e Engine ym er z in n g E Musaad et al., Enz Eng 2015, 5:1 DOI: 10.4172/2329-6674.1000137 ISSN: 2329-6674 Enzyme Engineering ReviewResearch Article Article OpenOpen Access Access Prevalence of Fissured and Geographic Tongue Abnormalities among University Students in Khartoum State, Sudan Ayah H Musaad1, Amal H Abuaffan2* and Eman Khier3 1General Dentist University of Medical Sciences and Technology, Khartoum, Sudan 2Department of Orthodontics and Pedodontics, University of Medical Sciences and Technology, Khartoum, Sudan 3University of Medical Sciences and Technology, Khartoum, Sudan Abstract Background: It is believed that the tongue represents the state of the body’s health and thus individuals need to pay close attention to any changes that may occur such as altered or loss of taste, burning sensations and abnormal texture. Objective: To determine prevalence of fissured and/or geographic tongue abnormalities in relation to gender and to asses level of awareness of their existing tongue abnormality among a sample of Sudanese university students. Materials and Methods: A cross-sectional study for 400 university students within 16 to 22 years old who participated was examined and tongue abnormality was identified and photographed. Chi square test was used to analyse data. Results: Overall incidence was 54.5% (19.5% among males and 35.0% among females). Most frequent tongue abnormality was fissured tongue (24.0%), ankyloglossia (2.5%), geographic tongue (1.2%), fissured and geographic tongue (0.5%), smooth tongue (0.25%) and lingual thyroid (0.25%). Level of awareness was 55.97% (10.26% in males and 45.71% in females). Conclusion: This study offers information concerning prevalence of tongue abnormalities, gender association, and types of tongue abnormalities with assessment of level of awareness of existing tongue abnormality among a subgroup of the university students of the Sudanese population. Keywords: Prevalence; Fissured tongue; Geographic tongue; In traditional chinese medicine (TCM) tongue examination is Ankyloglossia; Students vital in obtaining noteworthy information on the physiological body condition [7]. Background Several studies on tongue abnormalities were published from The tongue is considered as one of the vital organs of the body around the globe. And different results have been obtained [1,8-25]. with various important functions including taste, speech, mastication, deglutition, and breathing. Abnormalities that are developmental, Among the Arab population prevalence of tongue abnormalities genetic or environmental in nature can affect the tongue [1]. ranged from 9.2-58.1% with an overall slight male predilection. Fissured tongue was more common than geographic tongue in most of Fissured tongue is a common non-malignant and subclinical the studies which had a sample range from 44-2000 individuals [9,15]. disorder characterized by indentations extending along the lateral parts and dorsum of the tongue in different degrees of depth, common In the Asian population, on the other hand, studies on prevalence in individuals with a mental disability such as Down’s syndrome, of tongue abnormalities had a much wider range 4.6-83.3% [1,16-24]. Melkerson-Resenthal Syndrome and Trisomy [2]. The Tongue is With a relatively equal gender predilection on a sample ranging from usually protected by filiform papilla, this protective mechanism is 600-5000 individuals. diminished in fissured tongue and keratohyaline granules and keratin In the South American population, Vieira-Andrade et al., and may lead to inflammation [3]. Anaya et al., reported the prevalence of tongue abnormalities 84.9% In geographic tongue there is recurrent appearance and resolution (with female predilection) on 511 patients and 79.9% on 134 children, of irregular, smooth red patches with sharply defined borders on the respectively [8-25]. dorsum and lateral parts of the tongue. Although the exact aetiology It is believed that the tongue represents the state of the body’s is unknown, it may be hereditary, or associated with other conditions such as psoriasis, vitamin B12 or zinc deficiency [4]. Geographic tongue or benign migratory glossitis is a benign asymptomatic condition that *Corresponding author: Amal H. Abuaffan, BDS, MSc, Associate Professor, results in destruction of filiform papillae causing a change in taste Department of Orthodontic, University of Medical Sciences and Technology, sensation and may make feeding troublesome [5]. Disturbance during Khartoum, Sudan, P.O. Box 1719 Khartoum, Sudan, Tel: 00249912696035; the 4th week of intrauterine life (period of tongue formation) can lead to E-Mail: [email protected] formation of ankyloglossia: (partial or complete) congenital shortness Received October 28, 2015; Accepted December 28, 2015; Published December of the lingual frenulum extending to the tip or near the tip of the tongue 31, 2015 restricting movement of the tongue as it is bound to the floor of the Citation: Musaad AH, Abuaffan AH, Khier E (2015) Prevalence