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Oral Surgery/Tongue biopsy

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QUESTION: My husband went back to the os today and the biopsy showed chronic inflammation, squamous epithelial hyperplasia and parakertosis. The surgeon said this could have been caused from trauma like a bite but this doesn't make to much scenes to me bc his dentist has been watching the darkened area for a month and a half . Wouldn't trauma from a bite heal by now? My thoughts is this is his geographic tongue? When I asked him if that was the possible cause he said maybe ? To me that would make the most scene as to why the area was dark. When I asked if he biopsied the correct spot from the pics he said yes. He was very short with us like I offended him by second guessing . I just want to be 100% that he did biopsy the correct are which the dentist saw dark and watched under the velescope. So are these findings at all consistent with geographic tongue? Thanks.

ANSWER: Yes.  What the pathology report outlines could definitely be geographic tongue.

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QUESTION: The last biopsy he had said chronic inflammation consistent with gt and a whole bunch of other stuff describing the cells seen. So the know the inflammation is part of gt, but what about the squamous  epithelial hyperplasia and parakertosis? Do you think the correct area was biopsied and I shouldn't worry? Also do these findings explain for the constant darkness of hid tongue under the velescope?

ANSWER: Kim - whst the doctor described and what the path report said about the epithelial hyperplasis most inducstive of the geographic tongue

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QUESTION: What other conditions could cause this pathology report? So the hyperplasia is normally seen in gt biopsy lesions? When he had his last biopsy I don't remember them sayings anyhing about hyperplasia or parakertosis in the biopsy report. This is what I found online that is typical of a gt pathology report.
Micro abscesses are microscopically diagnostic of geographic tongue (called abscesses of Munro), inflammatory cells, and obvious loss of the epithelial surface in areas of the clinically denuded patches. The histological appearance of geographic tongue is microscopically similar to cutaneous psoriasis.

This says it would loss epithelial surface and hyperplasia is thickening on the epithelial surface?

Answer
Kim - rather than geographic tongue, the results are indicatve of chrinuc irritation. The most common cause is the teeth.  Their shape, their roughness, their alignment and the act of biting. That was indicative of the report and is very common.  You may not wsnt to hear this, but you have to leave it alone. Repeated often examination creates extensive irritation in the hands of a poorly trained individual.  So do your husband and yourself a little favor and let the dental professional examine your husband bi-yearly to accurately evaluate any changes.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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