Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ UNIQUE TONGUE CHANGES +++ Hairy Tongue (Black Hairy Tongue) ++ Etiology: elongation of keratin on filiform tongue papillae from inadequate oral hygiene, dry mouth, or microbial overgrowth (Fig. 4-1). Also associated with smoking, antibiotic therapy, extended hospital stays, and poor general health status Clinical findings: white, black, or brown hair-like projections on dorsal tongue, more concentrated toward posterior and often associated with halitosis. There may be a burning sensation from secondary candidiasis Treatment: scrape off daily with floss or a tongue scraper; eliminate smoking; improve oral hygiene; treat burning symptoms with antifungals ++ FIGURE 4-1 Black hairy tongue. (Used with permission from Dr Nadarajah Vigneswaran.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Hairy Leukoplakia ++ Etiology: HIV in AIDS (Fig. 4-2) Clinical findings: vertical or randomly oriented, asymptomatic white keratotic thickening of the lateral border of the tongue, usually unilateral. No other evidence of biting trauma and no ulceration Treatment: treat the HIV infection; this lesion will disappear with systemic treatment of the AIDS ++ FIGURE 4-2 Hairy leukoplakia. (Used with permission from Dr. Bela Toth.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Fissured Tongue (Scrotal Tongue; Lingua Plicata; Hamburger Tongue) ++ Etiology: developmental anomalies; becomes more pronounced over decades (Fig. 4-3) Associated frequently with: Melkersson-Rosenthal syndrome; Down syndrome; benign migratory glossitis (geographic tongue) Clinical findings: irregular, often deep fissures of the tongue dorsum, often with a fissure down the midline; may be symptomatic (burning sensation, pain with spicy foods) if associated with secondary candidiasis Treatment: maintain good oral hygiene; antifungals if symptomatic ++ FIGURE 4-3 Fissured tongue. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Bifid Tongue (in Oral-Facial-Digital Syndrome Type I) ++ Etiology: x-linked dominant inherited trait with multiple malformations of the face, oral cavity, and digits Clinical appearance (oral): multiple deep clefts along border of tongue give the illusion of border lobules, sometimes with a deep central fissure; hamartomas or lipomas of the ventral tongue; cleft of the hard or soft palate; accessory gingival frenula, hypodontia Treatment: surgical correction of clefts, as needed +++ Ankyloglossia (Tongue Tie) ++ Etiology: developmental defect fusing ventral tongue to oral floor (Fig. 4-4) Clinical findings: attachment of the ventral tongue to the floor of the mouth, even to the gingivae of the lower incisors; limits tongue movement but seldom interferes with speech Treatment: usually none is needed, but attachment can be surgically corrected if there is a speech defect or anterior mandibular gingiva becomes inflamed or deteriorated ++ FIGURE 4-4 Ankyloglossia. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Lingual Varicosities +... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth