Fissured Tongue: Causes and Treatment

Fissured tongue causes a change in appearance of the tongue. Discover the causes of the disorder and what you can do if you have it.

Written and verified by the dentist Vanesa Evangelina Buffa.

Last update: 28 November, 2022

A fissured tongue is a benign abnormality that occurs on the tongue surface. Although it may appear unsightly at first glance, it doesn’t really affect people’s lives.

The normal tongue is flat along most of its length. A fissured tongue has a deep groove in the middle and may also have small fissures on the surface. This gives it a wrinkled appearance.

This condition isn’t serious in itself, is usually painless, and isn’t contagious. According to the American Academy of Oral Medicine, fissured tongue occurs in 5% of the U.S. population. It tends to occur more frequently in young males.

As we’ll tell you today, its origin is usually associated with hereditary causes and the symptoms become more evident as a person ages. However, in some cases, it can be associated with certain diseases, so it’s advisable to seek an accurate diagnosis.

In this article, we’ll tell you the characteristics of fissured tongue, its causes, and how it’s treated. Read on and learn all about this oral condition.

What is fissured tongue?

Fissured tongue is a benign condition that affects the normal anatomy of the lingual organ. It’s also called scrotal tongue, because of its similarity to the appearance of the scrotum.

As the name implies, the surface of the tongue has multiple fissures or cracks. These may appear on the dorsum of the tongue or extend to the sides.

In general, there’s usually a median fissure in the center of the tongue and several cracks on the rest of the surface. The size and depth of these cracks vary from case to case, but usually range from 2 to 6 millimeters (up to 0.23 inches). The grooves may be connected to each other, making the tongue appear to be composed of separate lobes.

This condition usually doesn’t cause pain or discomfort. However, some people who have it often have tongue swelling, bad breath, and increased sensitivity to certain substances and flavors.

Signs of fissured tongue can occur as early as childhood; however, they become more evident and noticeable as the person ages.

Men are slightly more likely to suffer from fissured tongue than women. Older adults who, in turn, have dry mouths tend to have more obvious symptoms.

It’s important not to confuse this anomaly with migratory glossitis, or geographic tongue. This disorder is characterized by depapillated areas on the tongue surface. These are seen as rounded red spots with whitish edges, which change place over time. Although it’s important to differentiate between these disorders, there are cases of people with both abnormalities on their tongue.

Symptoms of fissured tongue

The main characteristic of fissured tongue is the wrinkled appearance of the lingual organ. A crack in the center of the tongue and several irregular grooves on the rest of its surface alter the flat appearance.

Cracks are usually asymptomatic, that is, they don’t cause pain or discomfort to the patient. However, there are occasions in which some of the following occur:

• Pain
• Bad breath or halitosis
• Swelling or inflammation of the tongue
• Discomfort or burning to certain stimuli and substances
• If there is no proper oral hygiene, candidiasis may develop

Complications

Beyond the possibility that some of the symptoms we have told you about may appear, patients with a fissured tongue may experience discomfort. The most common complication is the development of an infection caused by the fungus Candida albicans (oral candidiasis).

This infection can arise as a result of various situations, however, the most common is inadequate oral hygiene. The accumulation of bacteria inside the tongue fissures affects the balance of the normal flora of the mouth and favors the proliferation of fungi.

Candidiasis on the tongue causes white or red lesions, pain, burning, and inflammation. If not treated in a timely manner, it affects the normal functions of the mouth, such as eating, swallowing, and speaking.

To prevent the occurrence and aggravation of this fungal infection, it’s essential for patients with cracks on their tongues to maintain thorough oral hygiene. Special attention to cleaning the tongue is key.

This removes food debris and bacteria that accumulate in the fissures, and prevents infection. In addition, removing tongue debris also prevents the development of bad breath.

Common causes of fissured tongue

A precise cause of cracked or fissured tongue hasn’t yet been identified. On the one hand, it could be due to genetic or hereditary factors, or it could be associated with a different underlying condition.

Fissured tongue can be congenital and appear from birth or develop throughout a person’s life. As we have already told you, the symptoms tend to increase with age.

The hereditary and genetic factors are among the most relevant in explaining the onset of the disorder. Often, several members of the same family have these particular languages.

In addition, this condition is often a symptom of other conditions, such as Down syndrome or Melkersson-Rosenthal syndrome. In sone cases, the occurrence of this condition is associated with other health conditions:

• Psoriasis
• Diabetes mellitus
• Vitamin B deficiency
• Bruxism, stress and anxiety
• Allergic reactions to some foods or medications
• Using alcohol and tobacco: these substances cause dry mouth, which favors the appearance of cracks in the tongue

Treatments for fissured tongue

Fissured tongue doesn’t require any specific treatment to reverse it. However, certain hygiene practices will be necessary to help keep this organ healthy and functional and prevent associated complications.

To do so, it’s important to visit the dentist frequently. In order to obtain an accurate diagnosis, it’s necessary to rule out other lesions and understand how to take care of fissured tongue.

Regular dental check-ups every six months allow the dentist to evaluate the state of the tongue and rule out the presence of other pathologies. If mycosis or other infections develop, the dentist can initiate the appropriate treatment.

It’s also a good idea to visit the dentist if the tongue starts to burn, itch, or hurt. These symptoms may be indicative of a complication.

On the other hand, in addition to check ups, there are some simple practices that can prevent complications associated with a fissured tongue. We’ll tell you about them.

Strict oral hygiene

Keeping the oral cavity clean is one of the best strategies to prevent fissured tongue complications. Food debris and bacteria can accumulate in the crevices of the tongue, causing bad breath, and promoting infections.

It’s important to brush with fluoride toothpaste and floss to remove plaque from the mouth. In addition, special attention should be paid to cleaning the tongue.

To do so, it’s best to use a tongue scraper, or tongue cleaner. This is an instrument that’s specially designed to thoroughly clean the irregular surface of the tongue.

Cleaning consists of moving the instrument back and forth several times over the entire tongue surface. This allows you to get rid of debris and bacteria trapped in its grooves or cracks.

Not having a tongue scraper is no reason not to keep your tongue healthy. Keeping a toothbrush for this purpose, or using the back of the toothbrush head are two options.

Tongue hygiene should be carried out at least once a day. However, in patients with fissured tongue, increasing the frequency may be of greater benefit.

Supplementing cleaning with oral rinses is a way to remove debris that can’t be reached with a scraper. At the same time, you will obtain fresh, clean breath.

Reduce the consumption of irritating foods

A burning or itching sensation on the tongue on contact with certain substances is another complication that can appear in people with tongue fissures or cracks. Avoiding highly acidic, salty, bitter, and spicy foods is one strategy to prevent irritation.

Avoid tobacco and alcohol

Smoking and drinking alcohol increase the risk of drying out the oral cavity and accumulating more debris and bacteria in the mouth. This makes it more likely for mouth infections associated with a cracked tongue to develop, and the organ will also feel tender and sore due to a lack of moisture.

Avoiding these harmful habits not only improves the condition of the tongue, but also reduces the risk of serious conditions elsewhere in the body.

A bit of TLC for your tongue

A fissured, or scrotal, tongue is a benign condition that generally doesn’t require treatment. However, it’s important to pay attention to it by maintaining proper oral hygiene and care to avoid complications.

Proper and frequent tongue brushing, proper nutrition, and the absence of harmful habits help prevent infection and discomfort. Twice-yearly visits to the dentist complete the care routine, in order to ensure that fissured tongue doesn’t become a problem for the sufferer.

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