Online first
Review article
Published online: 2023-07-26

open access

Page views 576
Article views/downloads 623
Get Citation

Connect on Social Media

Connect on Social Media

Differences in the morphological structure of the human tongue

Klaudia Kulig1, Maksymilian Wiśniowski1, Karolina Thum-Tyzo2, Renata Chałas2

Abstract

Background: The tongue exhibits significant individual variability in terms of shape, color, and surface texture. Due to its location, it is easily accessible for medical examination, although often overlooked. This is due to the inadequate number of studies assessing the morphology of the tongue in the healthy population. Determining the range of normalcy allows for the definition of tongue pathology requiring further diagnostics. The aim of this study is to assess differences in the morphological structure of the tongue in healthy individuals based on existing literature. Morphological structure was evaluated in terms of volume, shape, color, coating, papillae, texture, and lingual tonsil.

Materials and methods: PubMed and ResearchGate databases were included for a thorough analysis of morphological differences in tongue structure.

Results: Tongue volume stabilizes by the end of the second decade of life and is closely correlated with BMI. Among the shapes of the tongue, forms such as circular, ellipsoidal, hammer-shaped, in the shape of the letter U, V, or W can be distinguished, and the multitude of these terms results from the lack of a uniform classification. There is agreement regarding tongue color, with various shades of pink and white being the most commonly observed, while the presence of another color may indicate disease. The density and size of individual papillae depend on the region of the tongue, age, and the presence of systemic disease. Geographic tongue, hairy black tongue, and fissured tongue are states of papillae pathology. Fissuring of the tongue increases with age, and fissured tongue is more common in men.

Conclusions: Differences in the morphological structure of the tongue provide significant information about the health status of each individual. It is necessary to be aware of the physiological changes occurring within the tongue for proper diagnosis.

