Influence of socioeconomic status on oral mucosa lesion prevalence in schoolchildren

The aim of this survey was to determine the prevalence of oral mucosa lesions in children aged 4-13 yr from two schools, one (S1) having a higher socioeconomic status than the other (S2). In all, 846 children were examined, 463 from S1 and 383 from S2, of whom 555 were boys and 291 were girls. There were 359 boys and 104 girls in S1; 196 boys and 187 girls in S2. Fifteen different lesion types were discerned. The most frequent ones were recurrent aphthous ulceration (RAU) (92 cases); fissured cheilitis (54); herpes labialis (44); angular cheilitis (30); geographic tongue (25); smooth tongue (22); and plicated tongue (17). An outstanding finding was the contrasting distribution of certain lesion types in the two schools. RAU was observed in 19% of the children from S1, making up 50% of all lesions detected. However, in S2 only 2% exhibited RAU, making up less than 4% of observed lesions. On the other hand, herpes labialis was seen in 1% of S1 and 10% of S2 children, regardless of age or sex. Plicated tongue was found in 3.2% in S1 and 0.5% in S2; fissured cheilitis in 2.9% in S1 and 12.8% in S2; and angular cheilitis in 1.1% in S1 and 6.5% in S2. Therefore, there were no statistical differences between the schools in the ratio of total lesions observed to children examined, but a significant difference was apparent when individual lesions were taken into account.     

The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area

Oral Diseases (2011) 17 , 210–216 Objectives: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area. Subjects and Methods: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents. Results: One hundred eighty‐one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P < 0.05). Conclusions: Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice.     

Familial study of fissured tongue

Abstract – Clinical and genetic characteristics of histologically defined fissured tongue were examined in a familial study. Fifteen probands with fissured tongue and four probands with geographic tongue were selected from earlier studies. In addition, 12 probands. with tongue fissuring, but without changes of papillary structure, were included. The total sample consisted of 31 families; the number of family members examined was 185 (93 men, 92 women), and the mean age of the subjects was 20 yr (range 1–78). Diagnosis of tongue form was emphasized, and this study describes an in vivo method of stereomicroscopy for examining the dorsum of the tongue. According to genetic analysis, fissured tongue with smooth-surfaced papillae was transmitted as a dominant characteristic with incomplete penetrance and was preceded by geographic tongue. The severity of fissured tongue changed with increasing age. Tongue fissuring with normal-appearing filiform papillae was not familial and was not associated with geographic tongue. Fissuring with normal papillary structure should be considered as variations of normal anatomy, whereas fissured tongue and geographic tongue are a clinical and etiological disease entity.     

The prevalence of oral mucosal lesions in a population in Ljubljana, Slovenia

The purpose of the present study was to evaluate the prevalence of oral mucosal lesions and conditions in a population in Ljubljana, capital of Slovenia. A total 1609 subjects represented the study population in the survey about the periodontal treatment needs in a population in Ljubljana, conducted from 1983 to 1987. Ten years later the same 1609 subjects were invited to the second examination. Altogether, 555 (34.5%) of the invited subjects in the age range 25-75 years came for an interview and clinical examination at the Department of Oral Medicine and Periodontology of the Dental Clinic in Ljubljana. Oral mucosal lesions and conditions were evaluated according to the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases and Conditions. The results showed the presence of one or more mucosal lesions in 61.6% of the population. Fordyce's condition was observed the most frequently (49.7%) followed by: fissured tongue (21.1%), varices (16.2%), history of herpes labialis (16.0%), history of recurrent aphthae (9.7%), denture stomatitis (4.3%), leukoplakia (3.1%), cheek biting (2.7%), lichen planus (2.3%), frictional keratosis (2.2%), geographic tongue (2.2%), geographic and fissured tongue together (1.1%), mucocele (0.9%), smoker's palate (0.5%) and angular chelitis (0.4%). In the population examined, no oral malignancies were observed. Mucosal lesions like whitish lesions, denture related lesions, fissured tongue, varices and mucocele were more prevalent with increasing age. Tobacco-related lesions (leukoplakia and smoker's palate together) were significantly more prevalent among men than among women (P<0.05), while lichen planus, denture stomatitis and herpes labialis occurred more frequently in the female population.     