of Fissured and mouth; and bifid tongue: divergence (mild, moderate or severe) at the Geographic Tongue Abnormalities among University Students in Khartoum State, tip of the tongue [1,6]. Patients are aware that it is custom for clinicians Sudan. Enz Eng 5: 137. doi:10.4172/2329-6674.1000137 to inspect the tongue. Thus, patients check their own tongue and as a Copyright: © 2015 Musaad AH, et al. This is an open-access article distributed result may be concerned about minor changes and assume that normal under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the characteristics such as foliate papilla are a reason for apprehension [4]. original author and source are credited. Enz Eng ISSN: 2329-6674 EEG, an open access journal Volume 5 • Issue 1 • 1000137 Citation: Musaad AH, Abuaffan AH, Khier E (2015) Prevalence of Fissured and Geographic Tongue Abnormalities among University Students in Khartoum State, Sudan. Enz Eng 5: 137. doi:10.4172/2329-6674.1000137 Page 2 of 5 health and thus individuals need to pay close attention to any changes the publication of this paper. Verbal and/or written consent forms that may occur such as altered or loss of taste, burning sensations were be taken from students who agreed to participate. Students then and abnormal texture, as these changes may be the body’s method of underwent analysis for presence or absence of the tongue abnormality sending warning signals to seek therapy for an underlying condition. by clinical examination through direct inspection of the oral cavity with the use of non-sterile disposable gloves under natural, and/or To our knowledge prevalence of tongue abnormalities in Sudan was artificial light. not well documented in previous literature and since it is thought that the tongue is a window to the body’s health and changes in texture or otherwise In the second stage, those with tongue abnormalities underwent may usually go unrecognised, this study was designed to evaluate the photographic documentation by the main investigator using prevalence among a Sudanese population of different ethnic backgrounds, Fujifilm FinePix J × 500, Fujinon lens, 14.0 mega pixels, 5 × optical to raise awareness and provide didactic education methods through self- zoom and a questionnaire, which was self-constructed, was filled constructed leaflets and to act as a base line for future studies. by the investigator. The questionnaire consisted of three parts. Part one included personal data, part two was to determine presence Methodology or absence of a tongue abnormality, part three was to assess level of This cross-sectional study was carried out to determine the awareness. prevalence of fissured and/or geographic tongue among students of During time of clinical examination, participating students were the UMST (University of Medical Sciences and Technology). UMST informed of their tongue abnormality if any, and given a leaflet to is a well-known qualified educational institution with 13 faculties educate them. In addition if needed, referral to appropriate department providing 5110 students with golden standard education by lecturers (s) was done. bearing several degrees and years of experience in education including Bachelor’s, Master’s and Doctor of Philosophy. This is university has Ethical clearance and permission was obtained from the University students from different ethnic backgrounds and is well populated with of Medical Science and Technology, Khartoum, Sudan, ethical students and for this reason was selected for this study. committee to carry out the study and consent was obtained from each faculty’s registrars. A written consent form was signed by each student The sample size was calculated according to the formula below: prior to carry out the clinical examination and taken of photograph, Nz* 2* p()1− p and the one whose photograph included in the manuscript signed Sampling size: n = * 2 2* another permission consent form. Nd + z p()1− p Where, Data Analysis n=sample size Computer program used was Statistical Package for Social N=population size (5110) Sciences (SPSS) for Windows, version 20 and Microsoft Excel for cross tabulation. Chi square test was used to study the prevalence and types of z=standard normal deviation at 95% confidence level (1.96) tongue abnormalities, in association with gender and level of awareness p=proportion in target population estimated to have a particular of existing tongue abnormality. For all statistical tests a P-value of less characteristic (0.5) than 0.05 was considered to be significant. d=degree of accuracy or the accepted margin of error (0.05) Data was grouped and analysed using frequencies and percentages thus the final results were grouped in forms of tables and figure. Therefore the sample size will be: Strengths and limitations 2 5110* ()()1.96 *0.5 1− 0.5 n = = 357students The study was simple to carry out- short quick clinical examination 22 5110* 0.05 1.96 * 0.5 1− 0.5 ()()() followed by a brief questionnaire. It is doable, time efficient and economical.