ORAL PATHOLOGY PROJECT

Amanda Mirabello2014

MEDICAL HISTORY

18 year old

Caucasian female

Negative medical history

Non-tobacco user

Adequate home care

INTRA-ORAL EXAMINATION

During routine intra-oral examination a short lingual frenum and splitting of the anterior tip of tongue were noted.

DESCRIPTION

Lingual frenum attached anterior on the tongue.

Tongue splits at anterior one third.

Intra-oral exam WNL

INTRA-ORAL PHOTOGRAPHS

INTRA-ORAL PHOTOGRAPHS

HISTORY OF ABNORMALITY

Patient states that her tongue has been split since birth.

Splitting of tongue has not caused any difficulties in speech, swallowing, or oral hygiene.

No history of trauma or piercings

SYMPTOMS

No pain reported

Normal upon palpation, no masses noted

Salivary glands WNL

Oropharynx and Larynx WNL

Voice WNL

No dysphagia noted

All other intra-oral and extra-oral exam findings WNL

DIFFERENTIAL DIAGNOSIS

1) Ankyloglossia:

- Pulling anteriorly on tongue causing it to appear bifid

- “Tongue Tied”

- Congenital

- Decreases mobility of the tongue tip

- Short, thick lingual frenum

- Mild-Complete

- Affects eating, speech and oral hygiene in more severe cases

DIFFERENTIAL DIAGNOSIS

2) Bifid Tongue:

- Congenital disorder occurring during fetal development in the 4th week

- Divided longitudinally at anterior

- Rare without other orofacial abnormalities

- Commonly seen in conjunction with syndromes and other orofacial abnormalities

DIFFERENTIAL DIAGNOSIS

3) Trauma to tongue:

- Possible biting of tip of tongue, or oral piercing causing splitting and scarring.

- Possible cosmetic surgery to achieve “snake tongue”

DIAGNOSIS PROCESS AND DIAGNOSIS Consulted on call dentist in clinic

Evaluated patient and ruled out any syndromes in conjunction with abnormality

Negative medical history

Bifid tongue in the absence of other orofacial abnormalities/syndromes = very rare.

No history of trauma or piercing to her tongue.

Due to the rarity of this abnormality without other symptoms or syndromes, and lack of trauma/piercing history: Ankyloglossia = diagnosis from the dentist on staff.

Intra-oral photographs were taken and Ankyloglossia bifid tongue was reported under intra-oral exam.

HEALTH PROMOTION METHODS Routine treatment was provided as planned.

Abnormality noted under patient’s intra-oral exam findings.

No effect on speech

No dysphagia

Prognosis abnormality is good.

BIBLIOGRAPHY

DMB Hall, M. R. (2005). Tongue Tie. Retrieved from Archives of Disease in Childhood : http://adc.bmj.com/content/90/12/1211.1.full

Kumar L. K. Surej, N. M. (2010). Isolated Congenital Bifid Tongue . Retrieved from National Journal of Maxillofacial Surgery: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304211/.

P.S Flemming, T. F. (2005). Bifid Tongue- a complication of tongue piercing. Retrieved from British Dental Journal: http://www.nature.com/bdj/journal/v198/n5/full/4812117a.html

 

 

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