Fissured tongue, also known as lingua plicata or scrotal tongue or plicated tongue or furrowed tongue, is a common and a benign medical condition involving the top most surface of the tongue. Tongue which is normal and healthy has a relatively flat surface; whereas a fissured tongue, as the name itself indicates, has deep grooves/ fissures in the middle and on the sides of the tongue. The fissures can vary in size as well as depth, varying from 2 to 6 mm. Almost 20% of people all over the world suffer from fissures and grooves on their tongue.
Fissures first, usually, tend to develop in childhood; however, adults more commonly have them. Patient usually doesn't have any symptoms with a fissured tongue unless there is a buildup of debris in them. People who suffer from a fissured tongue also can have other harmless tongue disorders such as geographic tongue. Geographic tongue is a medical condition where the tongue attains a map like appearance due to absence of tiny bumps on the tongue called papillae. The regions without the papillae are red and smooth in color.
Although the fissures in the tongue may look hideous, this is usually a harmless condition and does not require treatment.
Causes & Risk Factors of Fissured Tongue
The exact cause of getting fissures on the tongue is not known. According to researchers, fissured tongue is thought to be a variation of a normal tongue. There are certain factors which are believed to increase the risk of a fissured tongue:
- Fissured tongue is thought to be hereditary. Having a family history of a fissured tongue increases the risk of it.
- The depth of the grooves increase with age.
- Environmental factors also contribute to development of fissured tongue.
- Individuals with Down's syndrome (trisomy 21) are at an increased risk to develop fissured tongue. Down's syndrome is a genetic condition which causes various mental and physical impairments. Patients of Down's syndrome, instead of having two copies of chromosome 21, have three copies of it.
- Individuals with Melkersson-Rosenthal syndrome, which is a neurological condition, are at an increased risk to develop fissured tongue. The 3 primary symptoms of Melkersson-Rosenthal syndrome are: Fissured tongue, Bell's palsy, and swelling of face and upper lip.
- Men are more susceptible to have fissured tongue than women.
Signs & Symptoms of Fissured Tongue
- There is an obvious deep groove(s) on the tongue clearly seen.
- Patient may first develop fissures on tongue during childhood; although they are more common in adults.
- Just like wrinkles, fissures on tongue also deepen with age.
- A fissured tongue is spotted if the patient has regular dental checkups.
- In a fissured tongue, the tongue appears, as if it was lengthwise split in half characterized with a deep groove in the center of the tongue with small grooves branching off it and present on the sides.
- Some grooves can connect with each other and the tongue looks as if it is divided into different sections or lobes.
- The middle region of the tongue is commonly affected, although other areas, such as the sides of the tongue can also be affected.
- Fissured tongue is not a harmful or a contagious condition.
- Patient with fissures on the tongue can also have halitosis (bad breath) due to accumulation of debris in the fissures.
- Patients with fissured tongue may also experience burning sensation of the tongue.
- Along with a fissured tongue, patient may also experience other harmless tongue disorders, such as geographic tongue. Geographic tongue is a medical condition where the tongue has a map like appearance. This occurs due to absence of papillae on the tongue. The areas which do not have these tiny bumps are red and smooth in color.
Investigations for Fissured Tongue
Having regular dental checkups helps in early detection of fissured tongue. Visual inspection is sufficient for diagnosis of fissured tongue, due to the obvious cracks/fissures/clefts/grooves seen on the tongue, especially in the middle region.
Treatment for Fissured Tongue
Treatment is not commonly required for fissured tongue, as it is a harmless/benign condition. Many researchers are of the belief that the fissured tongue is a variance of a normal tongue. Patient with fissured tongue tends to develop symptoms like irritation, if debris or dead cells are collected in the fissures. For relief of this, gentle brushing of the tongue is required. It is also important to follow good dental and oral hygiene so as to avoid plaque and bacteria from collecting in the fissures. This can also lead to bad breath (halitosis) along with an increased risk for tooth decay. It is also very important for patients with fissures on the tongue to have regular dental checkups along with following a daily dental routine, such as daily brushing and flossing. Regular visits to dentist are also a must. If patient is suffering from bad breath, then mouth washes should be used and the tongue should be gently brushed to clean the debris in the fissures of the tongue.
If patient has other medical conditions, such as Down 's syndrome and Melkersson-Rosenthal syndrome, which have caused the fissured appearance of the tongue, then the patient needs to consult a specialist.