Fissured Tongue

What is a Fissured Tongue?

A fissured tongue occurs when someone has deep grooves on their tongue’s surface or sides. It can be several small grooves or one large groove down the center.

For many people, fissured tongue develops during childhood. In most cases, these original fissures get deeper with age. Fissures can also develop as someone ages, especially when dry mouth is a problem.

According to the American Academy of Oral Medicine (AAOM), only about five percent of the U.S. population has a fissured tongue.1

Fissured tongue is neither harmful nor painful. However, it can be a symptom of a health condition. It's important to speak to your dentist or doctor if you notice this or any other changes in your tongue.

What a Fissured Tongue Looks Like (With Pictures)

Non-fissured tongues are covered in small bumps but are relatively smooth. A fissured tongue has deep, noticeable grooves, cracks, and crevices. 

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Images of Fissured Tongue (Warning: Contains Medical Images)

Depositphotos 430965280 XL scaled

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

Causes of a Fissured Tongue

The exact cause of a fissured tongue is unknown. However, it is usually related to one of the following:

  • Geographic tongue: Occurs when the tongue is missing the papillae, which are the tiny pink or white bumps coating most people’s tongues. When these are missing, fissures that may be present beforehand become more visible.
  • Benign migratory glossitis: This condition occurs in approximately 3 percent of the total population. People with this condition have fissured tongues and also experience increased sensitivity to hot or spicy food. Often tongue lesions also develop.
  • Melkersson-Rosenthal syndrome: This disorder weakens facial muscles, and causes swelling of both or one lip, swelling of the face, and a fissured tongue.
  • Down syndrome: Many people with chromosomal disorders have fissured tongue
  • Folic acid: This nutrient aggravates existing cracks or toes and can also cause the faster formation of tongue cracks. Fissured tongue can develop during pregnancy due to the use of folic acid supplements.
  • Biotin: Biotin (B12) deficiency causes fatigue, paleness, and cracking on the surface of the tongue.
  • Iron: Iron deficiency causes fissured tongue.
  • Ariboflavinosis: Also known as a riboflavin deficiency, this condition can cause swelling and soreness of the throat, cracked skin at the corners of the mouth, and a swollen or cracked tongue. Swelling tends to aggravate fissured tongues.
  • Tongue bites: Biting your tongue on purpose or by accident can cause cracks or fissures or cause existing cracks or fissures to worsen.
  • Cuts: Cutting your tongue on sharp bites of food, chipped or jagged teeth, or other items can cause cracks to develop.
  • Teeth grinding: People who grind or rub their teeth together tend to be at higher risk of having a fissured tongue.
  • Genetics: Fissured tongue can be inherited
  • Sjogren’s syndrome: This is an autoimmune disorder that causes the body to attack its moisture glands, including the salivary glands.

Several things can worsen an existing fissured tongue, including:

  • Trauma: Exposing your tongue to a lot of friction causes cracks and fissures to worsen. The most common cause of tongue trauma is too-vigorous brushing.
  • Tobacco and alcohol: These substances irritate your tongue and cause cracks to form or worsen over time. Chewing tobacco also presents a problem and can cause the tongue to look black, hairy, and cracked.
  • Dehydration: Not drinking enough water causes the natural grooves in your tongue to dry up.

Signs of a Fissured Tongue

Signs of a fissured tongue include:

  • Appearance of the tongue being split in half
  • Cracking
  • Grooves
  • Crevices
  • Missing normal tongue papillae (normal tiny bumps on the tongue)
  • Foul-smelling breath when food and debris gets stuck in the tongues grooves 

Related Conditions 

The conditions most often associated with a fissured tongue include:

  • Down syndrome (trisomy 21): A genetic condition caused by additional copies of chromosome 21 that causes several mental and physical impairments including fissured tongue.
  • Melkersson-Rosenthal syndrome: A neurological condition that causes swelling of the face and upper lip, facial paralysis, and fissured tongue.
  • Orofacial granulomatosis (OFG): A condition that also causes swelling in the mouth and lips.
  • Malnutrition: A condition resulting from vitamin deficiencies.

Potential Complications of a Fissured Tongue

There are several complications that can occur due to tongue fissures, but most are avoidable. They include:

  • Oral health issues
  • Burning sensation or overall discomfort on the surface of the tongue
  • Bad breath

It is rare to have taste or speech changes unless there is a serious condition associated with the tongue. Most cases of a fissured tongue are asymptomatic. 

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Diagnosing & Treating a Fissured Tongue

Most people receive a diagnosis of a fissured tongue during a routine dental exam. Regular dental checkups are especially important if you have a fissured tongue because of keeping the tongue free of debris and irritation.

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

  • Use mouthwash every day
  • Brush your tongue with your toothbrush at least twice a day
  • Floss
  • 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 well-hydrated

If your tongue feels irritated, try drinking aloe Vera juice or gel.

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

Some people find that avoiding coffee and black tea helps them.

If a cracked tongue is caused by or worsened by vitamin deficiencies, supplement your diet with iron and/or biotin. Eating foods high in these vitamins can restore tongue health. 

Foods high in biotin and iron include:

  • Chicken
  • Eggs
  • Mushrooms
  • Beans
  • Spinach
  • Cheese
  • Almonds
  • Cauliflower

Resources

(1) “Fissured Tongue.” The American Academy of Oral Medicine. www.aaom.com.

(2) “What Is Fissured Tongue?” www.colgate.com.

(3) Assimakopoulos, Dimitrios, et al. “Benign Migratory Glossitis or Geographic Tongue: An Enigmatic Oral Lesion.” The American Journal of Medicine, vol. 113, no. 9, 15 Dec. 2002, pp. 751–755, 10.1016/S0002-9343(02)01379-7.

(4) Redman, Robert S. “Nutritional Deficiencies and Geographic Tongue.” Journal of Chronic Diseases, vol. 17, no. 7, July 1964, pp. 627–630, 10.1016/0021-9681(64)90086-4.  

(5) “Melkersson-Rosenthal Syndrome Information Page | National Institute of Neurological Disorders and Stroke.” www.ninds.nih.gov.

(6) Sheetal, Aparna. “Malnutrition and Its Oral Outcome – a Review.” JOURNAL of CLINICAL and DIAGNOSTIC RESEARCH, 2013, 10.7860/jcdr/2012/5104.2702.

(7) “Tongue Fissures: Possible Causes and Treatments.” American Celiac, 5 June 2021.

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