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Assessment – Nutrition-Focused Physical Exam to Detect Micronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
The tongue should appear moist and pink in color. Glossitis is an inflammation of the tongue which causes it to swell and become magenta in color (see Figure 7.6). Deficiencies in several micronutrients may lead to glossitis, including vitamins B2, B3, B6, B12, folate and/or iron.4,8 Several non-nutrient causes include Crohn’s disease, uremia, infection, malignancy, chemotherapy, or trauma.5,6 In atrophic glossitis, caused by atrophied filiform papillae, the tongue has a glossy, smooth appearance with partial to complete absence of papillae (see Figure 7.7). Potential micronutrient deficiencies include vitamins B12, B2, B3 and folate, as well as iron.7
The Nutrition-Focused History and Physical Examination (NFPE) in Malnutrition
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Always examine the tongue. Tongue pain can be caused by riboflavin (B2), niacin (B3) and ascorbic acid deficiency. Tongue burning is common in niacin deficiency (pellagra). A pellagrous tongue becomes reddened at the tip and borders. The erythema then spreads and the tongue swells. The surface becomes denuded, producing the classic large, tender, “beefy red” appearance we learned about in medical school. A cobblestone tongue is characteristic of riboflavin deficiency. This condition may also produce a magenta coloring as opposed to the fiery red tongue of pellagra. Atrophic glossitis, with loss of lingual papillae, occurs in B complex, folate, B12, iron and protein/calorie deficiencies (DeGowin 1994).
Oral Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Marcia Ramos-e-Silva, José Wilson Accioly Filho, Sueli Carneiro, Nurimar Conceição Fernandes
As irritating and predisposing factors in the genesis of precancerous alterations and oral cancer, smoking, repeated trauma due to ill-fitting dental prostheses, chronic infection by Candida albi-cans, and even viruses, alcohol, and atrophic lesions of the oral mucosa, such as may occur with atrophic glossitis associated with tertiary syphilis and pernicious anemia, which make the mucosa more vulnerable to carcinogens.
Oral microbial diversity analysis among atrophic glossitis patients and healthy individuals
Published in Journal of Oral Microbiology, 2021
Hong Li, Jing Sun, Xiaoyan Wang, Jing Shi
Atrophic glossitis is known as smooth tongue, tongues with it exhibit a smooth, glossy appearance with a red or pink background. The smooth quality is caused by the atrophy of filiform papillae. Histologically, atrophic glossitis is characterized by epithelial atrophy and varying degrees of chronic inflammation in the sub-epithelial connective tissue. It commonly occurs due to nutritional deficiencies such as vitamin B12, folic acid, iron deficiencies, or celiac disease [1–3]. Other aetiological factors include hyposalivation and candidiasis infection [4–6]. Currently, most studies suggested that Candida albicans was the primary component of the oral microbiota that was relevant to atrophic glossitis. Candida is the easiest genus to separate in the oral cavity and is one of the most common taxa of fungi that contribute to the early formation of in vitro biofilms [7,8]. However, apart from Candida albicans, little is known about other species in the oral microbiota that are correlated with atrophic glossitis. The oral microbiome, including bacteria and fungi, involved in atrophic glossitis should be explored.