A healthy tongue is the same, an unhealthy tongue…

There is a saying: Happy families are all alike, but each unhappy family is unhappy in its own way. This saying is also quite appropriate when it comes to the health of the tongue. That is, healthy tongues are all alike, but each unhealthy tongue has its own problems.

Therefore, when there are abnormalities in the health of the tongue, the consequences can be very strange.

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Different tongue shapes

Just looking at the "mild type" abnormalities of the tongue, there are "diamond tongue", "mirror tongue", "grooved tongue", "geographic tongue", "hairy tongue" and so on.

The so-called diamond tongue, also known as median diamond glossitis, can be manifested as a diamond-shaped area appearing in the middle of the back of the tongue; the so-called mirror tongue, also known as atrophic glossitis, can be manifested as the back of the tongue being as smooth as a mirror (but in fact it is not shiny); grooved tongue is the appearance of deep grooves criss-crossing on the back of the tongue; geographic tongue is the appearance of exposed patches on the back of the tongue; and hairy tongue is the appearance of long hair on the back of the tongue.

Although these anomalies look a bit scary, they are actually generally friendly.

How do these anomalies arise?

These abnormal manifestations on the dorsum of the tongue are related to the complex tissue structure of the dorsum of the tongue.

The oral mucosa is the lining of the oral cavity. It can be divided into three categories according to its distribution area and tissue structure: covering mucosa, chewing mucosa and special mucosa. The so-called chewing mucosa refers to the mucosa in the gums and hard palate area; the special mucosa refers to the mucosa on the back of the tongue; and the covering mucosa refers to all oral mucosa except the chewing mucosa and special mucosa.

The special mucosa, in addition to the mucosal structure itself, is also covered with lingual papillae and taste buds .

Among the various tongue abnormalities mentioned above, several are related to changes in the lingual papillae. For example, mirror tongue is caused by atrophy of the filiform papillae; geographic tongue is caused by regional atrophy of the lingual papillae, with raised serrated borders around the atrophic areas; and hairy tongue is caused by elongation of the filiform papillae.

Related factors behind tongue abnormalities

Among the above-mentioned tongue abnormalities, diamond tongue is related to fungal infection; mirror tongue is related to nutrient deficiency, such as iron, folic acid, vitamin B12, etc.; grooved tongue is related to systemic diseases, such as Down syndrome, etc.; geographic tongue is related to grooved tongue; hairy tongue is related to smoking, poor oral hygiene, and use of antibiotics, etc.

Do these exceptions need to be handled?

As mentioned above, although these abnormalities look a bit scary, grooved tongue, geographic tongue, and hairy tongue mostly do not need to be treated . Grooved tongue and hairy tongue occasionally need to be lightly brushed on the back of the tongue, and geographic tongue occasionally needs to be topically applied with hormone drugs.

Compared with the above-mentioned tongue abnormalities, lichen planus, hairy leukoplakia, white spots or erythema on the tongue are the abnormalities that deserve more attention.

References

1 Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care[J]. Am Fam Physician, 2010, 81(5): 627-634.