Fissured Tongue

What is Fissured Tongue?

A fissured tongue has one or more noticeable grooves or furrows on its top surface or sides. The fissures can be shallow or deep, and most occur near the middle of the tongue. 

Also known as a plicated or scrotal tongue, fissured tongue is a common condition. About 5% of the U.S. population has a fissured tongue, and some scientists believe it’s just a variation of a normal tongue.¹

For many people, fissured tongue develops during childhood. In most cases, these original fissures get deeper with age. Fissures become increasingly common with age, especially when dry mouth is a problem.

Fissured tongue is a benign condition, meaning it’s neither harmful nor painful. However, it can be a symptom of an underlying problem. Speak to your dentist or doctor if you notice any tongue changes.

Characteristics of Fissured Tongue

Non-fissured tongues are covered in small bumps (papillae) but are relatively flat. A fissured tongue surface has deep grooves, cracks, and crevices. The center ⅓ of the tongue is most commonly affected.

Characteristics of a fissured tongue include:

• A deep fissure that runs down the center of the tongue
• Cracks and crevices on the dorsal surface (top) and sides of the tongue
• Fissures vary in depth but can be up to 6 mm deep

If food debris gets trapped in the fissures, you may experience bad breath (halitosis). Proper oral hygiene can prevent this. Otherwise, fissured tongue is an asymptomatic condition.

Fissured Tongue vs. Geographic Tongue

Geographic tongue is a harmless condition that causes red patches on the top and sides of your tongue. Also called benign migratory glossitis, this condition is so-named because the patches can look like a map.

Fissured tongue and geographic tongue often occur together and may be related.¹ Signs and symptoms of geographic tongue include:

• Red, smooth patches on the tongue that may have a raised, white border 
• Patches vary in size and shape
• Patches may come and go over days, weeks, or months
• Missing areas of normal tongue papillae (tiny bumps)
• Mild pain or a burning sensation in response to certain substances

What Fissured Tongue Looks Like (With Pictures)

Medical Images of Fissured Tongue

Fissures can vary widely in number, length, or depth. 

Causes of  Fissured Tongue

The exact cause of fissured tongue is unknown. Research suggests it’s a normal tongue variant that may have a genetic correlation.¹

Anyone can get fissured tongue, but it’s more common among males.¹ It may be present at birth or develop later in life. Older adults with dry mouth often have more prominent fissures.

Conditions Associated with Fissured Tongue

Fissured tongue may be related to another underlying condition, such as:

• Melkersson-Rosenthal syndrome — This disorder causes swelling of both or one lip, facial swelling, facial paralysis (Bell’s palsy), and a fissured tongue.
• Down syndrome — Many people with chromosomal disorders have fissured tongues.
• Sjogren’s syndrome — This autoimmune disorder causes the body to attack its moisture glands, including the salivary glands.

Rarely, fissured tongue can be related to:

• Orofacial granulomatosis — A condition that causes swelling in the mouth and lips.
• Malnutrition — A condition resulting from vitamin and mineral deficiencies.
• Psoriasis — A skin disease that causes red, scaly, and itchy patches

When to See a Dentist for Fissured Tongue

Most people with fissured tongues don’t experience symptoms. Unless you’re experiencing pain, it may not be necessary to see a dentist for this condition.

However, you should see your dentist twice a year for routine visits and professional cleanings with a dental hygienist. Maintaining a good oral care routine can help prevent bad breath that may result from the accumulation of food debris in fissures.

Diagnosing Fissured Tongue

Most people receive a diagnosis of a fissured tongue during a routine dental exam. Your dentist will examine your tongue and ask about any symptoms. They may recommend additional testing if the fissures are related to an underlying condition.

Fissured Tongue Treatment

Specific treatments to fix the problem usually aren’t needed. However, you can do several things to prevent bad breath and dry mouth associated with fissured tongue, such as:

• Use mouthwash every day
• Brush your tongue with your toothbrush at least twice a day
• Floss your teeth before bed
• Visit the dentist at least two times a year for dental cleanings and to ensure food debris isn’t causing problems
• Drink plenty of water throughout the day to wash debris from the fissures
• Chew on fennel seeds to keep your mouth hydrated

Dietary changes can also help, especially if your tongue feels irritated or hurts. Acidic, salty, hot, and spicy foods cause the most problems. 

If a cracked tongue is caused by vitamin deficiencies, evaluate your diet and consider taking supplements. 

Prognosis

Fissured tongue is a benign condition that’s typically asymptomatic. It’s considered to be a variant of normal tongue structure.

Good oral hygiene and routine dental care can help prevent bad breath and pain that may occur if food debris builds up in the fissures.

Summary

Fissured tongue involves deep grooves or crevices on the top or sides of the tongue. There can be one fissure or many. Fissures are usually asymptomatic unless food debris accumulates and causes bad breath or discomfort.

Fissured tongue is also known as scrotal or plicated tongue. It’s not the same as geographic tongue, although these common conditions often occur together.

Treatment may not be necessary. However, routine dental exams and teeth cleanings can keep bad breath at bay.