Prevalence and Distribution of Variant Normal on the Tongue by Sex and Age Categories: A

Retrospective Study of Patients Dental Hospital Airlangga University

Ida Bagus Pramana Putra Manuaba1, Diah Savitri Ernawati2, Saka Winias2
1
Resident of Oral Medicine Specialistic Degree
2
Department of Oral Medicine, Faculty of Dental Medicine
Faculty of Dental Medicine, Universitas Airlangga, Surabaya-Indonesia

Email: ibpramanapm@gmail.com
Abstract
Background. Tongue is the mirror of the body. Many conditions and diseases including developmental,
traumatic, inflammatory, infectious, and neoplastic lesion may affect the tongue. Objective. The aim of
the present study was to determine the prevalence and distribution of lesion on the tongue include hairy
tongue, crenated tongue, and coated tongue of patients in Dental Hospital Airlangga University on
period between September 2017 and Desember 2019. Methods. A descriptive study was carried out by
retrospectively examining a total of 2153 medical and clinical examination record files of patients,
attending Dental Hospital Airlangga University for multidisciplinary dental treatments. The record file
included a civil status,chief complaint,medical history, and extraoral and intraoral clinical examination
during the period between September 2017 and December 2019. Results. The sample consisted of 1122
patients (52%) with coated tongue, 991 patients (46%) with crenated tongue, and 40 patients (2%) with
hairy tongue. Conclusions. The prevalence of coated tongue is higher than crenated tongue and hairy
tongue.
Key word: Hairy Tongue, Crenated Tongue, Coated Tongue

