Applicability of the Geographic Tongue Area and Severity Index among Healthcare Professionals: A Cross-Sectional Clinical Validation of a Newly Developed Geographic Tongue Scoring System

Bruna Lavinas Sayed Picciani; Lílian Rocha Santos; Thaylla Núñez Amin; Jonatas Daniel Rocha Santos; Sueli Carneiro; Jane Marcy Neffa Pinto; Joao Carlos Regazzi Avelleira; David Rubem Azulay; Heron Fernando de Sousa Gonzaga; Ronir Raggio Luiz; Arkadiusz Dziedzic

doi:10.3390/jcm10235493

Applicability of the Geographic Tongue Area and Severity Index among Healthcare Professionals: A Cross-Sectional Clinical Validation of a Newly Developed Geographic Tongue Scoring System

J Clin Med. 2021 Nov 24;10(23):5493. doi: 10.3390/jcm10235493.

Affiliations

¹ School of Medicine, Fluminense Federal University, Niteroi 28625-650, RJ, Brazil.
² Federal Center for Technological Education Celso Suckow da Fonseca, Rio de Janeiro 20271-204, RJ, Brazil.
³ Sector of Dermatology, Department of Medical Clinic, Rio de Janeiro Federal University, Rio de Janeiro 21949-590, RJ, Brazil.
⁴ Department of Dermatology, Fluminense Federal University, Niteroi 24220-900, RJ, Brazil.
⁵ Institute of Dermatology, Santa Casa da Misericórdia, Rio de Janeiro 20020-022, RJ, Brazil.
⁶ Department of Dermatology, Medical School, UNIMAR, Marília 17519-030, SP, Brazil.
⁷ Institute of Public Health Studies, Rio de Janeiro Federal University, Rio de Janeiro 21941-598, RJ, Brazil.
⁸ Department of Conservative Dentistry with Endodontics, Medical University of Silesia, 40-055 Katowice, Poland.

Abstract

Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis.

Objective: To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process.

Methods: One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category-mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey.

Results: The quantitative and qualitative assessment based on experts' opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators.

Conclusion: Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.

Keywords: evaluation; geographic tongue; geographic tongue area severity index; psoriasis; validation.