Article available in PDF format

View PDF Download PDF file

References

  1. Astekar M. Lingual morphology: a secure method for forensic identification. J Forensic Sci & Criminal Inves. 2018; 9(2): 555759.
  2. Stone M, Woo J, Lee J, et al. Structure and variability in human tongue muscle anatomy. Comput Methods Biomech Biomed Eng Imaging Vis. 2018; 6(5): 499–507.
  3. Huang Bo, Wu J, Zhang D, et al. Tongue shape classification by geometric features. Inf Sci. 2010; 180(2): 312–324.
  4. Hsu PC, Wu HK, Huang YC, et al. Gender- and age-dependent tongue features in a community-based population. Medicine (Baltimore). 2019; 98(51): e18350.
  5. Nakao Y, Yamashita T, Honda K, et al. Association among age-related tongue muscle abnormality, tongue pressure, and presbyphagia: a 3D MRI study. Dysphagia. 2021; 36(3): 483–491.
  6. Waters DL. Intermuscular adipose tissue: a brief review of etiology, association with physical function and weight loss in older adults. Ann Geriatr Med Res. 2019; 23(1): 3–8.
  7. St-Jean-Pelletier F, Pion CH, Leduc-Gaudet JP, et al. The impact of ageing, physical activity, and pre-frailty on skeletal muscle phenotype, mitochondrial content, and intramyocellular lipids in men. J Cachexia Sarcopenia Muscle. 2017; 8(2): 213–228.
  8. Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty infiltration of skeletal muscle: mechanisms and comparisons with bone marrow adiposity. Front Endocrinol (Lausanne). 2016; 7: 69.
  9. Sanders I, Mu L, Amirali A, et al. The human tongue slows down to speak: muscle fibers of the human tongue. Anat Rec (Hoboken). 2013; 296(10): 1615–1627.
  10. Ding X, Suzuki S, Shiga M, et al. Evaluation of tongue volume and oral cavity capacity using cone-beam computed tomography. Odontology. 2018; 106(3): 266–273.
  11. Liégeois F, Albert A, Limme M. Comparison between tongue volume from magnetic resonance images and tongue area from profile cephalograms. Eur J Orthod. 2010; 32(4): 381–386.
  12. Koren N, Shust-Barequet S, Weissbach T, et al. Fetal micro and macroglossia: defining normal fetal tongue size. J Ultrasound Med. 2023; 42(1): 59–70.
  13. Iida-Kondo C, Yoshino N, Kurabayashi T. Comparison of tongue volume/oral cavity volume ratio between obstructive sleep apnea syndrome patients and normal adults using magnetic resonance imaging. J Med Dent Sci. 2006; 53(2): 119–126.
  14. Humbert IA, Reeder SB, Porcaro EJ, et al. Simultaneous estimation of tongue volume and fat fraction using IDEAL-FSE. J Magn Reson Imaging. 2008; 28(2): 504–508.
  15. Uysal T, Yagci A, Ucar FI, et al. Cone-beam computed tomography evaluation of relationship between tongue volume and lower incisor irregularity. Eur J Orthod. 2013; 35(5): 555–562.
  16. Surendra L, Haragannavar VC, Rao RS, et al. Visualization of tongue morphology: an emerging mode of personal identification. World J Dent. 2020; 11(6): 501–505.
  17. Xie J, Jing C, Zhang Z, et al. Digital tongue image analyses for health assessment. Med Rev. 2021; 1(2): 172–198.
  18. Oji T, Namiki T, Nakaguchi T, et al. Study of factors involved in tongue color diagnosis by kampo medical practitioners using the farnsworth-munsell 100 hue test and tongue color images. Evid Based Complement Alternat Med. 2014; 2014: 783102.
  19. Shareef S, Ettefagh L. Geographic Tongue. StatPearls [Internet], Treasure Island (FL) 2023.
  20. Sun S, Wei H, Zhu R, et al. Biology of the tongue coating and its value in disease diagnosis. Complement Med Res. 2018; 25(3): 191–197.
  21. Tsuchida S, Yoshimura K, Nakamura N, et al. Non-invasive intravital observation of lingual surface features using sliding oral mucoscopy techniques in clinically healthy subjects. Odontology. 2020; 108(1): 43–56.
  22. Seerangaiyan K, Jüch F, Winkel EG. Tongue coating: its characteristics and role in intra-oral halitosis and general health — a review. J Breath Res. 2018; 12(3): 034001.
  23. Van Gils LM, Slot DE, Van der Sluijs E, et al. Tongue coating in relationship to gender, plaque, gingivitis and tongue cleaning behaviour in systemically healthy young adults. Int J Dent Hyg. 2020; 18(1): 62–72.
  24. Correa M, Hutchinson I, Laing DG, et al. Changes in fungiform papillae density during development in humans. Chem Senses. 2013; 38(6): 519–527.
  25. Saqib A, Farooq I, Faraz M. Oral mucosa. In: Farooq I, Saqib P, Anderson P. ed. An illustrated guide to oral histology. Wiley-Blackwell, Hoboken 2021: 123–145.
  26. Fischer ME, Cruickshanks KJ, Schubert CR, et al. Factors related to fungiform papillae density: the beaver dam offspring study. Chem Senses. 2013; 38(8): 669–677.
  27. Zhang GH, Zhang HY, Wang XF, et al. The relationship between fungiform papillae density and detection threshold for sucrose in the young males. Chem Senses. 2009; 34(1): 93–99.
  28. Karikkineth AC, Tang EY, Kuo PL, et al. Longitudinal trajectories and determinants of human fungiform papillae density. Aging (Albany NY). 2021; 13(23): 24989–25003.
  29. Piochi M, Dinnella C, Prescott J, et al. Associations between human fungiform papillae and responsiveness to oral stimuli: effects of individual variability, population characteristics, and methods for papillae quantification. Chem Senses. 2018; 43(5): 313–327.
  30. Zdilla MJ, Gibson LN, Hunt AJ. Sexual dimorphism of human vallate papillae: an in vivo study of normative morphology. Folia Morphol. 2015; 74(2): 245–251.
  31. Vinubal S. Foliate papillae of human tongue — a microscopic study. Ind J App Res. 2016; 6(10): 18–21.
  32. Maeda M. Dermoscopic patterns of the filiform papillae of the tongue in patients with Sjögren's syndrome. J Dermatol. 2006; 33(2): 96–102.
  33. Díaz-González JM, Vega-Memije ME, Mosqueda-Taylor A, et al. Dermoscopic patterns of filiform papillae of the tongue in patients with and without connective tissue autoimmune diseases. Int J Dermatol. 2018; 57(8): 938–942.
  34. Sudarshan R, Sree Vijayabala G, Samata Y, et al. Newer classification system for fissured tongue: an epidemiological approach. J Trop Med. 2015; 2015: 262079.
  35. Järvinen J, Mikkonen JJW, Kullaa AM. Fissured tongue: a sign of tongue edema? Med Hypotheses. 2014; 82(6): 709–712.
  36. Vella Fd, Lauritano D, Lajolo C, et al. The pseudolesions of the oral mucosa: differential diagnosis and related systemic conditions. Applied Sciences. 2019; 9(12): 2412.
  37. Hamrah MH, Baghalian A, Ghadimi S, et al. The prevalence and correlates of fissured tongue among outpatients in Andkhoy City, Afghanistan: a cross-sectional study. Clin Cosmet Investig Dent. 2021; 13: 335–342.
  38. Feil ND, Filippi A. Frequency of fissured tongue (lingua plicata) as a function of age. Swiss Dent J. 2016; 126(10): 886–897.
  39. Costello R, Prabhu V, Whittet H. Lingual tonsil: clinically applicable macroscopic anatomical classification system. Clin Otolaryngol. 2017; 42(1): 144–147.
  40. Çoban K, Köycü A, Aydın E. Lingual tonsil hypertrophy in patients with allergic rhinitis. Am J Rhinol Allergy. 2020; 34(1): 87–92.
  41. Friedman M, Wilson MN, Pulver TM, et al. Measurements of adult lingual tonsil tissue in health and disease. Otolaryngol Head Neck Surg. 2010; 142(4): 520–525.
  42. Joly A, Huttenberger B, Pare A. [Physical examination of oral cavity and physiological variations]. Presse Med. 2017; 46(3): 286–295.
  43. Sharabi AF, Winters R. Glossitis. StatPearls [Internet], Treasure Island (FL) 2023.
  44. Gonzalez M, Riera March A. Tongue cancer. StatPearls [Internet], Treasure Island (FL) 2023.
  45. Ishizuka K, Katayama K, Ohira Y. Moeller-Hunter glossitis. BMJ Case Rep. 2022; 15(8): e251810.
  46. Anastasi JK, Chang M, Quinn J, et al. Tongue inspection in TCM: observations in a study sample of patients living with HIV. Med Acupunct. 2014; 26(1): 15–22.
  47. Eigenschink M, Dearing L, Dablander TE, et al. A critical examination of the main premises of traditional Chinese medicine. Wien Klin Wochenschr. 2020; 132(9-10): 260–273.
  48. Mangold AR, Torgerson RR, Rogers RS. Diseases of the tongue. Clin Dermatol. 2016; 34(4): 458–469.
  49. Arnold DL, Krishnamurthy K. Lichen Planus. StatPearls [Internet], Treasure Island (FL) 2023.