Cracked Tongue and Tongue Fissures: Causes and Treatments

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Cracked TongueA cracked tongue is when pronounced grooves, cracks, or fissures appear on the tongue’s surface. A cracked tongue may be sore, sensitive to certain foods, tingly, or feel completely normal other than the obvious texture differences.

Although it’s a very specific symptom, cracked tongue causes come from a surprisingly varied pool. For instance, a cracked tongue can indicate a thrush infection, or it might be a sign of a deeper problem within the body.


Characteristics of a Cracked Tongue

A fissured tongue tends to appear with an obvious central crack running down the middle, with smaller ones branching off or encroaching in from the sides. Beyond this, there are several additional characteristics that may occur:

  • The cracks and grooves are only present on the tongue and not other parts of the mouth.
  • There may be soreness, pain, a burning sensation, or a feeling of “pins and needles.”
  • The tongue fissures may be shallow or several millimetres deep.
  • Acidic or spicy food may provoke a burning or painful sensation.
  • The tongue may appear red.

Who Can Get a Cracked Tongue?


Many of the causes of a cracked tongue do not discriminate based on age, gender, or ethnicity, so anyone can potentially develop one. That said, some underlying causes have their own risk factors which can influence who is most susceptible.

For instance, oral thrush is more common in anyone with an impaired immune system including those with autoimmune diseases or poorly controlled diabetes. Aging can also cause the tongue’s natural wrinkles to be more pronounced.

What Does a Cracked Tongue Reveal about Your Health?

If you’re looking solely at a cracked tongue for health answers, you’ll have a hard time finding them. A cracked tongue diagnosis usually requires looking at more than just the grooves and fissures and often involves inspecting your body and/or mouth for other symptoms. That said, there are two specific conditions that can be assessed by looking at just the tongue cracks.

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Geographic Tongue

The tongue is normally coated in a series of tiny, pinkish-white bumps called papillae. Geographic tongue is a condition where patches of the tongue are missing these papillae and appear as smooth “islands” that give a map-like (“geographic”) appearance.

As the papillae in one area recover and then fade in another, it can give the illusion that the patch is moving over time. The absence of the papillae can make the natural grooves in the tongue more pronounced and the patches may hurt if you eat salty, spicy, or acidic foods.

Vitamin Deficiency

Cracked tongue from a vitamin deficiency takes two main forms: iron or a vitamin B12 (biotin). Both substances are used to mature the tongue’s papillae and lacking in one or both can result in large, smooth patches developing on the tongue.

As with geographic tongue, the smooth patches will make the natural fissures in the tongue more noticeable.

Is a Cracked Tongue Linked to Other Diseases?

Most causes of a cracked tongue are not linked to actual disease or infections, but there are a few outliers that bear mentioning.

Oral Thrush

As mentioned initially, a cracked tongue can be a symptom of a thrush infection, which is brought about by an overgrowth of Candida fungus, which is naturally found on the tongue. The lumpy, white lesions can spread to the gums or elsewhere in the oral cavity and can cause pain or throw off your sense of taste.

Oral thrush is largely an opportunistic infection, which means it is more prone in babies, the elderly, or those with already compromised immune systems.

Black and Hairy Tongue

Yes, this is the actual name of the condition and it’s a fairly apt description. As mentioned above, your tongue is coated in a layer of papillae, which grow over time like hairs. Although normally worn down by chewing and drinking, papillae can sometimes become overgrown and get discolored as bacteria or food particles take up residence.

It’s most common in those who smoke, drink coffee or tea, or have poor dental hygiene. Black and hairy tongue technically counts as a disease since it can be caused by bacteria, but the bacteria themselves don’t actually do anything besides give you an unfortunate dye job.

Tongue Cancer

Tumors can form almost anywhere in the body and your tongue is no exception. Tongue cancer can present as a persistent red lump or lesion that doesn’t show signs of going away. The sections of tongue around the tumor can become painful, cracked, and swollen in response to the growth.

It’s important to get evaluated if you suspect that a lesion on your tongue is not being caused by a canker sore or more benign condition.

Other Causes of a Cracked Tongue

Melkersson-Rosenthal Syndrome

This is a rare neurological disorder that doesn’t have a known cause and results in a fissured tongue about 20% to 40% of the time, among other symptoms. Melkersson-Rosenthal presents with the swelling of the lips (one or both), one or more cheeks, eyelids, and in rare cases entire sides of the scalp.

The swollen lips can also become cracked and painful. As the salivary glands get impaired during these episodes, the sense of taste will be reduced as well. About 30% of the time, Bell’s palsy (partial facial paralysis) will arise. The swelling does normally go away within a few hours or days, but it can also get worse and even become permanent.

Down Syndrome

This is a chromosomal disorder that results in intellectual disability and often causes distinctive facial features, short neck and limbs, and low muscle tone. For unclear reasons, about 80% of those with Down’s syndrome also have fissured tongues, compared to two to five percent of the population at large.

Sjogren’s Syndrome

This is an autoimmune disorder where the body attacks its own moisture-producing glands. As the salivary and tear glands are damaged, symptoms like a sore and cracked tongue, dry mouth, fatigue, joint pain, and burning or itchy eyes will develop.

Sjogren’s does not have a clear cause but the current assumption is that it’s a mix of genetic predisposition and environmental exposures to certain infections.

Trauma

Your tongue can be subject to a surprising amount of abuse ranging from brushing too aggressively to being routinely poked by a chipped tooth or orthodontic hardware. These forms of constant friction can lead to the development of cracks and fissures in the tongue’s surface.

