TONGUE DISORDERS

Common tongue disorders include abnormalities of its size or appearance, which may/may not be of clinical consequence.

Macroglossia is seen in hypothyroidism, Down syn­drome, Beckwith syndrome, Pierre Robin syndrome and tongue hemangioma.

Abnormal appearance, e.g. geographic tongue (single/ multiple, well-demarcated, smooth red plaques due to transient papillary atrophy), scrotal tongue (deep fissured tongue with wrinkled appearance), black hairy tongue (dark-coated tongue with papillary hyperplasia) may be idiopathic or secondary to infection, malnutrition, atopy or trauma. No treatment is needed in these cases, except to ensure adequate oral hygiene, nutrition and control of infection, if present.

14.5.5 SALIVARY GLAND DISORDERS______________

Salivary gland abnormalities may involve one or more of three salivary glands—parotids, submandibular or submental glands.

Acute parotitis is almost always caused by mumps (usually bilateral), though needs to be differentiated from rare case of acute suppurative parotitis in staphylococcal infections (unilateral), or other causes of parotid enlarge­ment, e.g. malnutrition, HIV infection, cystic fibrosis and benign salivary gland hypertrophy.

Xerostomia (dry mouth), seen in any fever, dehydration, anticholinergic therapy and Sjogren's syndrome, may also precipitate parotid swelling/parotitis due to desi­ccation of salivary secretions in their ducts.

Ranula is a common cyst of major salivary gland (usually sublingual), presenting as a large, soft, mucus containing swelling over floor of the mouth at any age, which needs to be excised.

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