Tobacco smoking and denture wearing as local aetiological factors in median rhomboid glossitis.

The importance of tobacco smoking and denture wearing in the aetiology of median rhomboid glossitis (MRG) has been evaluated in 39 patients. Significantly more of the MRG patients (85%) smoked tobacco compared with the corresponding proportion (41%) of the 39 healthy age-and sex-matched control subjects. Their tobacco consumption was also heavier. A significantly greater proportion of the MRG patients wore their dentures continuously compared with the controls. The number of MRG patients who were both tobacco smokers and denture wearers was significantly increased above that of the control group, as was the number who both smoked and wore dentures continuously. Only 1 patient neither smoked nor wore dentures and she was taking an antidepressant (imipramine hydrochloride) with a reported association with oral candidosis. It is suggested that these local factors may play a part in the development of MRG by favouring the local proliferation of Candida albicans on the dorsum of the tongue. Although conservative or surgical treatment may provide relief, management should also include attention to possible predisposing local factors.