A similar effect can happen if you regularly grind your teeth. Since some people grind their teeth when they sleep, you may not realize this is the cause without help.

Tobacco or Alcohol

Heightened alcohol consumption can irritate the tongue and lead to the development of cracks over time. Chewing tobacco, in addition to being a possible cause of black and hairy tongue, is also capable of causing cracks after prolonged use.

Dehydration

A cracked tongue is one of many symptoms you will experience during dehydration. As the tongue is deprived of moisture and dries up, the natural grooves and fissures will become heavily pronounced.

Symptoms of a Cracked Tongue

 

  • Discoloration, including red, white, or yellow tongue patches
  • Pain (possibly a throbbing or burning)
  • Aggravation when spicy, acidic, or salty foods are eaten
  • Lumps or lesions on the tongue, or nearby in the mouth
  • Bad breath
  • Swelling in other areas of the face or mouth
  • Muscle weakness
  • Swelling within the cracks themselves—a possible indication of cancer

How Is a Cracked Tongue Diagnosed?

A cracked tongue diagnosis usually involves looking at the tongue to see what else is occurring alongside the cracks. Most causes of a cracked tongue have distinctive and telltale symptoms, so a visual inspection followed by a medical history can accurately determine most culprits.

If the cause is not immediately apparent and there is reason to suspect an underlying condition, certain tests may be run as well. For instance, a biopsy of a lesion may be taken to determine if it’s cancerous, and a biopsy of a swollen lip might be used to identify Melkersson-Rosenthal syndrome. A blood sample may be taken to identify any nutritional deficiencies.

How Do You Relieve a Cracked Tongue?

Once a cause is identified, remedies can be used to cure your cracked tongue. It’s worth pointing out that most causes of a cracked tongue do resolve on their own without treatment, but this may happen at too slow a rate for your liking. When cracked tongue remedies are sought, the following can commonly be employed.

1. Proper Dental Hygiene

Even if you don’t have black and hairy tongue specifically, the pronounced grooves and fissures of a cracked tongue create lots of room for bacteria to hide out. Making sure to regularly brush your teeth and, if necessary, use a tongue cleaner, can be a good way to keep microorganisms and food particles out of the crevices and prevent their growth.

Using a soft toothbrush and gentle motions is advised. Some flavors of toothpaste have been known to irritate sensitive tongues, so if you find that your normal toothpaste is causing you trouble, consider switching to one with a milder flavor, like spearmint.

2. Water

Proper hydration is not as common as you might think and you may be depriving your tongue of necessary moisture levels without realizing it. Take care to get proper fluid intake and drink a few glasses of water each day.

3. Avoid Irritants

If you have a lesion on your tongue, chances are that it’s going to be extra sensitive to salty, spicy, or acidic foods. Avoid these until the cracks in your tongue resolve, since the more it gets aggravated the longer the condition will stick around. If the irritation is coming from a physical object in your mouth, like a chipped tooth or brace, keeping your tongue away from further trauma may be easier said than done.

Talk to your orthodontist or dentist about possible solutions that can make these surfaces less prone to poking at your tongue. If you grind your teeth in your sleep, your dentist can help you acquire a mouth guard to wear during the night.

4. Dietary Changes

If your tongue troubles are from a biotin or iron deficiency, boost your intake of chicken, eggs, mushrooms, cauliflower, and other foods rich in the necessary nutrients. Try cutting back on coffee, tea, alcohol, or tobacco, since these can irritate your tongue and promote staining in certain cases.

5. Medication

Oral thrush is treated with anti-fungals, and some cases of black and hairy tongue can be remedied with antibiotics. In cases of discomfort, as caused by geographic tongue for example, your doctor may recommend certain over-the-counter pain relievers or mouth rinses that contain anesthetic.

Melkersson-Rosenthal is treated using NSAIDs and Sjogren’s often calls for certain stimulants and artificial tears.

Preventative Measures to Avoid a Cracked Tongue

  • Maintain proper dental hygiene.
  • Avoid biting your tongue or running it against pointy objects in your mouth.
  • Get adequate biotin and iron intake.
  • Cut back on or quit smoking or chewing tobacco.
  • Reduce the amount of alcohol, coffee, or tea you drink.
  • Stay hydrated.

A cracked tongue can be a surprising condition to suddenly find yourself facing, but the good news is that most cases are more cosmetic than harmful. Don’t be afraid to talk to your doctor if any tongue lesions don’t seem to be going away or if the discomfort or pain is getting too much to bear on your own.

Also Read:

Pimple on Your Tongue: Treating Your Lie Bumps

Tongue Ulcers: Causes and Treatments

Sources for Today’s Article:
“Cracked Tongue,” Med-Health web site; http://www.med-health.net/Cracked-Tongue.html, last accessed March 23, 2016.
Thompson, S., “Cracked, Sore Tongue,” Livestrong web site, last updated August 16, 2013; http://www.livestrong.com/article/319694-cracked-sore-tongue/, last accessed March 23, 2016.
“Geographic Tongue: Definition,” Mayo Clinic web site, July 25, 2013; http://www.mayoclinic.org/diseases-conditions/geographic-tongue/basics/definition/con-20027435, last accessed March 23, 2016.
“Melkersson Rosenthal Syndrome,” NORD web site; http://rarediseases.org/rare-diseases/melkersson-rosenthal-syndrome/, last accessed March 23, 2016.
Kloss, K., “9 Surprising Secrets Your Tongue Can Reveal About Your Health,” Reader’s Digest web site; http://www.rd.com/health/conditions/tongue-disease-signs/, last updated March 23, 2016.