Part 2 book “Differential diagnosis of dental diseases” has contents: Diseases of paranasal sinuses, endocrine disorders affecting oral cavity, white and red lesions, benign neoplasm of oral cavity, malignant neoplasm of epithelial tissue, chronic orofacial nerve pain, and other contents. | 14 Diseases of Tongue Geographic tongue/Migratory glossitis (Figs and B) refers to irregularly shaped, reddish areas of depapillation. There will be thinning of dorsal tongue epithelium. There is spontaneous development and regeneration of affected area. There may be associated fissured tongue, although this may be a coincidental finding. Etiology of geographic tongue is not clear. An immunologic reaction is suggested. No inheritance pattern is noted. The disease is asymptomatic but some may complaint of burning, pain and stinging. Clinically irregularly shaped red patches with white patterns look like a map. Red patches are smaller to start surrounded by a white rim. Red patches go on enlarging and regressing and pattern goes on changing every week. No sex predilection is found. The central portion of lesion sometimes appears short, while the border may be outlined by thin, yellowish white line or band. Desquamated areas are located in one area for a short while, heal and then reappear in another area thus giving the name migratory glossitis. Coated/hairy tongue is an unusual condition characterized by hypertrophy of filliform papillae of tongue (Fig. ). Normally keratinized surface layers of filliform papillae are continuously desquamated due to friction of food and 272 Differential Diagnosis of Dental Diseases Figs and B: Clinical and histological picture showing geographic tongue Diseases of Tongue 273 Fig. : Hairy tongue anterior upper teeth. These are replaced by new epithelial cells from below. When tongue movements becomes restricted during illness, the papilla enlarges and become heavily coated. The color of papilla varies from yellowish white-brownish black depending upon the type of stains the tongue is exposed to. Longer papilla entangles food particles of different colors. Tobacco smoke colors it black. Mid dorsum is first to be affected. Dehydration and terminally ill patients also develop thick coatings. Nicotinamide .
