Prevalence of different morphologic forms of the human tongue in young Finns

Tongue feature dataset construction and real-time detection

BACKGROUND

Tongue diagnosis in traditional Chinese medicine (TCM) provides clinically important, objective evidence from direct observation of specific features that assist with diagnosis. However, the current interpretation of tongue features requires a significant amount of manpower and time. TCM physicians may have different interpretations of features displayed by the same tongue. An automated interpretation system that interprets tongue features would expedite the interpretation process and yield more consistent results.

MATERIALS AND METHODS

This study applied deep learning visualization to tongue diagnosis. After collecting tongue images and corresponding interpretation reports by TCM physicians in a single teaching hospital, various tongue features such as fissures, tooth marks, and different types of coatings were annotated manually with rectangles. These annotated data and images were used to train a deep learning object detection model. Upon completion of training, the position of each tongue feature was dynamically marked.

RESULTS

A large high-quality manually annotated tongue feature dataset was constructed and analyzed. A detection model was trained with average precision (AP) 47.67%, 58.94%, 71.25% and 59.78% for fissures, tooth marks, thick and yellow coatings, respectively. At over 40 frames per second on a NVIDIA GeForce GTX 1060, the model was capable of detecting tongue features from any viewpoint in real time.

CONCLUSIONS/SIGNIFICANCE

This study constructed a tongue feature dataset and trained a deep learning object detection model to locate tongue features in real time. The model provided interpretability and intuitiveness that are often lacking in general neural network models and implies good feasibility for clinical application.

Clinical Orodental Anomalies in Taiwanese Children under Age Six: a Study Based on the 1995-1997 National Dental Survey

There are few published studies that report the prevalence of intraoral anomalies for young children. The purpose of this study was to investigate the prevalence and distribution of several congenital oral and paraoral anomalies in Taiwanese children under age six. Twenty-five cities and townships were randomly sampled in different areas of Taiwan using the stratified method. These cities and townships represent cross-sectional samples of geographic locations and socioeconomic levels. A total of 981 Taiwanese children under age six were examined with dental mirrors and explorers as part of the national dental survey. The results of this survey indicated an 11.31% prevalence of geographic tongue. This number is higher than that reported in studies previously performed in different countries. The occurrence of double teeth in primary dentition was found to be 2.14%. Ankyloglossia had a frequency of 1.22%, and primary talon cusp a frequency of 0.61%. Seven (0.71%) children exhibited fissured tongues. Thirteen (1.33%) cases of hypodontia were found. These values were different from those reported in several other countries, which may be attributed to differences in the ethnic and racial composition of the population studied.

Determining salivary and serum levels of iron, zinc and vitamin B12 in patients with geographic tongue

Background. Benign migratory glossitis or geographic tongue, whose cause still remains a mystery, emerges as annular lesions on the dorsal surface of the tongue. Several reasons have been reported for this condition, including vitamin deficiencies, digestive disorders, emotional stress and nutritional deficiencies. In order to introduce an efficient treatment for the geographic tongue, the present study investigated the levels of iron, zinc and vitamin B12 in the blood and saliva. Methods. The present study evaluated 40 subjects. The oral disease specialists examined the patients in the Dental School, Tehran University International Campus and Mashhad Dental School. Accordingly, inclusion and exclusion criteria were used to enroll the patients. The blood and salivary samples were collected from the case and control groups. Finally, independent t-test was used to analyze the data. Results. Overall, 20 subjects suffered from geographic tongue. They consisted of 8 females and 12 males, with a mean age of 33.5±4.8 and age range of 19‒49 years. Moreover, the mean age and age range of the healthy subjects were 29.40±7.5 and 24‒25 years, respectively. It should be pointed out that the subjects were equally divided into 10 males and 10 females. There was no difference between other variables in the blood and saliva. Conclusion. The results showed that patients with geographic tongue had lower levels of salivary zinc, compared to the control group. Although iron and vitamin B12 affect the lingual papillae, their serum and salivary levels did not change.

