American Family Physician

R ecognition and diagnosis of tongue abnormalities require examination of tongue morphology and a thorough history, including onset and duration, antecedent symptoms, and tobacco and alcohol use. A complete head and neck examination, with careful assessment for lymphadenopathy, is essential. According to the National Health and Nutrition Examination Survey, the point prevalence of tongue lesions is 15.5 percent in U.S. adults. Lesion prevalence is increased in those who wear dentures or use tobacco. The most common tongue condition is geographic tongue, followed by fissured tongue and hairy tongue. Table 1 summarizes common tongue conditions.