Factors associated with geographic tongue and fissured tongue

Objectives: The primary objective of this study was to investigate the association of systemic diseases, use of medications, allergies and tobacco habits with geographic tongue (GT) and fissured tongue (FT) lesions. The secondary objectives were to evaluate the clinical characteristics of tongue lesions and to compare the overall results for referred and non-referred patients.

Methodology: Non-referred patients with GT (GTgp; n?=?130) and FT (FTgp; n?=?62) were examined by general practitioners (gp) and compared to a control group without oral mucosal lesions (C; n?=?1029). Referred patients with GT (GTs; n?=?166) and FT (FTs; n?=?15) were examined by oral medicine specialists (s) and compared to GTgp and FTgp. Statistical analyses were performed using unpaired t-test or Fisher’s exact test. A multiple logistic regression model was developed to control for age and gender as confounders.

Results: Compared to the C group, GTgp patients used more anti-hypertensive medications and Swedish snus (p?p?p?Conclusion: This study identified an association between GT and anti-hypertensive medications, as well as the use of Swedish snus. It also found differences in the activities and symptoms of the lesions between referred patients and their counterparts who were seen in general dental practice; these parameters influenced the results when these conditions were taken into account.     

地图舌危险因素的研究进展

地图舌（良性游走性舌炎）是一种常见的浅表性良性舌部炎症,临床表现为丝状乳头剥脱红斑区伴周围黄白条带状微凸边缘,病理为非特异性炎症表现,大多数患者无症状,病损可自愈,常有复发,一般不需药物治疗。当病损累及舌部以外口腔黏膜时称异位性地图舌（游走性口炎）,其临床表现及组织病理学特点均似地图舌。地图舌病因尚不明确,与年龄相关,儿童多发;危险因素复杂,包括免疫因素、遗传因素、过敏体质、精神压力、吸烟、内分泌因素以及缺锌等;可伴发其他疾病如沟纹舌、银屑病、糖尿病、胃肠紊乱、灼口综合征或唐氏综合征等。地图舌是否为银屑病的口腔表征尚存争议,其与沟纹舌关系尚待进一步研究。本文就地图舌危险因素的研究进展作一综述。     

Prevalence of tongue lesions in 1013 Jordanian dental outpatients

Abstract – Over a period of 10 months, 1013 consecutive dental outpatients attending the Screening Clinic in Faculty of Dentistry, Jordan University of Science and Technology, in the city of Irbid were investigated for the presence of tongue lesions. All subjects were seeking treatment for caries and periodontal diseases and none was complaining of oral mucosal disorder. The results showed that 240 subjects (23.7%) had one or more tongue lesions. Geographic tongue and fissured tongue were detected in 6.8% and 11.4% of the examined population respectively, and an association of the two conditions was observed in 2.9% of the subjects. Hairy tongue was diagnosed in 3.4% of the subjects with significantly higher prevalence in males ( P < 0.0005). A strong correlation was found between hairy tongue and smoking.     

Prevalence of geographic and plicated tongue in 6090 Iraqi schoolchildren

Abstract The prevalence of geographic and plicated tongue among 6090 Iraqi schoolchildren was determined according to age and sex. Geographic tongue was observed in 4.3% of the population and plicated tongue in 2.6%. Significant sex difference was found only in children with plicated tongue. The prevalence rates varied irregularly with age in both sexes for both tongue anomalies and although significant differences were found between the ages, a steady increase or decrease was not clear, which could be due to the short span of age used in this investigation. The only significant association found was between geographic and plicated tongue in males, which may indicate a genetic linkage between the two conditions.     

Risk factors associated with tongue lesions: a propensity score-matched case-control study

