Prevalence of fungi in cases of geographical and fissured tongue.

One of the most common malformations of the tongue is fissured tongue, very often, is accompanied by geographic tongue; the etiopathogenesis of them is not known. The aim of study was to evaluate the prevalence of fungi in cases of fissured and geographic tongue, and to determine their species and susceptibility to selected antifungal drugs. The study included 104 patients with fissured and/or geographical tongue. To determine fungi present in the tongue, the material was collected with a sterile swab for mycological examination. The procedure was conducted according to that used at our Department. The in vitro susceptibility of the strains to nystatin and miconazole was evaluated. In 45 (43%) cases fissured tongue, in 28 (27%) geographic tongue, and in 31 (30%) both conditions were diagnosed. Mycological examination revealed fungi on the tongue in 73 (70%) patients, including 31 patients (69%) with fissured tongue, 19 (68%) with geographic tongue, and 23 (74%) with concomitant changes. The most frequently detected was Candida albicans (detected in 48-66% of cases); in individual cases, other species of Candida species were found. The strains demonstrated greater sensitivity to nystatin than to miconazole. An analysis of reported symptoms based on the presence or absence of fungi on the tongue revealed that idiopathic pain and burning were significantly more frequently reported by patients with fungi on the tongue (p = 0.034174). Statistically significant differences exist between the presence and absence of fungi with regard to the signs, symptoms of changes on the tongue (p = 0.026015). Also, statistically significant differences (p = 0.00000) exist regarding the presence of fungi with regard to brushing a fissured tongue, or a fissured and geographic tongue; fungi are frequently present when brushing is absent. The prevalence of fungi is greatest in patients with geographic tongue, especially those who do not brush the surface of the tongue.

Changes in composition of whole saliva in patients with fissured tongue.

Both resting and paraffin-stimulated whole saliva were studied in 25 patients with fissured tongue and in their age and sex-matched healthy controls. The groups did not differ in dental or periodontal health. No significant differences were found between the groups in the salivary secretion rate, pH and buffer capacity, or in the frequency of lactobacilli and yeasts in saliva samples and scrapings from tongue surface. In patients with fissured tongue, unstimulated whole saliva displayed significantly elevated levels of sodium, lysozyme, myeloperoxidase and all immunoglobulins (isotypes A, G and M) when compared with the controls. These changes most likely reflect the inflammation frequently seen in the biopsies of fissured tongue. No differences between the groups existed in the amounts of salivary potassium, calcium, inorganic phosphate, amylase and total protein. Our study shows that in patients with fissured tongue the salivary secretion and composition are normal. However, components from plasma and inflammatory cells are diagnostically elevated in the whole saliva samples of patients with fissured tongue when compared with the healthy controls.