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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
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
Clinical presentation: There are several erythematous plaques, depilated, curved, circinate, and usually painless, with a whitish and slightly elevated border (Figure 16.1). While the fungiform papilla remains intact and prominent, the filiform papilla peels off. The atrophic appearance is due to the loss of filiform papilla. The migratory aspect of the condition predominates, showing erythematous plaques that disappear from one place on the tongue, only to reappear in another. It may represent an atopic background, psoriasis, vitamin deficiencies, or hereditary factors. Occasionally, it is associated with glossodynia.
Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
The circumvallate papillae form prominent pink nodules on the posterior tongue. The filiform papillae may appear white as a result of drinking coffee, cigarette smoking and other exposures. A white discoloration of the filiform papillae can be mistaken for Candida infection. Hypertrophy of the lingual tonsils may cause dysphagia, a globus sensation or a feeling that something is stuck in the throat.
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.
Comparative studies on the tongue of the Egyptian fruit bat (Rousettus aegyptiacus) and the common quail (Coturnix coturnix)
Published in Egyptian Journal of Basic and Applied Sciences, 2023
Amany Attaallah, Yousra Fouda, Abd El-Fattah B. M. El-Beltagy, Amira M. B. Saleh
Six subtypes of filiform papillae were identified on the dorsal surface of bat tongue: small, conical, giant, cornflower, leaf-like and rosette filiform papillae. The small filiform papillae appear rounded or triangular and have posterior directed several pointed processes and widely distributed on the tip of lingual apex. Conical filiform papillae are more localized on the two lateral regions of the anterior part of the tongue and showed posteriorly directed multiple pointed processes from all borders of the papillae. Giant filiform papillae are found on the anterior median region of tongue and overlapped on each other. Each papilla has a wide rectangular body, and from which extended posteriorly three fingers like processes called tri-dentates papillae. Cornflower filiform papillae appeared on the lateral regions of middle part (inter-molar tubercle) of the tongue and took the shape of the cornflower. The lateral edges of cornflower filiform papillae appeared bended on the dorsal surface of papillae forming a central rounded groove and ended with posteriorly directed processes. Leaf-like filiform papillae were distributed in the median region of inter-molar tubercle part of tongue. They take characteristic appearance of leaf-like. Each papilla was ended posteriorly with one main process from which extended two fine processes. Rosette-shaped filiform papillae were found densely on the median area of posterior part of tongue take the rosette shape. Each papilla had a rounded base and posteriorly directed apex. The rosette-shaped papilla carries multiple posteriorly directed processes giving it its characteristic basket-like appearance.
Soluble LPS receptor CD14 is increased in saliva of patients with geographic tongue
Published in Acta Odontologica Scandinavica, 2023
The role of CD14 in the host defense against viral and bacterial infections has shown opposing results. A protective role of CD14 has been shown in intestinal infections, while the opposite effect has been described in pulmonary infections, depending on the infectious agent [22]. In periodontitis, higher levels of CD14 were reported in gingival crevicular fluid without an increase in serum levels, indicating local production of CD14 in response to bacterial challenge [23]. Furthermore, high levels of CD14 in the gingival crevicular fluid were associated with fewer and shallower gingival pockets, which contributed to a protective role by enhancing the phagocytosis of pathogenic plaque bacteria [24]. The high levels of sCD14 found in patients with GT may be due to an altered microbial composition of the tongue mucosa. We have previously shown a shift in the lingual bacterial ecology in GT patients [25]. GT lesions are characterised by atrophy of the filiform papilla on the dorsum of the tongue. Due to the presence of such lesions, the lingual microbiota might upregulate the sCD14 levels. Interestingly, upregulation of sCD14 levels in blood has been also reported in the gut, in the presence of sustained dysbiosis or epithelial barrier damage [26]. It is suggested that if this condition is sustained, it may result in systemic immune activation, which ultimately leads to the loss of immune regulation and becomes a chronic condition [26]. It remains unknown if the shift in the lingual microbiota in GT is a consequence of the lesions or dependent on other immunological or genetic factors that are associated with the initiation of the condition. Collectively, our data support a possible role for the host-microbial interactions in the GT pathogenesis. However, a limitation of the present study is the relatively small sample size, which limits the possibility to draw a robust conclusion.