Tongue coating in relationship to gender, plaque, gingivitis and tongue cleaning behaviour in systemically healthy young adults

OBJECTIVES

The purpose of this observational study was to investigate the relationship between tongue coating (thickness [Tc] and surface discoloration [Td]) and gender, plaque, gingivitis (bleeding on marginal probing [BOMP] and bleeding on pocket probing [BOPP]) and tongue cleaning behaviour.

MATERIALS AND METHODS

A total of 336 participants were screened for this cross-sectional study, from which 268 (150 male, 118 female) were found to be eligible. Aspects of tongue coating were visually assessed. Additionally, BOMP, BOPP and the plaque index (PI) were scored. To ascertain the tongue cleaning behaviour, the Oral Hygiene Behavior questionnaire was used.

RESULTS

Most tongue coating was found at the posterior sections of the tongue surface. A thin coating and white discoloration were most prevalent as highest score for both males (92.7%) and females (87.4%), as well as white discoloration for the whole group of participants (50.2%). A gender difference was observed for TC and Td (P < .001). Analysis did not reveal a relationship between Tc and PI and between Td and PI. Also, no relation was detected between tongue cleaning behaviour and Tc or Td. However, tongue cleaning was associated with lower BOMP and BOPP scores.

CONCLUSION

BOMP, BOPP or PI score did not appear to be linked to Tc and Td. A significant gender difference was found for Tc and Td. Self-reported tongue cleaning behaviour was associated with slightly lower BOMP and BOPP scores.

Black and Brown: Non-neoplastic Pigmentation of the Oral Mucosa

Black and brown pigmentation of the oral mucosa can occur due to a multitude of non-neoplastic causes. Endogenous or exogenous pigments may be responsible for oral discoloration which can range from innocuous to life-threatening in nature. Physiologic, reactive, and idiopathic melanin production seen in smoker's melanosis, drug-related discolorations, melanotic macule, melanoacanthoma and systemic diseases are presented. Exogenous sources of pigmentation such as amalgam tattoo and black hairy tongue are also discussed. Determining the significance of mucosal pigmented lesions may represent a diagnostic challenge for clinicians. Biopsy is indicated whenever the source of pigmentation cannot be definitively identified based on the clinical presentation.

Black hairy tongue after chemotherapy for malignant brain tumors

Black hairy tongue (BHT) developed in five patients (2.6%) among 192 patients undergoing chemotherapy for malignant brain tumors. Three patients with a history of diabetes mellitus developed BHT within 10 days after the initiation of chemotherapy. The other two patients suffered more than 100 days after induction and lymphopenia of grade 3 or worse developed for more than 20 days, which was not observed in the three patients with diabetes. We found that BHT could develop after chemotherapy for malignant brain tumors. Patients with diabetes mellitus presented early after chemotherapy, while patients with longstanding severe lymphopenia presented in late phase.

Paediatric Geographic Tongue: A Case Report, Review and Recent Updates

Geographic tongue is a benign recurrent condition of uncertain aetiology affecting the tongue characterized by loss of epithelium especially filiform papillae giving a characteristic appearance. The clinical presentation may vary from asymptomatic to painful and burning ulceration. The condition is commonly seen in adults but few cases are reported in children. A case of asymptomatic geographic tongue in three-year-old male child and literature review with new insight in aetiology is presented here. Management depends on the clinical condition and underlying aetiology.

Black hairy tongue syndrome

Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient's re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

Clinical Aspects of the Oral Cavity in Patients with Psoriasis: An Initial Study and a Proposal of a New Evaluation Method

The involvement of the oral cavity is rare but possible in patients with psoriasis. Most frequently different clinical entities are reported such as geographic tongue, fissures, angular cheilitis and ectopic geographic tongue. This interdisciplinary study was conducted by dermatologists in collaboration with dental hygienists on 22 patients with psoriasis. We examined 11 men and 11 women aged between 25 and 72 years during a period of 6 months. The involvement of the oral cavity was examined and a full photographic evaluation was carried out. A new assessment evaluation named Oral Psoriasis Area and Severity Index (OPASI) is proposed herein. The results obtained show the presence of oral lesions in 45.6% of the cases. This high involvement could be explained by the interdisciplinary nature of the study. We believe OPASI can be useful to assess the severity of lesions of the oral cavity, and may help to evaluate the response to therapy in relation to the Psoriasis Area and Severity Index (PASI) improvement.

