A young man brushing his teeth and tongue in front of the bathroom mirror

What Is a Fissured Tongue?

Stick your tongue out in the mirror. Do you see any deep grooves? Would you consider your tongue "cracked" looking? If so, fear not! You may have a common condition known as a fissured tongue. If you're just now noticing that your tongue has some abnormal creases or grooves, it may be the first time you've really considered your tongue.

As arguably the strongest muscle in your body, your tongue is usually one texture, with small little dots covering its top surface. While we're generally concerned with keeping our teeth and gums clean, the tongue is a critical part of our oral cavity too. So now that you're noticing some unusual creases in yours, you may have questions about how to get rid of a fissured tongue, what causes it, and if it's related to other health conditions.

What Does a Healthy Tongue Look Like?

To understand what a fissured tongue is, it's essential to get a good mental picture of a healthy tongue. A healthy tongue is pink in color and covered in tiny bumps called papillae. The majority of these papillae are filiform papillae, which fill in most of the tongue's top surface. Other types of papillae include foliate, fungiform, and circumvallate papillae. The various papillae can grow and change at different rates, often changing the appearance of the tongue's surface.

What Is a Fissured Tongue?

We use the term "fissured tongue" as a descriptor for the tongue's appearance when there is a change in papillae's growth on its top surface. According to the American Academy of Oral Medicine (AAOM), a fissured tongue appears in about five percent of the U.S. population. Its defining characteristic, cracks, and crevices can vary widely in number, length, and depth. There is even sometimes a prominent crack down the center of the tongue.

This condition can develop in childhood, but the creases and cracks tend to deepen with age. A fissured tongue is more common as we age, especially for older adults with dry mouth, notes the AAOM. And while seeing deep creases in your tongue may be alarming at first, note that they are harmless. Don't worry about outside factors deepening or worsening your fissured tongue. You do not need to change your diet or stay away from specific oral care devices because of this condition.

Other Tongue Conditions

While the exact cause of a fissured tongue is unknown, genetics could play a role. A fissured tongue may have links to several other health conditions:

  • Orofacial granulomatosis
  • Down syndrome
  • Pustular psoriasis
  • Melkersson-Rosenthal syndrome
  • Malnutrition

Besides the above conditions, two other disorders can affect the tongue's appearance:

  • Geographic tongue, also known as benign migratory glossitis, occurs when the papillae become inflamed. This condition has earned the name "geographic" tongue because the papillae form an abnormal pattern that resembles how the continents on Earth's surface look, as noted by the National Organization for Rare Disorders. The condition is associated with a fissured tongue and may be hereditary.
  • Median rhomboid glossitis occurs when the tongue's center section is missing the papillae projections. It does not seem to have a genetic connection to a fissured tongue.

Both geographic tongue and median rhomboid glossitis are generally harmless, just like a fissured tongue. They can be safely monitored with a dental professional's routine assessment.

Should You Be Worried if You See Fissures?

If you see some little deep cracks on the surface of your tongue when you look at it in the mirror, they are likely nothing to worry about. Most often, there is no pain associated with the condition, and it is not contagious. But we always recommend visiting your dental professional as they will be able to officially diagnose your fissured tongue and help put your mind at ease.

Since the deeper grooves can collect more bacteria, fungal species, and food particles, it's crucial to clean your tongue at least once a day. The only fissured tongue treatment you really need to take part in is to keep up with your rigorous oral care routine. As noted by Medical News Today, a fungal infection caused by Candida albicans could, in very rare and extreme cases, infect the deep grooves of your tongue. But Candida is the most common form of fungal infection, and your dentist can prescribe a topical antifungal medication for treatment.

It's vital to incorporate into your oral care routine the habit of cleaning your tongue. You most likely already brush your teeth twice a day and clean between your teeth with floss, a water flosser, or another interdental cleaning device once a day. You can now add a tongue scraper to your routine as a gentle cleaning tool before or after you brush your teeth. Good oral hygiene also reduces the risk of bad breath that can stem from microorganisms' growth on your tongue. So it's an all-around win to keep your tongue as clean as it can be!

And as always, routine visits to your dental professional can provide you with early detection of any oral health issues or anomalies. Your dentist and dental hygienist will be able to notice deviations from normal tongue papillae and other oral conditions. While a fissured tongue may sound alarming, it's not an indicator of your oral cavity's overall health. Continue your rigorous oral care routine and show up for your regular dental appointments as you did before. Before you know it, the minimal extra care of cleaning your fissured tongue will become second nature!

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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