Background to analyse the potential risk factors of tongue lesions, comparing the results with a control group.Material and Methods An observational, case-control study was designed. The study included a case group comprising 336 patients with tongue lesions and 336 sex and age-matched controls. We recorded tobacco/alcohol habits, presence of dentures, allergies, medical conditions, and medications. Statistical analysis was performed via logistic regression models to estimate the odds ratio (OR) adjusted for gender, age, tobacco, and alcohol using propensity score-matching analysis (PSM).Results According to the final PSM model, patients with tongue lesions were more likely to suffer from allergies (OR 2.13; 1.27-3.66) or medical conditions (OR 2.14; 1.19-3.85), and more likely to take medication (OR 1.99; 1.11-3.57). Elderly individuals were more prone to hairy tongue (OR 3.82; 1.53-10.47). Smoking was associated with coated tongue (OR 2.05; 1.12-3.63), hairy tongue (OR 3.77; 1.52-9.22) and median rhomboid glossitis (OR 40.49; 5.84-860.43). Allergic individuals were more likely to exhibit sublingual varices (OR 1.73; 1.02-2.88). Medical conditions increased the chances of having coated tongue (OR 2.44; 1.36-4.64) or crenated tongue (OR 2.70; 1.42-5.30). Arterial hypertension was associated with median rhomboid glossitis (OR 5.85; 1.08-34.18). Individuals on medication showed a higher risk of fissured tongue (OR 1.87; 1.20-2.94) and varices (OR 2.42; 1.58-3.80). Agents acting on the alimentary tract and metabolism increased the probability of fissured tongue (OR 2.31; 1.42-3.79).Conclusions As far as we are aware, this is the first study on lingual pathology to include a PSM analysis. The results suggest that a history of allergies, the presence of medical conditions, and the use of medication are associated with increased probability of tongue lesions. The analysis of diseases and medications by subgroups requires studies matched by habits with larger sample sizes, in order to corroborate our observations. Key words:Tongue lesions, fissured tongue, allergies, medications, risk factors, systemic diseases.     

Geographic tongue: clinical characteristics of 188 cases

The purpose of this study was to investigate the clinical characteristics and assess other factors associated with geographic tongue in Thailand. One hundred and eighty-eight Thais with geographic tongue and 188 controls were interviewed regarding their medical history, symptoms, and the nature and migratory pattern of their lesions. Variations in the clinical appearance, lesion location, and any associated tongue fissures were recorded. The age range for the 188 subjects was 9 to 79 years. The highest incidence (39.4%) occurred in the 20-29 age group. Women were affected more than men (1.5:1). The leading group of medical conditions consisted of allergy-related disorders; however, the incidence of these problems among both subjects and controls was not significantly different (55.2% vs. 44.8%). Our results demonstrated a significant co-existence of geographic tongue and fissured tongue. Most of the geographic tongue lesions manifested a typical appearance consisting of a central atrophic area bounded by a raised white circinate line (69.1%) with multiple tongue sites affected (62.8%). The most common locations were at the lateral margins and tip of the tongue. The majority of our subjects (75.5%) were asymptomatic. The results of this study correspond with the findings of previous geographic tongue studies in other populations.     

Study of the oral mucosa in 200 consecutive patients with psoriasis

Abstract – The oral cavities of 200 consecutive psoriasis patients, most of them with widespread disease on the skin, were examined (man/woman ratio 1.63:1, mean age of the patients 43.7 yr). The average duration of the disease at time of examination was 15.8 yr. When questioned, 16% of the patients reported changes in the joints, which, according to them, had been verified by radiography. 72.5% of the patients reported on nail involvement at some time during their disease. Fissured tongue was present in 9.5% of the patients, and geographic tongue and smooth tongue each in 1 % of the patients. Angular cheilitis was found in 3.5% of the patients. In 20 out of 200 cases, the oral mucosa showed changes and biopsy was taken. Four out of 20 patients showed histologic features typical of psoriasis, including accumulations of leukocytes in the upper layers of the epithelium, all with widespread psoriasis skin involvement. Areas of oral mucosa were most often deep red in color, the buccal mucosa and tongue being the two most common sites. Two out of these four patients had a fissured tongue and one had a geographic tongue.     

