6 Roles Of The Tongue In Disease Diagnosis

6 Roles Of The Tongue In Disease Diagnosis.

The tongue is a muscular organ that performs deglutition, taste, and speaking. It serves as an immediately accessible organ for assessing an individual’s health and displaying the body’s status of hydration. The tongue is thought to be the gastrointestinal system’s mirror, and any abnormal functioning of the stomach and intestines will be mirrored on the tongue.

In various disorders, the tongue undergoes some distinctive alterations. That is why a tongue examination is critical and can provide some diagnostic information. All clinicians examine the tongue and look for changes in size, shape, color, moisture, coating, nature of papillae, and motions, among other things.

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Tongue appearance in various aberrant conditions:

1. Tongue Movements:

• When protruded, the tongue in one-sided paralysis (hemiplegia) travels towards the parylised side.
• Tremulus movement of the tongue is observed in disorders such as thyrotoxicosis, delirium tremens, and parkinson’s disease. Tremor can also be found in anxious patients.
• In progressive bulbar palsy, the tongue will be wasting and paralyzed, with fibrillation. The tongue eventually shrivels and becomes useless in the floor of the mouth. This syndrome is characterized by dribbling saliva and loss of speech.
• In chorea (involuntary rhythmic movements), the patient may be unable to keep the protruded tongue still; it will move involuntarily.
• Tenderness of the tongue: The moistness of the tongue indicates the condition of hydration in the body.

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Water deficiency causes peripheral circulation insufficiency, which manifests as weakness, thirst, restlessness, anorexia, nausea, vomiting, and a dry and parched tongue.

2. The following conditions cause tongue dryness.

• Diarrhoea
• Severe sickness
• Advanced uraemia
• Hypovolmic shock
• Heat exhaustion
• Hyponatraemia Acute intestinal blockage
• Starvation I Prolonged fasting

3. Change in tongue color:

A. Cyanosis centralis:

Cyanosis is a bluish discoloration of the mucus membrane caused by a decrease in blood oxygen levels.

Anoxia, cardiac failure, and respiratory failure are all examples of this.

Cyanosis causes the tongue, lips, and other body parts to turn pale blue.

B. Jaundice:

• This is the yellowish discoloration of all mucous surfaces of the body (including the tongue) caused by a rise in bilirubin in the blood.
• Jaundice is evident in hepatitis, bile duct obstruction, accelerated destruction of RBCs, and so forth.

C.  Advanced uremia:

• This is an increase in urea and other nitrogenous waste products in the blood caused by renal failure. Here, the tongue turns brown.

D. Keto acidosis:

• This is the acidosis with ketone body buildup found most commonly in diabetic mellitus.
• The tongue turns dark, and the mouth emits a characteristic ketone odor.

E. Riboflavin deficiency:

• A lack of this vitamin (vitamin B2) results in megenta-colored tongue, as well as pain and lip fissures.

F. Niacin deficiency:

• A lack of niacin (vitamin B3) and other B complex vitamins causes a bright scarlet or meaty red tongue.

G. Anaemia:

• It is a reduction in the blood’s hemoglobin percentage.
• The tongue gets pale when suffering from severe anaemia.

4. Tongue coating:

A. Bad breath:

• The main reason of foul breath is the formation of a pasty coating (bio film) on the tongue, which traps thousands of anaerobic bacteria, resulting in the production of offensive gases.
• Those who complain about poor breath may have a thick coating on the back of their tongue.

B. Typhoid fever:

• Typhoid fever causes the tongue to turn white and furry.

C. Candidiasis;

• It is a fungal infection that affects the mucous surfaces of the body.
• Sloughing white lesions will appear on the tongue.

D. There will be sloughing white lesions in diabetes and hypoadrenalism.

E. Secondary syphilis:

• Syphilis is a sexually transmitted disease caused by trepenoma pallidum infection.
• In the secondary stage of this condition, we can detect painless mucous patches, smooth white glystening opalescent plaques that are difficult to scrape off.

F.  Leokoplakia:

• White keratotic patches might be noticed on the tongue and oral cavity.
• This is a precancerous condition.

G.  AIDS:

• Hairy leukoplakia can be present in these people.

H. Peritonitis:

• It is an inflammation of the peritoneum (the inner covering of the abdominal cavity that also covers the intestines and keeps them in place). There is white furring of the tongue in this illness.

I. Acute illness:

• Furring is also present in some acute illnesses.

5. Papillae:

These are tiny projections on the tongue related with taste. On a healthy tongue, there are several types of papillae. Some disorders cause aberrant alterations.

A. A hairy tongue:

• This disorder is caused by the extension of filiform papillae, which is evidenced in poor dental hygiene, overall debility, and dyspepsia.

B. Geographic tongue:

• The tongue develops uneven red and white spots.
• These lesions resemble a map.
• The exact cause is unknown.

C.  Median rhomboid glossitis:

• There is a smooth nodular red patch in the posterior midline of the tongue with this disease.
• This is a birth defect.

D. Nutritional deficiency:

• Glossitis (tongue inflammation) occurs in nutritional insufficiency, followed by papillary enlargement and atrophy.

E. Benign migratory glossitis:

• It is an inflamatory disorder of the tongue in which several annular zones of desquamation of papillae occur on the tongue and change from area to area over a few days.

F. Thiamine and riboflavin deficiency:

• These vitamins deficiency causes hypertrophied filiform and fungiform papillae.

G. Niacin and iron deficiency:

• The papillae are atrophying in this situation.
• Iron deficiency causes smooth tongue.

H. Vitamin A deficiency:

• This generates a wrinkled tongue.

I. In nutritional megaloblastic anaemia, the tongue becomes smooth.

J. Folic acid deficiency:

• There is macrocytic megaloblastic anaemia with glossitis here.

K. Cyano coblamine deficiency:

• Glossitis with macrocytic megaloblastic anaemia and peripheral neuropathy is seen here.

L. Scarlet fever;-

• This streptococcal infection is distinguished by brilliant red papillae protruding from a thick white coat. Later, the white coat disappears, leaving increased papillae on the bright red surface, which is known as strawberry tongue.

6. Tongue ulcers:

A. Apthous ulcer:

• These circular, painful sores form commonly in stressed individuals. It could be related to a food allergy. The tongue, lips, oral mucosa, and so on are common locations.

B. Herpes simplex:

• Herpes simplex virus causes acute vesicular eruptions.
• When these vesicles break, ulcers occur.

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C. Cancer ulcer:

• Cancerous ulcers have everted edges with a firm foundation.
• There is also evidence of bleeding.
• Tobacco users are more likely to develop tongue cancer.

D. Syphilitic ulcers:

• Syphilitic fissures run longitudinally.
• Extra genital chancre on the tongue is observed in primary syphilis.
• Multiple shallow sores on the undersurface and sides of the tongue are found in secondary syphilis.
• Gumma on the midline of the dorsum of the tongue may be found in tertiary syphilis.

E. Dental Ulcers:

• These sores are caused by the sharp edges of carious teeth.