[Prevalence of oral mucosal alterations in Brazilian adolescents held in two juvenile re-education centers]

The purpose of the present study was to verify the prevalence of oral mucosal alterations in Brazilian adolescents institutionalized. A total of 231 adolescents, all male were examined. The criteria used for clinical diagnostic of the lesions were the former proposed by SB 2000 (Brazil). The total oral mucosal lesions prevalence was 27.70% (64 lesions). The total prevalence of buccal mucosal lesions were 27.70% (64 lesions) in 24,24% of the adolescents. The most frequent one was plaque. It was found 293 mucosal alterations. 78.35% of the adolescents examined presented at least one alteration. The melanin pigmentation was the most common alteration. The data collected had been analyzed statistically through Kruskall Wallis non-parametric test and associations through Qui-Square test, considering significant level of 5%. Statistical significant difference was identified concerning between basic lesions and/or mucosal alterations and race (p=0,002) and skin colours and average number of the mucosal alteration (p=0,000) and the present of the melanin pigmentation and leukoedema and race (p=0,000 and p=0,002). There wasn't any statistically significant difference between average number of the mucosal lesions and race (p=0,618).

Evaluation of oral mucosal lesions in 598 referred Iranian patients

The mucosal membrane of the oral cavity displays at times classical developmental lesions considered to be variations of normal structures rather than having disease characteristics. Of these lesions leukoedema, Fordyce granules, geographic-, fissured- and hairy tongue, median rhomboid glossitis and lingual varices were studied in 598 patients referred to the School of Dentistry, Tehran, Iran. The prevalence was studied in relation to age, gender, occupation, education, smoking habits, general health, addictions and or drug therapies. Oral developmental lesions were seen in 295 patients (49.3%). Only Fordyce granules (27,9%), fissured tongue (12,9%), leukoedema (12,5%) and hairy tongue (8,9%) had enough cases for statistical analysis. Three of these lesions increased with age but not fissured tongue. All were more common in men. After adjusting for age, the parameters education, occupation and complaints upon referral had little influence on the prevalence of the lesions. Fewer Fordyce granules were seen in oral mucosa of smoking men. Leukoedema and hairy tongue were significantly associated with smoking, leukoedema with diabetes mellitus. We conclude that there was a highly significant association between these oral lesions and age, gender and smoking. Few significant associations were found between oral lesions and general diseases.

Prevalence of oral lesions in 13- to 16-year-old students in Duzce, Turkey

OBJECTIVE

The aim of this study was to determine the prevalence of oral lesions in 13- to 16-year-old students.

METHODS

A cross-sectional survey was carried out on students in Duzce, a province in the western Black Sea region of Turkey. A total of 993 children aged between 13 and 16 from eight secondary schools were examined. Oral lesions with recurrent behavior, if observed, were recorded at the time of examination. Venous blood samples were obtained for detecting hemoglobin levels.

RESULTS

Two hundred sixty adolescents (26.2%) were diagnosed with at least one oral mucosal lesion at the time of the examination. Thirteen different mucosal alterations were diagnosed, and the most common lesions were angular cheilitis (9%), linea alba (5.3%), and aphthous ulceration (3.6%). The correlation between occurrence of mucosal lesions and sex was not statistically significant (P > 0.05). Statistical evaluation of the data revealed a significant relationship only between the presence of angular cheilitis and anemia (P < 0.05).

CONCLUSION

This study is the first epidemiologic study of oral mucosal lesions in adolescents in Turkey. Angular cheilitis was the only oral mucosal lesion that had a significant correlation with anemia.

Differences in methodologies of measuring the prevalence of oral mucosal lesions in children and adolescents

AIM

This review offers a brief summary of three of the more commonly surveyed and reported oral mucosal conditions found in children, and an appraisal of the variation between selected elements of prevalence study methodologies.