Some local and systemic factors related to tongue inflammation

As part of a larger study aimed at surveying the clinical, histological and immunohistochemical features of filiform atrophy and geographic and fissured tongue, this work presents the clinical findings of three patient groups and controls. 200 individuals were examined; 18 (9%) had atrophic tongue, 15 (7.5%) geographic tongue and 53 (26.5%) fissured tongue; further, 12 (6%) had hyperkeratotic lesions of the tongue and 102 (51%) subjects had no tongue lesions. According to the anamnestic information, patients with atrophic or geographic tongue seemed to have a stronger tendency toward allergy than subjects in other groups, while patients with atrophic tongue had more abnormalities of the heart and circulatory system. These tongue forms did not show any association with smoking or drinking habits, but hyperkeratotic lesions (leukoplakia, lichen planus, hairy tongue) of the tongue were clearly associated with moderate and heavy smoking. Atrophic, geographic and fissured tongue seem to be specific changes of the lingual mucosa; patients with these changes did not have more changes elsewhere on the oral mucosa than the controls. Patients with atrophic tongue had lowered rates of saliva secretion. Histologically, heavy inflammation was noted in fissured tongue. In geographic tongue, inflammation was moderate and in atrophic tongue often only mild. Each tongue form seems to have its own typical histological morphology.     

Prevalence and distribution of oral lesions: a cross-sectional study in Turkey

OBJECTIVES: The purpose of this study was to evaluate the prevalence and distribution of oral lesions (OLs) in Turkish population. SUBJECTS AND METHODS: In this cross-sectional study, 765 residents (F/M: 375/390) were selected by the cluster sampling method and examined according to WHO criteria. RESULTS: Excessive melanin pigmentation (6.9%) was the most common lesion in the study population. The tongue lesions observed in this study were as follows: fissured tongue (5.2%), varices (4.1%), hairy tongue (3.8%), geographic tongue (1.0%), atrophic tongue papillae (0.7%) and ankyloglossia (0.3%). The denture-related lesions were denture stomatitis (4.3%), suction irritation (0.8%), denture hyperplasia and torus palatinus as bony lesion (0.5%) and traumatic ulcers (0.3%). In regression analysis, being 65 years old and over was found as a statistically significant risk factor for the occurrence of pigmentation, fissured tongue, varices, hairy tongue, denture stomatitis and petechiae (P < 0.05). CONCLUSIONS: Pigmentation, fissured tongue and denture stomatitis were observed to be the most common lesions in Turkish population. Elderly population was a significant risk factor for occurrence of some OLs.     

Clinical orodental abnormalities in Mexican children

A total of 32,022 Mexican children (16,473 boys, 15,549 girls) were examined for several congenital oral and paraoral anomalies. The findings for commissural lip pits (boys 53.1, girls 52.4 per 1000) are less than those reported for adults. This may indicate that pits become accentuated with age. Fordyce granules were seen with a prevalence of 1.2 per 1000. This is in contrast to the reported 85.6% prevalence for the adult population, also possibly reflecting increased manifestation with increased age. Our data for exogenous tooth pigmentation show increased prevalence with age (group I [5 to 10 1/2 years], 9.8%, versus group II [10 1/2 to 14 1/2 years], 12.9%), possibly indicating decrease in attention to oral hygiene. The prevalence of talon cusp was found to be 0.6 per 1000, and for ankyloglossia 8.3 per 1000. Prevalence values for bifid tongue are reported for the first time, indicating one affected per 187 children examined. The prevalence of fissured tongue (15.7%) shows a statistically significant difference between boys (16.8%) and girls (14.5%). The prevalence of geographic tongue (1.9%) shows a marked difference between group I (2.2%) and group II (1.2%).     

Familial study of fissured tongue

Clinical and genetic characteristics of histologically defined fissured tongue were examined in a familial study. Fifteen probands with fissured tongue and four probands with geographic tongue were selected from earlier studies. In addition, 12 probands with tongue fissuring, but without changes of papillary structure, were included. The total sample consisted of 31 families; the number of family members examined was 185 (93 men, 92 women), and the mean age of the subjects was 20 yr (range 1-78). Diagnosis of tongue form was emphasized, and this study describes an in vivo method of stereomicroscopy for examining the dorsum of the tongue. According to genetic analysis, fissured tongue with smooth-surfaced papillae was transmitted as a dominant characteristic with incomplete penetrance and was preceded by geographic tongue. The severity of fissured tongue changed with increasing age. Tongue fissuring with normal-appearing filiform papillae was not familial and was not associated with geographic tongue. Fissuring with normal papillary structure should be considered as variations of normal anatomy, whereas fissured tongue and geographic tongue are a clinical and etiological disease entity.     

