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    The tongue, like the rest of the inner surface of the mouth, may have several diseases common to the inner mouth cavity. However, its refinements in touching and tasting bring it in contact with all substances entering the mouth and expose it to more irritation than the rest of the oral cavity.
    There are a variety of causes for tongue discolouration. Fortunately, the majority of them are not serious and most can be resolved quickly. In some instances, however, a discoloured or painful tongue can indicate more serious conditions, including vitamin deficiencies, AIDS, or oral cancer. For this reason, it is important to seek medical advice

    There are number of causes responsible for it.
    a.Leukoplakia- This condition causes cells in the mouth to grow excessively that leading to formation of white patches in oral cavity including tongue also. Although not dangerous on its own, leukoplakia can be a precursor to cancer. So medical attention should be given to it. Smoking, tobacco chewing, alcohol abuse, chronic trauma from ill fitted dentures or cheek bite are some of the etiological factors.
    b.Oral thrush- it is caused by candida albicans. It appears as a white grey patch. When wiped off, they leave a erythematous mucosa. Oral thrush is most commonly seen in infants and the elderly, especially denture wearers, or in people with compromised immune systems. Oral thrush is more likely to occur after the use of antibiotics, which may kill the "good" bacteria in the mouth.
    c.Oral lichen planus.
    d.Mouth breathing

    a.Vitamin deficiency- Niacin and folic acid deficiency may lead to red and smooth tongue.
    c.Scarlet fever- The first sign of scarlet fever may be a change from the tongue's normal colour to a strawberry, and then raspberry, colour.
    d.Kawasaki Syndrome- This disease, usually seen in children under the age of five, affects the blood vessels in the body and can cause strawberry tongue. During the acute phase of illness, children often run an extremely high fever and may also have redness and swelling in the hands and feet.
    e.Geographic tongue- This condition, also known as benign migratory glossitis, is named for the map-like pattern of reddish spots that develop on the surface of the tongue. At times, these patches have a white border around them, and their location on the tongue may shift over time.

         A black tongue discolouration is most commonly caused by organisms such as yeast
         and bacteria growing on the surface of the tongue. These bacteria and yeast produce
         blood cell pigments called porphyrins which give rise to the black colour
         characteristically seen. The overgrowth of bacteria can also cause cells of the tongue
         to be shed more slowly, causing the tongue to take on a hairy appearance, known as
         a black, hairy tongue.
            A variety of factors are believed to contribute to this phenomenon including 
            improper tooth and gum care; the use of tobacco products; drinking excessive
            amounts of tea or coffee; or use of antibiotics, bismuth containing medications and
            in immune- compromised individuals.
          Bluish discolouration on the tongue is usually a type of birthmark. It is usually
           painless, does not bleed and is not sore, is slightly elevated and occasionally
          covered with small amounts of hair. They have great nuisance value but little actual
          danger. They, of course, exist from childhood.

    On ruling out external causes (heavy smoking, tobacco chewing, etc.) tongue discolouration and coating should be investigated all the way with routine blood and urine analysis. If necessary, ultra sound scan or CT scan for abdomen or endoscopic procedures should be done when there arises a suspicion of digestive tract involvement. Other important tests which can guide for diagnosis are:

    • Scraping and culture - to identify fungal (Candida) or bacterial infection
    • Biopsy - to diagnose cancer
    It is depending upon the cause but management has to be maintained.
    1.oral hygiene has to be maintained
    2.Smoking should be quit
    3.Avoid chewing tobacco
    4.Diet should be nutritious and balanced.

    Role of homoeopathy
    Tongue discolouration and coating can be treated well by the homeopathic system of medicine. It will help in diagnosing diseases and remedy selection. In homeopathy, there are lots and lots of medicines for tongue discolouration, coating and disorders. The right simillimum (appropriate homeopathic medicine) will act by getting to the core of the disease and clear tongue problems simultaneously.

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