The tongue is a strange organ, a source of wonder and
pleasure both for the possessor and receiver of its peculiar qualities. If that sounds unconvincing, just watch a
dog. Watch how he gleefully licks
himself in places I shouldn’t mention, and you’ll see he hasn’t a care in the
world; it’s very Zen-like in its simplicity.
We all should be that fortunate to simply enjoy the moment or be limber
enough to…well, another topic for someone else’s website. Putting that aside, the tongue may exhibit a few
intriguing anomalies, depending on your point of view. There are a whole variety of tongue ailments resulting
from medical disease which would fill an entire textbook. This segment only covers two conditions that
may be familiar to you, or perhaps not:
“Hairy Tongue” and “Geographic Tongue”--strange-sounding medical terms
which may leave you wondering whether these are serious abnormalities or the rantings of a stoned doc.
Hairy Tongue
Believe it or not, this is a bona fide, for-real medical
term. It actually looks like hair, but
really it’s not. This condition occurs
on the “dorsal” tongue, the top part of the tongue that usually has a finely
textured surface. The smooth
undersurface is called the “ventral tongue,” in case you’re wondering. On closer inspection, perhaps with a
magnifying glass, you’ll notice tiny projections that cover the dorsal tongue--these
are the thousands of small “papillae” (the plural form of “papilla”) that cover
the surface. Papillae can vary in appearance
from person to person, so don’t despair if your papillae look different from someone
else’s, and if for some bizarre reason you have a tendency to compare your
tongue to the tongue of others, please stop or suffer the consequences of
Papillae Envy, a pseudo-medical term I just made up.
 |
| Greenish-brown Hairy Tongue |
Sometimes these papillae become elongated due to buildup of
keratin—a substance normally produced by the lining tissue of the mouth that
usually sloughs off and is cleared by your saliva—which accumulates on the
papillae, making them longer than usual and giving the appearance of hair. Bacteria or yeast that normally live in the
mouth can accumulate in these elongated papilla, and are the source of a
variety of colors—black, brown, green or white.
Certain medications can also do this, staining those long papillae. “What the heck is going on there with my
tongue?” you may cry out if you’re one of the lucky people to have this. It can be more prevalent in those with dry
mouths, after antibiotic treatment or in people who smoke—so stop smoking if
you do. It’s a benign condition however
(ie, it’s not cancer and it won’t kill you) though in some case it looks really
gnarly. Good oral hygiene such as
regular teeth and tongue brushing can help resolve this condition.
Geographic tongue
This term perfectly describes this other benign
condition. The dorsal tongue usually is
quite uniform and regular, other than when it gets “hairy” as discussed above. Yet here are times when groups of these fine
papillae get larger or shorter or disappear entirely, sometimes forming
patches, and giving rise to a map-like appearance—hence the term “Geographic
Tongue.” Sometimes the pattern can change
in appearance from one day to the next. Sometimes this is painful
or sore. The cause of this is idiopathic—a fancy medical term meaning
“unknown” or “we don’t have a clue.”
Treatment is symptomatic to help relieve any discomfort: other the
counter pain medications or topical anesthetics (i.e., a numbing spray), and
avoidance of hot, spicy foods and tobacco.
Geographic tongue, Dec 2022
Geographic
tongue, same patient, Jan 2023
Both hairy tongue and geographic tongue typically do not require a biopsy
(removal of a piece of the tissue to obtain a diagnosis). Of course, if the condition persists or
worsens, the tongue gets more painful or uncomfortable, please see your doctor
or dentist to have this evaluated further to make sure it isn’t something more
serious.
If indeed you have one of these two conditions and no other
concerns are raised by your doc or dentist, then profit from these
features: Stick your tongue out and show
it around to friends and family the next time you’re at a party or other social
event. It’ll be a show-stealer! You might win a prize. Check this one out:
Green hairy tongue
AND geographic tongue
As an aside: the tongue is much larger than you think. I happen to know this since I at times must
operate on the tongue. When you pull it
way out, it’s remarkable the amount of length and bulk it has. Even our small dog has a large tongue, and if
I’m fortunate to perchance get a hold of his tongue while he’s happily lapping
it about, I can pull it way out before he recoils back. WARNING:
Don’t try this at home. Your dog may be
entirely different and his/her mouth is much larger than you think. So if you find your head tightly locked in
the jaws of some innocent canine…well, I told you so…
©Randall S. Fong, M.D.
©Randall S. Fong, M.D.
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