Prevalence study of tongue lesions in a Hungarian population

Abstract – The aim of the study was to assess the prevalence of tongue lesions in a district population, in Budapest, called regularly for X-ray lung examinations. Oral examinations of 7820 individuals were performed, 42% were over 60 yr of age, 42.9% were men and 57.1% women. Tongue alterations were found in 18.52% of the examined individuals, more frequently in women than in men. Lingua fissurata has been diagnosed in 8.8%, geographic tongue in 3.0% of the examined subjects. Atrophic lesions of the tongue were found in 6.37%, among them 5.42% central papillary atrophy (median rhomboid glossitis): 0.35% of the total sample. Manifest clinical symptoms of oral Candidiasis were found in 2.15% of the total sample, and in 4.28% of patients with tongue lesions. The occurrence of oral leukoplakia and lichen in patients with tongue lesions was respectively 0.47 and 0.07%. The prevalence of tongue alterations was consistent with the literary data, the oral screening attached to the X-ray lung examinations proved to be useful in detecting changes of the oral mucosa.     

Developmental oral anomalies among schoolchildren in Gizan region, Saudi Arabia

The present report gives prevalence values for some developmental oral anomalies in 1932 schoolchildren aged 6-12 yr in Gizan region, Saudi Arabia. The developmental oral anomalies identified in this study were: torus palatinus (1.4%), fissured tongue (0.8%), geographic tongue (0.2%), and tongue tie (0.1%). None of the following developmental oral anomalies were observed: lip pits, cleft lip and/or palate, torus mandibularis, microglossia, macroglossia or median rhomboid glossitis.     

Cross-sectional study of oral mucosal conditions among a central Amazonian Indian community, Brazil

BACKGROUND: A cross-sectional study on the oral mucosal conditions among the Waimiri Atroari Indians from central Amazonia, Brazil, has been conducted. These Indians keep their traditional way of life and are free from habits such as smoking, alcohol drinking, and use of pacifiers. METHODS: Clinical examinations of a representative, randomly selected sample of patients during routine dental treatment, following ethical procedures recommended by Brazilian laws were made. RESULTS: Out of 922 individuals, 587 were examined, among which 52.57% of the children up to 12 years old and 73.44% of patients aged 13 years or older presented at least one oral mucosal condition. The conditions more frequently observed were, in decreasing order of prevalence: fissured tongue, focal epithelial hyperplasia (FEH), lesions of traumatic origin, geographic tongue, Fordyce's spots, and candidiasis. Only one case of leukoplakia was identified. CONCLUSIONS: Conditions observed among theses Indians were essentially the same that have been described in other populations around the world, except for FEH, which, as a characteristic lesion of Indians, had high prevalence (20.95%). The lesions observed were related to the way of life of this specific population.     

The prevalence of scrotal tongue and geographic tongue in 70,359 Israeli schoolchildren

abstract The prevalence of scrotal and geographic tongue among 70,359 Israeli schoolchildren was examined according to age, sex and father's country of birth. Scrotal tongue was observed in 1.96 % of the population, but increased with age from 0.60 % at 7 years to 3.76 % at 12–18 years. Males had a significantly higher prevalence. There were significant differences in the prevalence among the different population groups examined, in that the Ashkenazi had a higher prevalence (2.17 %) than both the non-Ashkenazi (1.93 %) and the Israeli (1.70%). Prevalence of geographic tongue was 1.14% and was not associated with age. Males had a significantly higher prevalence. The differences between the population groups were significant. A highly significant association was found in the occurrence of scrotal and geographic tongue.     

The prevalence of scrotal tongue and geographic tongue in 70,359 Israeli schoolchildren

abstract The prevalence of scrotal and geographic tongue among 70,359 Israeli schoolchildren was examined according to age, sex and father's country of birth. Scrotal tongue was observed in 1.96 % of the population, but increased with age from 0.60 % at 7 years to 3.76 % at 12–18 years. Males had a significantly higher prevalence. There were significant differences in the prevalence among the different population groups examined, in that the Ashkenazi had a higher prevalence (2.17 %) than both the non-Ashkenazi (1.93 %) and the Israeli (1.70%). Prevalence of geographic tongue was 1.14% and was not associated with age. Males had a significantly higher prevalence. The differences between the population groups were significant. A highly significant association was found in the occurrence of scrotal and geographic tongue.