most instances good oral hygiene with a toothbrush or tongue scraper
will result in elimination of the build up.
 A solution of 1 part hydrogen peroxide to 2 parts water may help remove
the hair-like growths

18. LEUKOPLAKIA
Leukoplakia appears as thickened, white patches on your gums, cheeks and bottom of your
mouth that can't be scraped off.
TYPES
Types of leukoplakia are:
Homogenous: A thin, evenly colored white patch that is consistently wrinkled, smooth, or
ridged throughout the area of the patch
Non-homogenous: An irregularly shaped patch that is elevated, speckled, flat, or has
protrusions
Leukoplakia can be an indicator that Tongue Cancer is developing. The determination of cancer
depends on abnormal cells and the appearance, size, and shape of the patches. The only way to
reliably differentiate a non-cancerous leukoplakia from one harboring cancer is through biopsy.

19. CAUSES
Leukoplakia is typically caused by:
 Heavy Smoking
 Chewing Tobacco
 Alcohol Use.
TREATMENT
 Using a laser to remove the patches.
 Using light-activated cancer drugs (photodynamic therapy).
 Using cryotherapy, which is extreme cold that freezes and kills abnormal cells
and removes the patches.
 Using an electrically heated needle or other instrument to remove the patches
(electrocauterization).
 Studies suggest of leukoplakia comes back around 15% of the time after it’s
removed. Surgery to remove leukoplakia is the only way to make it go away.

20. BURNING MOUTH
• Burning mouth syndrome (BMS) is a burning sensation on your tongue, roof of your mouth or lips.
• It can happen anywhere in your mouth or throat.
• BMS often starts seemingly out of nowhere. It may feel like your tongue is being burned by a hot liquid like
coffee.
CATAGORIES:
There are two categories of burning mouth syndrome:
Primary BMS is when burning mouth isn’t caused by an underlying condition.
Secondary BMS is caused by an underlying condition, such as acid reflux. Treating the condition often
cures burning mouth syndrome.
SYMPTOMS
 Pain in your mouth that feels like tingling, scalding or burning.
 Numbness in your mouth that comes and goes.
 Altered taste.
 Dry mouth

21. CAUSES
 Researchers believe the cause of primary BMS is nerve damage affecting the area of your tongue
that controls taste and pain. There’s a relationship between burning mouth and taste (gustatory)
changes.
 Acid reflux.
 Allergies to metal dental products or certain foods.
 Depression.
 Hormonal changes.
 Mouth infections.
 Nutritional deficiencies.
TREATMENT
 Some antidepressants.
 Antiseizure medication.
 Gabapentin (a medicine used for seizures and herpes pain).

22. MACROGLOSSIA
• Macroglossia (enlarged tongue) is a rare condition that typically affects more children
than adults.
• People with macroglossia have tongues that are larger than typical, given the size of their
mouths.
SYMPTOMS
 You may also have trouble eating, breathing or talking.
 Noisy, high-pitched breathing (stridor).
 Snoring or low-pitched breathing (stertor)
CAUSES
 More frequently, macroglossia is a symptom of an underlying condition that people
either inherit or acquire through illness
 Some surgeries and medical treatments may cause macroglossia.

23. CONTI…
Amyloidosis: This is a protein disorder that keeps tissues and organs from working
as they should.
Hypothyroidism: This is a common condition where your thyroid doesn’t create
and release enough thyroid hormone into your bloodstream. This makes your
metabolism slow down.
Acromegaly: This is a rare condition that causes your body to release too much
growth hormone. People with acromegaly often have oversized tongues, jaws, hands
and feet.
Diphtheria: This is an infectious disease that may cause your tongue to swell.

24. WHAT INHERITED CONDITIONS MIGHT CAUSE MACROGLOSSIA?
o Beckwith-Wiedemann syndrome: This is a growth disorder syndrome that causes large body size,
large organs and can increase children’s risk for developing certain childhood cancers.
Approximately 90% of children who have Beckwith-Wiedemann syndrome also have macroglossia.
o Hurler/Hunter syndrome (mucopolysaccharidosis): This is a group of diseases that affects your
body’s ability to break down sugar molecules.
o Down syndrome: People with Down syndrome are born with an extra chromosome, which changes
the way their brain and body develop, creating and physical and mental challenges.
HOW TO DIAGNOSE MACROGLOSSIA?
o Computed tomography (CT) scan. CT scans use a series of X-rays and a computer to create three-
dimensional (3D) images of your or your child’s mouth, head and neck.
o Magnetic resonance imaging (MRI). This is a painless test that uses a large magnet, radio waves
and a computer to produce very clear images of organs and structures within your or your child’s
body.

25. TREATMENT
Macroglossia treatments may include:
Medication such as corticosteroids for swelling.
Orthodontic treatment.
Surgery for macroglossia to reduce the size of their tongues.

26. How Can I Improve My Tongue Hygiene?
Here are seven things you should be doing daily to ensure your tongue is clean and healthy.
1.Brush your tongue regularly. Each time you brush your teeth, it is important to remember to
brush your tongue as well.
2.Try a tongue scraper
3.Rinse well.
4.Drink green tea.
5.Monitor the color of your tongue.
6.Drink plenty of water.
7.Healthy diet.