DESIGN

Searches of electronic databases (i.e. MEDLINE, CINAHL, EMBASE and EBM Reviews) were conducted to find publications related to oral mucosal conditions in children. Studies were included and reviewed if they contained data on the prevalence of any of the following oral mucosal conditions: geographical tongue, oral ulceration and herpes labialis in children or adolescents (up to the age of 19 years).

RESULTS

A total of 29 articles out of 333 met the inclusion criteria and were reviewed. Of these 29 reports, 18 considered geographical tongue, 12 herpes labialis and 10 oral ulceration, although a number of the surveys reported on more than one condition. The approaches used in these studies varied on a number of the potentially important areas associated with validity, comparability, and whether or not the findings may be extrapolated beyond the study population, such as the sampling frame, diagnostic criteria, training and calibration, and examination features.

CONCLUSION

Although there were a number of surveys relating to the prevalence of geographical tongue, herpes labialis and oral ulcers in children and adolescents, reported prevalences varied and few studies were directly comparable in terms of the methodology applied. In particular, there was substantial variation between surveys in terms of the diagnostic criteria and method of detection employed although, in many instances, there was inadequate detail to allow full appraisal of the methodology. There is a need for more good-quality epidemiological studies in this area.

The prevalence of tongue lesions in 5150 Turkish dental outpatients

OBJECTIVE

The aim of this study was to assess the prevalence of nine tongue conditions and relate to data obtained about oral hygiene or habits in Turkish dental outpatients.

SUBJECTS

A total of 5150 subjects (2837 women, 2313 men) were included in this study.

RESULTS

Of the 5150 subjects, 2690 subjects were detected as having tongue lesions with a prevalence of 44.2 and 62.0% for women and men, respectively. The difference was found to be statistically significant (P < 0.0001). There was a strong correlation between tongue lesions and increasing age. There was also a strong association between tongue lesions and smoking, black tea drinking, and fair or poor oral hygiene. Hairy and coated tongue was significantly higher in males. Contrary to this, papillary atrophy was more prominent in women.

CONCLUSION

A strong correlation was found between tongue lesions and age, sex, oral hygiene and habits in Turkish dental outpatients. An efficient oral health program such as the elimination of risk habits and attention to cultural practices may improve tongue hygiene.

Prevalence of tongue lesions in Hungarian children

OBJECTIVE

The aim of this study was to investigate the prevalence of tongue lesions in Hungarian children in relation to age, sex, systemic diseases and allergies.

MATERIAL AND METHODS

A total of 1017 preschool and school children aged 1-14 years were examined. The age, sex and tongue lesions diagnosed were recorded together with any history of systemic diseases and allergies.

RESULTS

Tongue lesions were found in 35.11% of all the children examined. Fissured tongue was the most frequent lesion (29.2%), apparently associated with age and sex. It occurred more commonly in boys, and in older children, than in girls and younger children. Geographic tongue was found in 5.7%, occurred more often in boys, and a relationship existed between fissured and geographic tongue. Among the children with geographic tongue 44.82% also had fissured tongue. These findings agree in general with the epidemiological data reported on population samples elsewhere in the world. Crenated tongue occurred in 0.68%, central papillary atrophy in 0.78%, and partial ankyloglossia in 0.88% of the children examined: confirming the rarity of these lesions. Although there was no obvious correlation with systemic diseases, geographic tongue appeared to be coincident with a history of allergic diathesis in some cases.

CONCLUSION

In some cases early recognition of tongue lesions may provide useful diagnostic markers for some diseases.

Benign migratory glossitis or geographic tongue: an enigmatic oral lesion

Benign migratory glossitis, or geographic tongue, is usually an asymptomatic inflammatory disorder of unknown etiology that affects the epithelium of the tongue. Local loss of filiform papillae leads to ulcer-like lesions that rapidly change the color and size. Histopathologic findings parallel the clinical appearance, and may have a psoriasiform pattern. The disorder is characterized by exacerbations and remissions. In most cases, patients do not require treatment other than reassurance about the benign nature of the disorder.

Risk factors for oral soft tissue lesions in an adult Spanish population

OBJECTIVES

The aims of this study were (i) to determine the prevalence of oral lesions in adults over 30 years old in the city of Oviedo (Spain), and (ii) to analyze the relationship between the prevalence of oral lesions, toxic habits (tobacco and alcohol) and denture wearers in these patients.

