Frequency and Determinants of Tongue Lesions among Patients Reported in a Teaching Institute: A Cross-Sectional Study

Aims: The purpose of the study is to evaluate the frequency, distribution and determinants of tongue lesions in our teaching institute. Also to find an association of common tongue lesions with various study variables.

Study Design: Cross-sectional study design.

Place and Duration of Study: The study was conducted at Fatima Jinnah Dental College & Hospital, Karachi, Pakistan. All the lesions presented on the tongue were included reported from January 2017 to December 2020.

Methodology: There were 670 oral lesions documented in the Department of Oral Pathology and Oral Medicine out of which 93 (13.8%) represented tongue lesions. We included 93 patients with tongue lesions (45 men, 48 women; age range 18-80 years). These lesions include the atrophic tongue, geographic tongue, candidiasis, keratotic lesion, ulceration, oral pigmentation, fibroma, black hairy tongue, traumatic neuroma, herpes infection, oral submucous fibrosis, and oral squamous cell carcinoma.

Results: In the study, common clinical presentations on the tongue were ulceration (29%), erythematous/depapillated tongue (22.6%), white keratotic and plaque-like lesions (21.6%), and black discoloration (8.6%). The clinical presentation was statistically associated with gender (p=0.03), age (p=0.04) and site of lesion (p<.001). Atrophic glossitis (19.4%), traumatic ulcer (12.9%), pseudomembranous candidiasis (12.9%), oral pigmentation (8.6%), oral squamous cell carcinoma (7.5%), geographic tongue (6.5%), recurrent aphthous stomatitis (6.5%), and frictional keratosis (6.5%) were most commonly reported tongue lesions. There was a relationship of tongue lesions with causes and site of the lesion (P<0.001).

Conclusion: Initial tongue lesions may reflect underlying massive abnormal changes and this could be an early diagnostic parameter. Through vigilant screening of the oral mucosa, we may be able to detect such mucosal alterations and search out the possible cause in order to provide effective treatment to the patient. In this way, we may also prevent the malignant transformation of any susceptible oral lesions.