Recent research from The University of Edinburgh has studied the unique surface of the tongue. It used artificial intelligence (AI) to gain an improved understanding of the papillae. The key outcomes of this study focused on personalised nutrition, recognising the anatomical reasons why people enjoy eating chocolate, for example, and aiming to help professionals find and promote healthy alternatives to different patients. However, another benefit of recognising people's unique tongue prints was brought to light—monitoring for abnormal growths.
This technology combined with AI is still in development. However, this key takeaway is valuable for many clinicians. The ability to recognise unique tongue anatomy will help professionals and patients notice anything out of the ordinary, like changes in colour and texture or pain, early on. Additionally, by adopting readily available tools to assist in pre-diagnostic testing, clinicians can offer advice and referrals with confidence.
Becoming familiar with unique anatomy
Tongue prints are unique to each person – even identical twins have different tongue anatomy from one another. Some studies suggest that this could make the tongue a useful tool in forensic investigations. Advising patients to become familiar with the features of their own tongue is essential for helping them to monitor their oral health and notice any changes early.
Signs of illness and deficiency may present in the tongue in a number of different ways. These include changes in colour, texture, and pain. Typically, a healthy tongue is pink, with some variation for different people. If the tongue changes from the colour patients are used to seeing, adopting a white, red, or yellow hue, this may be cause for concern. White patches might indicate oral thrush, oral lichen planus, or leukoplakia. The latter occurs due to cell overgrowth in the mouth, with some cases benign and others potentially leading to cancer.
A red or purple hue might indicate geographic tongue, vitamin B (9 or 12) deficiency, Kawasaki disease, or scarlet fever. A yellow tongue usually indicates bacterial overgrowth, but can also be caused by tobacco use, psoriasis, and jaundice. Some of these conditions can be resolved by a change in oral hygiene or diet, whereas others should be treated quickly to prevent severe consequences. As such, it’s important that patients discuss any abnormalities with a professional to ensure they receive the care they need.
Patients and clinicians should also make note of any soreness or bumps in the mouth and on the tongue. This is of particular concern if it is causing the patient pain and could happen as a result of tobacco use, mouth ulcers, tongue biting, or burns. If soreness and bumps do not clear up after two to three weeks, they could be a sign of oral cancer, and clinicians should run further tests or refer the patient for diagnosis and treatment.
Check for anything abnormal
Ensure your patients understand the importance of seeking care if they notice anything unusual with their tongue, even if they assume it’s harmless. Receiving a proper diagnosis is vital, as anything unusual may be a sign of something more serious. Discolouration and changes in texture are some of the potential indicators of oral cancer. Patients should report anything abnormal and get it checked, including a mouth ulcer which lasts longer than three weeks. These could be the early signs of oral cancer and, if caught early, might mean improved survival rates – particularly if treatment begins in its early stages.
Oral cancer is common, with around 8,500 new cases diagnosed in the UK per year. Currently, tissue biopsy is the gold standard for cancer diagnosis, however, the invasive nature of the procedure means that is can be painful and uncomfortable. Many traditional non-invasive methods are not sufficiently sensitive, and are therefore potentially unreliable. As such, the use of a new non-invasive pre-diagnostic test, which provides information about oral cancer biomarkers in incredibly helpful for informing the need for further testing and biopsy.
The BeVigilant OraFusion system from Vigilant Biosciences is a quick and easy pre-diagnostic test which is designed to be used at point of care, using saliva. If a dentist spots a lesion which they think is suspicious, the BeVigilant Orafusion system can be used to identify the presence of biomarkers associated with oral cancer, producing a result in 15 minutes or less. This is ideal for clinicians who would like to feel more confident when referring patients, and assessing for oral cancer.
In order to more effectively monitor patients’ health, it’s important to be familiar with the different signs of illness. When clinicians and their patients regularly monitor their anatomy, checking for any abnormalities, they are more able to pick up on illnesses early, and improve survival rates for conditions like oral cancer.
References available on request.