METHODS

A representative sample of the adult population in Oviedo (Spain) was obtained through randomized sampling (n = 753); a total of 308 (41%) subjects were finally included in the study. The observed oral pathology was classified according to the WHO criteria and earlier epidemiological studies.

RESULTS

A little over half of all patients (51.1%) had oral lesions. The most frequent lesions were frictional lesion (7.5%), traumatic ulcer (7.1%), denture stomatitis and pseudomembranous candidosis (6.5%), followed by melanin pigmentation (5.8%) and denture-induced hyperplasia (5.2%), plicated tongue (3.9%), lichen planus and hemangioma (3.2%), angular cheilitis and cheek biting (2.9%), fibrous hyperplasia and coated tongue (2.6%), recurrent aphthae (1.9%) and oral leukoplakia (1.6%). In relation to leukoplakia, the odds ratio (OR) of heavy drinkers was 15.98 and the OR of heavy smokers was 12.37. The OR of heavy smokers or heavy drinkers diagnosed of frictional lesion was four times greater than that of nonsmokers or nondrinkers. The OR of heavy smokers with melanic pigmentations was 4.08. The OR of complete denture wearers with candidosis was 11.38. The OR of partial removable denture wearers with hemangioma was 5.01.

CONCLUSIONS

This study shows the relation of heavy tobacco and heavy alcohol to traumatic keratosis and leukoplakia, and of complete dentures to pseudomembranous candidosis, fibrous hyperplasia and stomatitis. Programs designed to eradicate toxic factors (alcohol and tobacco) should, therefore, be implemented with adequate maintenance of dentures.

Psoriasis: pathophysiology and oral manifestations

Psoriasis is a chronic, remitting and relapsing inflammatory skin disorder with a strong genetic predisposition. Psoriasis affects 1-3% of the world's population in their early lives representing a disabling condition with significant social and economic impact. Despite a great deal of research on the etiology and tissue destruction mechanisms, the disease is not well understood. The purpose of this paper is to provide current information from the literature with a special focus on oral manifestations. The major signs and symptoms presented in the oral environment of a psoriasis patient may include geographic tongue, fissure tongue, gingival and/or mucosal lesions. Inflammatory temporomandibular joint lesions have been reported in less than 5% of psoriasis patients. Multiple treatment strategies, be they topical or systemic, have been applied to these patients for symptom relief but not for cure.

Histocompatibility antigens and geographic tongue

The HLA-A, B and HLA-DR antigens were investigated in 50 unrelated Greek persons with geographic tongue and in 380 healthy control persons. An increased incidence of DR5 and DRW6 antigens was observed in the blood of persons with geographic tongue. Ten (20%) of them had the DRW6 antigen, and it was significantly increased compared with 29 (7.6%) of the controls (p < 0.01, RR = 3.32). Twenty-seven (54%) of the experimental group showed DR5 antigen compared with 136 (35.7%) of the controls (p < 0.025, RR = 2.18). On the contrary, only 12% (5) of the experimental group had the B51 antigen in comparison with the controls (26.3%) (p < 0.05, RR = 0.37). A decrease of the DR2 antigen was also found in the persons with geographic tongue (24%) in comparison with the controls (39.2%) (p < 0.05, RR = 0.58).

Prevalence study of tongue lesions in a Hungarian population

The aim of the study was to assess the prevalence of tongue lesions in a district population, in Budapest, called regularly for X-ray lung examinations. Oral examinations of 7820 individuals were performed, 42% were over 60 yr of age, 42.9% were men and 57.1% women. Tongue alterations were found in 18.52% of the examined individuals, more frequently in women than in men. Lingua fissurata has been diagnosed in 8.8%, geographic tongue in 3.0% of the examined subjects. Atrophic lesions of the tongue were found in 6.37%, among them 5.42% central papillary atrophy (median rhomboid glossitis): 0.35% of the total sample. Manifest clinical symptoms of oral Candidiasis were found in 2.15% of the total sample, and in 4.28% of patients with tongue lesions. The occurrence of oral leukoplakia and lichen in patients with tongue lesions was respectively 0.47 and 0.07%. The prevalence of tongue alterations was consistent with the literary data, the oral screening attached to the X-ray lung examinations proved to be useful in detecting changes of the oral mucosa.

