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Fissured tongue

Fissured tongue is a benign condition in which deep grooves or fissures appear on the lateral sides and back of the tongue. This condition is also known as scrotal tongue, lingua plicata, plicated tongue or furrowed tongue. It is painless in most cases and it is sometimes accompanied by a burning sensation. The fissured tongue affects 2-5% of the general population and it is more frequent in males than females. Even though it may be diagnosed in childhood, it is more frequent in older people and it tends to accentuate with age.

Some studies have suggested that patients diagnosed with fissured tongue have a genetic predisposition. Most of the cases of fissured tongue are discovered through routine oral examination or by accidental findings. The condition is frequently associated with the geographic tongue (benign migratory glossitis) and it is also often encountered in Melkersson-Rosenthal syndrome and Down syndrome. No biopsy is required for the diagnosis of the fissured tongue; the clinical appearance is often times enough for the confirmation of the diagnosis.

Symptoms of Fissured tongue

These are the most common symptoms of the fissured tongue:

  • Deep grooves or fissures present on the lateral and back side of the tongue
  • Might be just one groove or several in number
  • These grooves can have a depth of 2-6 mm
  • Large central furrow is present in some patients, with small fissures extending from the central one (perpendicularly)
  • The grooves can also appear on the dorso-lateral portion of the tongue
  • Burning sensation – this appears especially when the patient drinks or eats certain foods (cold beverages, spicy foods)
  • Soreness
  • Pain
  • Redness of the tongue
  • Difficult eating and swallowing (especially if the tongue is inflamed)
  • No other part of the body is affected other than the tongue
  • The grooves can connect with each other; the tongue will appear as being split into lobes or sections
  • Debris can build up in these fissures, causing upsetting symptoms
  • Symptoms are worse in case the patient also has a geographic tongue

Causes

The exact cause that leads to the appearance of the fissured tongue has yet to be identified. Below, you will find the theories that have been suggested so far:

  • Genetic predisposition – the fissured tongue has been encountered in several members of the same family.
  • Age – the condition is more frequent in older people and it also accentuated with age.
  • Environmental factors are believed to be triggers for the fissured tongue.

Association with other medical conditions:

  • Geographic tongue – this is a condition in which the surface of the tongue has a map-like appearance.
  • Melkersson-Rosenthal syndrome – this is a rare neurological disorder, in which the patient suffers from facial paralysis, swelling in the face (including lips) and tongue fissures.
  • Down’s syndrome – this is a genetic disorder, in which there is an extra chromosome causing a wide range of medical problems, including fissured tongue. Almost all children diagnosed with Down’s syndrome have fissured tongue.
  • Pustular psoriasis – this is an uncommon form of psoriasis, in which raised bumps, filled with pus (white blood cells) appear on the skin.
  • Orofacial granulomatosis – condition in which the soft tissues in the oral area are swollen, without any pain being associated with the disease.
  • Acromegaly – this is a condition in which the anterior pituitary gland produces excessive quantities of growth hormone.
  • Sjögren’s syndrome – this is a chronic auto-immune disease in which the white blood cells practically destroy the exocrine glands (these are the lacrimal and salivary glands). The mouth is excessively dry and the tongue becomes more prone to fissures.

Other causes include:

  • Tongue inflammation
  • Poor nutrition
  • Anemia or other hematologic abnormalities
  • Oral yeast infection (caused by candida fungus)
  • Vitamin B deficiency
  • Electrolytic imbalance
  • Oral cavity or tongue injuries (especially in people who bite their tongue or those who grind their teeth)
  • Excessive intake of alcohol
  • Constant and prolonged tobacco chewing
  • Reaction to certain types of medication

Treatment for Fissured tongue

These are the most common courses of treatment undertaken for fissured tongue:

  • Mechanical tongue cleansing:
    • Recommended as part of the oral hygiene routine
    • Indicated in case of debris accumulated in the tongue fissures, causing halitosis (bad breath)
    • The regular brushing is recommended so as to remove debris accumulation, reduce irritation and also the unpleasant odor in the exhaled breath
    • The cleansing of the tongue can be performed with the toothbrush (most of them have a special part on the back of the head for such purposes) or with specific cleaning devices for the tongue that can be found in most pharmacies
  • Antibiotics and topical creams are recommended in cases of secondary infections or trauma to the tongue
  • Good oral hygiene
  • Drinking a lot of water – this is recommended to prevent excessive dryness of the mouth (if the tongue is hydrated, then there is a higher risk for fissures to appear)
  • Natural remedies – gargling with baking soda can help with the symptoms. Chewing spearmint gum can also help in some cases but there are patients who describe more irritation after doing that

In Chinese medicine, the tongue is a map that shows the entire health of the body. It is believed the deep fissures in the tongue are signs of chronic conditions. The deeper a fissure, the more chronic the condition actually is. It is believed that fissured tongue appears when a person does not drink enough water and when there is a lot of stress. Chinese specialists recommend the treatment of hormonal imbalances and guarantee an improvement of the fissured tongue.

Fissured tongue Pictures

Photos, Images and Pictures of Fissured tongue…

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Pain relief

In case there are a lot of grooves on the surface of the tongue and debris builds up in those fissures, the tongue might become irritated and painful. In such cases, apart from the mechanical cleansing of the tongue, you might be recommended anti-inflammatory medication in order to obtain pain relief. These drugs are especially recommended when there are fissures in the tongue and there is a lot of inflammation associated with the condition. Pain relief can also be obtained with the help of natural remedies as well (baking soda).


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