Introduction distress that usually accompanies limitation of

function of this organ.5 Physiological condition
Tongue is the mirror of the body and a
as a result of form versus function takes the
remarkable muscular organ which performs a
form of crenated tongue (crena – notch latin).6
host of diverse yet important functions such as
The term is applied to a condition in which
taste, phonation, mastication, deglutition,
indentations of teeth are observed at the lateral
suckling, maintenance of oral hygiene,
margins of the tongue.7 Hairy tongue, it is also
protection of deeper structures, and facilitation
called as ‘lingua villosa, lingua nigra, black
of orofacial growth.1 Tongue lesions constitute
hairy tongue.7 Is characterized by an impaired
a considerable proportion of oral mucosal
desquamation of the filiform papilla, which
lesions which are of prime concern when
leads to the hairy-like clinical appearance.8
considering oral and general health of an
There is marked accumulation of keratin on the
individual.3 Lesions occurring on the tongue
filiform papillae of the dorsal tongue.7 Tongue
are vast and ranges from developmental
coating comprises bacteria, large amounts of
disorders to infections, idiopathic lesions,
desquamated epithelial cells released from the
malignancies and due to underlying systemic
oral mucosa, leukocytes from periodontal
illness.2 Tongue lesions represent an important
pockets, blood metabolites and different
segment of oral mucosal lesions, with
nutrients.9
prevalence varying among epidemiologic
studies from different countries probably Materials and Methods
because of specific characteristics presented by
We restrospectively analyzed a total of 2153
the studied population (including sex, race, and
medical and clinical examination records of
age).4 Local and systemic disorders affect the
tongue and provide some understanding of the
patients attending dental hospital Airlangga Table 1: Tongue lesions related sex (n=2153)
University for multidisciplinary dental
Sex
treatments on period between September 2017 Tongue Lessions
and December 2019. The informed consent Male Female
was obtained from each participant. Each Crenated Tongue 409 582
medical and clinical examination record file Hairy Tongue 25 15
reports the patient’s civil status, chief
complaint, 4medical observation, drugs intake, Coated Tongue 531 591
and extraoral and intraoral clinical
examination. The civil status consists of age, Figure 1: The diagram shows the prevalence of
gender, present ocucupation, and address. tongue lesions
Chief complaint with its anamnesis that let the
individual consults at dental hospital Airlangga
University was performed. The medical history
and the previous surgery and hospitalized
period were collected by questioning the
patient. Extraoral examination of the facial
disharmony, cutaneous, temporomandibular
articulation, and palpation of the lymph nodes
was done. Also,intraoral examination noted the
presence of any lesions or an anatomical
variation on the oral mucosa.
Results Table 2 : Tongue lesions distribution related
age (n=2153)
A Total of 2153 patients were recruited into the
study, among whom 1188 (55%) were female, Tongue Lessions
Crenated Hairy Coated Total
and 965 (45%) were male (Table 1). The age
Tongue Tongue Tongue
group is divided into six decades consisting 0-
0-10 9 0 38 47
10 years old 47 (2%), 11-20 years old 295
11-20 139 7 149 295
(13%), 21-30 years old 870 (40%), 31-40 years
old 295 (13%), 41-50 years old 320 (15%), 51- 21-30 440 8 422 870
60 years old 213 (10%), and over 60 years old 31-40 148 6 141 295
113 (5%). The analysis shows that coated 41-50 148 7 165 320
tongue 1122 (55%) has higher prevalence than 51-60 82 6 125 213
crenated tongue 991 (42%) and hairy tongue 40 >60 25 6 82 113
(3%). From sex group the highest prevalence is
found in female patients with coated tongue
591 (27%) but the difference not statistically
significant with female patients on crenated
tongue 582 (27%). From age group the highest
prevalence is found in decade 21-30 years old
with crenated tongue 440 (20%) but the
difference not statistically significant with
coated tongue patients on same decade 422
(19%)
Figure 2: Diagram shows the prevalence of
tongue lesions related age
Discussion
Sudden increase in the size of tongue
may indicate neoplasm or endocrine disorder or
metabolic disease like amyloidosis, abnormal
tongue movements are suggestive of motor
neuron disease, depapillation with redness is a
common feature of nutritional deficiencies,
erythematous tongue may be a first indicator of
candidiasis. Sometimes the tongue abnormality
may be the first clinical evidence of a
previously undiagnosed systemic condition,
the early recognition and treatment of which
may modify the course or reduce the severity
of the underlying disease, and thus render
profound service to the patient.1
The overall prevalence of tongue
lesion was found to be higher in young adult
patients than older patients, and it can be
related with different habbit related age.
Smooking, poor oral hygiene, consumption of
drugs and alcoholic become a risk factor of
tongue lesion. Many tongue lesion related of
poor oral hygiene Tomar and Sinha found that
the prevalence of habits in Indian population
was 55,1% including both sex and age.
Most common tongue lesions in the
study such as coated tongue from 31-50 years
old age group.1 The distribution of majority of
lesions in 31–50 years age group may be owed
to more number of patients from the middle age
group reporting to the department. The study
conducted in a dental college may be more of a
model indicative of general and daily dental
practice rather than the scenario in general
population which is obviously randomized.
Other reports, however, indicated that oral
lesions tend to increase with age in association
with tobacco consumption and denture use.
The age of the patient is crucial in patient
assessment, treatment planning and health
education.10
Patil et al. showed males were more
affected than females. In our study, tongue
lesion affected 55% of females and only 45%
males. 11 Because the tongue lesion may
indicate neoplasm and the sign of benign lesion
are common in the young and females while
cancerous and precancerous lesions are more
common in elderly.10
Conclusion
The results of the current study should be
interpreted with caution and conducting such
surveys in different racial populations and on
large random samples is recommended. Many
factors can influence the results as the
prevalence of the sample. Young adult
populations have relatively a higher percentage
of tongue lesion than other decade of age
group. Habits, like tobacco smooking, alcohol
consumption, poor oral hygiene, and systemic
disease can also increase the incidence of
tongue lesions. Systemic disease and drugs can
be related to tongue lessions.
Acknowledgment
The authors would like to thank to Dental
Nurse of Department Oral Medicine Faculty of
Dental Medicine Airlangga University
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