Causes, Effects, and Signs of Fissured Tongue

Fissured tongues vary greatly in appearance. However, they all feature grooves between two and six millimeters in depth, typically in the middle section of the tongue, though they can spread across the surface. While the grooves may look unnerving, they are often painless. However, food can enter the grooves and cause inflammation, a burning sensation, and halitosis.

While research is ongoing, there is still no conclusive evidence pinpointing the exact cause of fissured tongue. Studies of families show that the condition may be inheritable. Researchers have also noticed a few conditions that seem to appear more often in people with fissured tongues. It is unclear what degree of correlation the conditions have with fissured tongues.

Some of the most common underlying conditions with direct ties to fissured tongues are Melkersson-Rosenthal syndrome and Down syndrome. A person with Melkersson-Rosenthal syndrome experiences facial nerve paralysis and enlargement of the soft tissues of the mouth and lips called orofacial granulomatosis. Down syndrome typically involves physical growth delays and mild to moderate intellectual development issues.

Many people who have fissured tongues also develop geographic tongue, an inflammatory condition that affects the top of the tongue. On a normal tongue, small, hair-like bumps called papillae cover the surface. A person with geographic tongue has sections of smooth, red areas because they lack papillae. While often harmless, geographic tongue can sometimes cause sensitivities to spices, salt, or even some sweets. It is unclear how fissured tongue and geographic tongue are related.

While the direct cause is unknown, fissured tongue does have a few risk factors. While the condition can occur at any age, it affects older people more frequently. As a person ages, the fissures may also become deeper. People with a family history of fissured tongue are also more likely to have the condition. Some studies suggest that conditions such as psoriasis and functional dyspepsia increase the risk of developing fissured tongue.

Because fissured tongue is usually clearly visible, doctors can diagnose the issue with a simple clinical assessment. In some cases, a medical expert may perform tests to ensure there are no underlying conditions or to exclude other possible issues. The most common diagnostic test is a biopsy, though blood or urine tests are also possible.

Most cases of fissured tongue do not require any treatment. However, maintaining proper oral care is a necessity. Brushing the top of the tongue can clean the fissures and remove any remaining food debris. This prevents bacteria and plaque that can contribute to bad breath or tooth decay. Dentists or oral hygienists may recommend a specific cleaning plan for some people with fissured tongues.

Because fissured tongue is typically harmless, it tends to have very little effect on a person’s life. The few exceptions are when there is an underlying condition, such as Melkersson-Rosenthal syndrome, or when the fissures develop an infection. People with fissured tongues should visit a doctor or dentist if they feel odd sensations on their tongues or if the fissures bleed.

Fissured tongue is a common condition affecting between 6.8 and 11% of people. Research shows that it is more common in males than females. Additionally, the prevalence jumps significantly with age. Around 40% of the population over the age of 40 has fissured tongues. The condition is not contagious.

A few studies have recommended further classification systems for fissured tongue. The belief is that by classifying the condition, doctors may more easily discover any correlations with other conditions. One study suggested classifying the fissures by location on the tongue and noted that central fissuring is the most common type. Many health groups classify the condition by number and size of grooves rather than location.