Clinical orodental abnormalities in Mexican children

A total of 32,022 Mexican children (16,473 boys, 15,549 girls) were examined for several congenital oral and paraoral anomalies. The findings for commissural lip pits (boys 53.1, girls 52.4 per 1000) are less than those reported for adults. This may indicate that pits become accentuated with age. Fordyce granules were seen with a prevalence of 1.2 per 1000. This is in contrast to the reported 85.6% prevalence for the adult population, also possibly reflecting increased manifestation with increased age. Our data for exogenous tooth pigmentation show increased prevalence with age (group I [5 to 10 1/2 years], 9.8%, versus group II [10 1/2 to 14 1/2 years], 12.9%), possibly indicating decrease in attention to oral hygiene. The prevalence of talon cusp was found to be 0.6 per 1000, and for ankyloglossia 8.3 per 1000. Prevalence values for bifid tongue are reported for the first time, indicating one affected per 187 children examined. The prevalence of fissured tongue (15.7%) shows a statistically significant difference between boys (16.8%) and girls (14.5%). The prevalence of geographic tongue (1.9%) shows a marked difference between group I (2.2%) and group II (1.2%).

Familial study of fissured tongue

Clinical and genetic characteristics of histologically defined fissured tongue were examined in a familial study. Fifteen probands with fissured tongue and four probands with geographic tongue were selected from earlier studies. In addition, 12 probands with tongue fissuring, but without changes of papillary structure, were included. The total sample consisted of 31 families; the number of family members examined was 185 (93 men, 92 women), and the mean age of the subjects was 20 yr (range 1-78). Diagnosis of tongue form was emphasized, and this study describes an in vivo method of stereomicroscopy for examining the dorsum of the tongue. According to genetic analysis, fissured tongue with smooth-surfaced papillae was transmitted as a dominant characteristic with incomplete penetrance and was preceded by geographic tongue. The severity of fissured tongue changed with increasing age. Tongue fissuring with normal-appearing filiform papillae was not familial and was not associated with geographic tongue. Fissuring with normal papillary structure should be considered as variations of normal anatomy, whereas fissured tongue and geographic tongue are a clinical and etiological disease entity.

Benign migratory glossitis in patients with juvenile diabetes

The prevalence of tissue type HLA-B15 has been shown to be higher in atopic patients with benign migratory glossitis and in patients with insulin-dependent diabetes mellitus than it is in the general population. Despite this apparent link, the possible relationship between benign migratory glossitis and insulin-dependent diabetes mellitus does not appear to have been investigated previously. This study of 87 diabetic patients and 105 age- and sex-matched nondiabetic control subjects revealed a fourfold increase in the prevalence of benign migratory glossitis in the diabetic group. These results suggest that benign migratory glossitis may be linked to diabetes mellitus and that further investigation of this association is warranted.

The pH of stimulated and resting saliva in different morphologic forms of the tongue surface in a young population

Salivary condition and its correlation to tongue morphology was studied in 149 dental students. The students were divided according to the morphologic form of the tongue. The salivary pH and the buffer capacity of resting and stimulated saliva were determined. The pH values in the resting saliva of the fissured tongue group were more alkaline than those in the control group. The difference in pH values of stimulated saliva in the fissured tongue and control groups was only indicative. The stimulated saliva values of the normal tongue and the geographic tongue groups were similar. The pH valves of resting saliva in the geographic tongue group were more acidic than those in the normal tongue group. The salivary pH values of the filiform atrophy group were more acidic than those of the control group: resting salivar highly significantly and stimulated saliva significantly. The pH values of the hairy tongue group were also more acidic than those of the control group: both resting saliva and stimulated saliva highly significantly. No differences were observed in salivary buffer capacity, although buffer capacity in the hairy tongue group seemed to be lower than in the other groups.