What are the Anomalies of Tongue? And its Types?

Tongue is a muscular organ of the human body which helps with a lot of functions in everyday life like tasting, swallowing, chewing, and most important speech. It is surrounded by upper and lower sets of teeth and posteriorly by your tonsils. It is connected to various muscles which help with the movement of the tongue. It has rich blood and nerve supply.

Anomalies of Tongue

Anomaly means something that is not normal or as expected. Developmental anomalies result due to disturbances that occur during the growth and developmental stages of the human while still in the womb. These disruptions of the regular growth and development patterns lead to various mild to severe anomalies. While certain disturbances in the tongue occur due to various factors like trauma, tobacco, infectious diseases, etc.

Anomalies can be divided into two subparts:

Congenital Anomalies of Tongue ( Present Since Birth)

While the baby is still inside the mother, a lot of developmental phases take place. During this period, if there are discrepancies in the regular pattern of the development, it can result in various types of anomalies as listed below:

Absence of Tongue or Aglossia Congenital

AGLOSSIA CONGENITALThe complete absence of the tongue at the time of birth is known as Aglossia. It results due to alterations in growth pattern during the 4th to 8th gestational week. Aglossia could lead to severe hurdles in day-to-day life since it causes a disability with speech, swallowing, etc.

Partial or Deficient Tongue or Hypoglossia or Microglossia

Microglossia Images

It is a rare condition wherein a very short or rudimentary tongue is present. The tongue is developed incompletely and is usually in association with other oral deformity syndromes.

Large Tongue or Macroglossia

Macroglossia

It is a rare condition characterised by the presence of an unusually large tongue. It occurs due to the overdevelopment of the muscular structure of the tongue. It can hinder regular functions like speaking, swallowing, and breathing.

Tongue Tie or Ankyloglossia

Ankyloglossia

In this condition, the soft tissue attachment between the bottom surface of the tongue and the floor of the mouth is short and thus leads to restricted movement of the tongue which is known as Tongue-tie. It is usually attached from the tip of the tongue. It can cause problems with speech and pronunciation majorly.

Lingual Thyroid Nodule

Lingual Thyroid Nodule

The abnormal presence of the thyroid gland at the base of the tongue is known as the Lingual thyroid nodule. This condition arises when a part of the thyroid gland or the entire gland fails to descend to its position while the developmental phase. It might be associated with hypothyroidism. It could lead to frequent coughing, difficulty swallowing, and sleep apnea.

Acquired Anomalies of Tongue ( Person Acquires at a Later Stage in Life)

Acquired anomalies refer to the various diseases of the tongue that occur due to various reasons. The most common reasons are as follows:

  • Injury
  • Infection
  • Nutritional deficiencies
  • Auto-immunity
  • Tobacco
  • Low oxygen flow

Injury

Injury of any kind to the tongue might lead to mild to major functional issues. Injury to head and face area resulting in direct trauma to the tongue or indirect in form of nerve damage associated with tongue might cause issues with the normal functioning of the Tongue. Other situations might also include injury during seizures which might cause biting a small or significant part of the tongue. Certain dental procedures may require Local anesthesia to the Inferior Alveolar Nerve which might cause transient loss of sensation. A minor thermal injury while eating or drinking hot food may also occur.

Infection

Infection of the tongue also known as Glossitis might cause swelling and burning sensation of the tongue. This could be due to various reasons like thrush, smoking, etc. Glossitis leads to loss of lingual papilla of the tongue which makes the tongue appear smooth and shiny unlike the regular rough texture of the tongue.

Nutritional Deficiencies

Nutritional deficiencies lead to various discrepancies in the tongue. The deficiency of Vitamin B12 leads to an extremely red tongue also known as Beefy Red Tongue. Iron deficiency and megaloblastic anemia cause Glossitis (Inflammation and redness of the tongue).

Auto-immunity

When a person’s own immune system starts acting against it, it is classified as Autoimmunity. Certain disorders like Sjogren’s syndrome and Myasthenia Gravis indirectly affect the tongue. Sjogren’s syndrome causes dryness of the mouth due to less saliva secretion which indirectly affects the tongue and might cause inflammation, burning sensation, and pain. Myasthenia Gravis affects muscular control and makes it weak leading to weaker tongue control causing speech issues and also affecting the ingestion. It also affects the nerve supply which might cause difficulty swallowing and speaking.

Tobacco

Nicotine present in tobacco has proven to alter the normal structure of the oral cavity and affect the tongue. The oral cavity is supposed to be soft and elastic but the presence of nicotine via any mode of transmissions like smoking or chewing may cause the tissue of the oral cavity to become inelastic and restrict movement of the mouth. It also leads to malignant changes in the mucosa and the tongue which leads to various types of cancers. A type of cancer known as Squamous Cell Carcinoma which is malignant, and some cases might be uncontrollable. This might lead to severe consequences and might require complete removal of the tongue which leads to a major disability with phonation, swallowing, and tasting.

Low oxygen flow

Decreased amount of oxygen flow in various parts of the body leads to bluish discoloration of the skin and tissues. Similarly, with tongue bluish discoloration occurs which is known as Cyanosis. The tongue appears pale and blue due to restricted blood supply. This can be diagnosed usually by Pulse oximetry and should be treated immediately.

Apart from the reasons listed above, there are a few rare other reasons which might also cause acquired anomalies of the tongue. They are Endocrinopathy, Cardiac issues, Degenerative disease, Metabolic Dysfunction, Blood dyscrasias, certain drugs and medications, and other idiopathic reasons.

References

Tongue abnormalities – portal myhealth. (n.d.). Retrieved November 5, 2021, from http://www.myhealth.gov.my/en/tongue-abnormalities/

Emmanouil-Nikoloussi, E. N. (1992). Developmental malformations of human tongue and associated syndromes (review). PubMed. https://pubmed.ncbi.nlm.nih.gov/1477514/

Shimizu, T., Kato, H. (2012). Tongue: Anatomy, Kinematics, and Diseases. United States: Nova Science Publishers.

Dr Deepak Kansal

Dr Deepak Kansal is a dentist, who is currently working in Sri Ganganagar. He did his Bachelor of Dental Surgery from Rajasthan University of Health Science.

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