Fact Checked

What Is a Fissured Tongue?

Written by Fernanda Elizalde

November 28, 2022

Medically Reviewed

By Dr. Greg Grillo, DDS

Have you taken a good look at your tongue in the mirror lately? If so, it's possible that you noticed some deep cracks or fissures and asked yourself, "Is this normal? How did this happen?"

Luckily, there's likely nothing to worry about. However, if you notice abnormal grooves or creases, you may have a relatively common condition known as fissured tongue.

If you've observed some unusual areas on your tongue, it's normal to have questions about what causes fissured tongue, whether it's related to other health conditions, and how to get rid of it.

In this article, we'll discuss what a healthy tongue should look like and what to do if yours has unusual cracks or fissures.

What does a healthy tongue look like?

Before we get into what fissured tongue is, it's vital to understand how a "normal" tongue should look.

Generally, a healthy tongue is pink colored with no noticeable injuries, coatings, changing colors, or areas of discomfort. It should also be moist, smooth, and have normal tongue papillae, including tiny bumps called taste buds, on the surface.

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Changes to the tongue's appearance often indicate disease. One example is a white or yellow coating, which may suggest an acute illness, such as a cold or digestive issue, a contagious disease, or other oral conditions. Likewise, a swollen tongue may result from an allergy or infection.

What does fissured tongue look like?

The term "fissured tongue" is typically used to describe a tongue with visible cracks on its top surface. The condition may also be called "scrotal tongue," "lingua plicata," or "plicated tongue," but they all essentially mean the same thing.

Fissured tongues usually have cracks throughout the entire dorsal or top surface. These fissures may vary widely in number, depth, and length. So, they can be shallow or deep, long or short, and there may be one single fissure or multiple.

In many cases, there is one prominent fissure in the center of the tongue. However, most are found in the middle third. You're unlikely to find fissures or cracks on the tongue's bottom or ventral surface.

Is fissured tongue normal?

So, are fissures or cracks on the tongue normal? Yes and no. Typically, there are no large cracks or deep grooves on a tongue's surface. However, having a fissured tongue is not as rare as you might think.

According to the American Academy of Oral Medicine (AAOM), about 5% of the U.S. population has fissured tongue. Additionally, you're unlikely to experience any uncomfortable symptoms unless debris builds up in the fissures.

What is geographic tongue?

Someone with a fissured tongue may also experience a condition known as geographic tongue. The two are frequently confused or occur together, but they are different tongue conditions.

Geographic tongue, also known as benign migratory glossitis (BMG), is harmless. However, it is different because it appears as inflamed patches on the surface of the tongue. These smooth, red patches often have raised borders and create a pattern resembling a map, which is the reason behind the name "geographic."

Geographic tongue occurs in about 1 to 3 percent of the population, and although it may look alarming, it typically doesn't cause serious health problems. That said, some people do experience increased sensitivity and discomfort, especially when eating hot and spicy foods.

What can cause you to potentially develop fissured tongue?

The exact cause of fissured tongue is still unknown. In fact, many healthcare professionals consider it to be a variation of normal.

However, some researchers believe fissured tongue has a genetic component. Men and older adults with dry mouth may also be slightly more likely to develop fissured tongue.

Another possible cause is malnutrition. Specifically, a lack of essential nutrients and minerals can negatively affect the mouth and cause various side effects, including a cracked or fissured tongue.

Common health conditions when fissured tongue occurs

Although there is no definitive cause, fissured tongue may be linked to several other health conditions, including:

  • Down syndrome – a condition in which a person is born with an extra chromosome, leading to symptoms such as intellectual disabilities and developmental delays.

  • Melkersson-Rosenthal syndrome – a rare neurological disorder characterized by repetitive facial paralysis and swelling of the lips and face.

  • Malnutrition and vitamin deficiencies – lack of specific vitamins and minerals that contribute to oral health can result in changes to the teeth and tongue.

  • Psoriasis – a chronic skin disease that causes itchy red patches, most commonly on the knees, trunk, elbows, and scalp.

  • Orofacial granulomatosis – another rare condition that causes swelling in the mouth and lips.

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Treatment for fissured tongue

There is no actual treatment to repair fissures or cracks in the tongue. However, fissured tongue is a harmless condition and usually has no symptoms. So, no treatment is necessary.

That said, these cracks can easily trap food and bacteria, becoming a breeding ground for infection. Because of this, it's important to practice good oral hygiene and regularly clean your tongue to help manage potential infections and avoid bad breath.

Visiting a dental hygienist for a professional cleaning is always recommended to maintain good oral hygiene. They may also recommend a topical antifungal medication if you develop a severe fungal infection in one of the fissures.

You may also consider purchasing a tongue scraper, mouthwash, or other tongue cleansing product to help remove food debris.

FAQ

What causes a fissured tongue?

Researchers still don't know why fissured tongue occurs. However, genetics may play a role. Other illnesses, such as down syndrome, psoriasis, and malnutrition, may also be linked to this condition.

Can tongue fissures be cured?

There is no cure or treatment for fissured tongue, but it rarely causes any life-threatening symptoms. The best way to manage uncomfortable symptoms is to keep the cracks clean and free from debris. It's also important make routine visits to the dentist for professional cleanings.

What deficiency causes tongue fissures?

Some vitamin and mineral deficiencies, especially those that contribute to a person's oral health, can cause fissured tongue.

Is fissured tongue normal?

Although fissured tongue is only seen in about 5% of the population, it is still considered by many healthcare professionals to be simply a variation of normal and has no cause for concern.

Summary

Fissured tongue is a benign condition that affects about 5% of the population. It is characterized by cracks or fissures throughout the surface of the tongue. These cracks may be deep or shallow and vary widely in length and number.

There is no exact cause behind this condition. However, many other oral health issues, including geographic tongue and Melkersson-Rosenthal syndrome, have been linked to it.

Because it is rarely harmful, there is no need to "treat" fissured tongue, but keeping the tongue clean and free from debris is vital to prevent dangerous infections and other oral health issues, like bad breath and tooth decay. It's also important to book regular dental exams to maintain a healthy mouth.

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