COMMON DISEASES OF THE TONGUE Leukoplakia. A whitish discoloration, as a soft wet crusting on the tongue surface and occasionally on the inner surface of the cheek, is termed leukoplakia. It is the result of chronic irritation, such as over-indulgence in the use of tobacco, but is also thought at times to be related to syphilis or some other systemic diseases. Leukoplakia definitely is a pre-cancerous condition and necessitates immediate expert medical care. Fig. 28. Leukoplakia on the tongue is a white, leathery, sometimes sore formation, resulting from chronic irritation. Often caused by smoking, it is considered potentially cancerous and should not be ignored. Cancer of the Tongue. Any ulcer or recent sore irregularity on the tongue might be the beginning of cancer. Three percent of all bodily cancer, and found much more in the male sex, it is often associated with jagged and broken teeth, or other irritations such as leukoplakia, glossitis or syphilis. It is definitely a disease of later years; it was formerly associated with syphilis about fifty percent of the time. Now, however, coincidence with syphilis is very low, and association with heavy smoking is becoming higher and higher. Any sore on the tongue over two weeks in duration demands a physicians early attention. Paralysis of the Tongue. The tongue normally has great agility to move in any direction including straight out. When it loses the ability to move, especially to one side, difficulties such as strokes are quickly suspected. Paralysis of the tongue, whether in whole or part, almost always represents difficulty with nerves which bring motion ability to the tongue muscle and the physicians examination alone can uncover the basic difficulty. Enlarged Tongue. An enormously enlarged tongue (macro-glossia) sometimes is found in unusual diseases of the body tissues, along with accompanying enlargements of other soft tissue areas of the body, such as the lips, nose and facial features. Diagnosis and treatment for these difficulties becomes considerably involved and the physicians advice is without equal. he tongue, like the rest of the inner surface of the mouth, may have several diseases common to the inner mouth cavity. However, its refinements in touching and tasting bring it in contact with all substances entering the mouth and expose it to more irritation than the rest of the oral cavity. Tongue Discoloration. A gray tongue discoloration, coated on the tongue with a map-like appearance, is often called geographic tongue and is of little significance. This condition is known to persist at times for years without any disease being Fig. 26. Geographic tongue-a clearly demarcated discoloration of the tongue surface, arriving and departing without an exactly known cause. It is sometimes thought due to body metabolism and sometimes to external pigmentation as from excessive smoking. present. It ordinarily disappears in a short time without any treatment and may well represent a temporary gastric upset. Brownish-yellow Tongue Discoloration has two usual meanings. The first is the over-use of tobacco in which the tongue is stained with nicotine and tar to produce brownish stain on its surface. The stain will disappear shortly after the use of tobacco is stopped. The second possible meaning of a brownish-yellow tongue may mean pernicious anemia. When the possibility of tobacco staining is not present, and the patient is fifty years of age or over, the lemon-yellow tongue may have serious meaning, and should be seen by the physician. Bluish Discoloration on the tongue is usually a type of birthmark. It is usually painless, does not bleed and is not sore, is Fig. 27. Blood vessel tumors (angiomas) usually exist since birth as birthmarks. Soft bluish masses, they are usually painless and rarely cancerous. slightly elevated and occasionally covered with small amounts of hair. They have great nuisance value but little actual danger. They, of course, exist from childhood. Fiery Red Coloration of the tongue, usually means glossitis, or an irritated tongue. Glossitis can be quite painful and appears to have no apparent cause. It is however, frequently due to a deficiency of vitamins, particularly vitamin B12, and frequently improves when this vitamin is given. The condition is thought by some physicians to be a pre-cancerous condition and worthy of careful observation.