Fissured Tongue

What is Fissured Tongue?

Fissured tongue is non cancerous condition that affects the apex of your tongue. A healthy tongue is fairly flat. Fissured tongue is characterized by a deep groove at the center. Small fissures may also appear across the tongue making it to have a furrowed look^{2, 5}.

Your tongue may have many fissures of different sizes and depth. This condition affects men more than women and its severity tends to increase with age. Fissured tongue is common across the populations globally but it varies with geographical locations. Medical research studies have reported at least 30% of fissured tongue cases among populations in the world.

Causes

Medical studies have not yet identified the real cause of fissured tongue. However, there are a number of factors and medical conditions that researchers believe cause fissured tongue: They include^{2, 4, 5}:

Genetic factors

Studies have shown that fissured tongue is found in family members. This means it can be passed from infected parents to the child.

Down syndrome

Down syndrome is a genetic disorder condition. It occurs when a baby is born with an additional copy of Trisomy 21 or chromosome 21. This may slow down mental and physical developments of the baby leading to deformities.

Normally, both parents contribute their genes to their offspring. These genes are transmitted in chromosomes. During formation of the baby, the baby’s cells are supposed to receive 23 chromosomes from each parent so as to have a total of 46 chromosomes.

In babies with Down syndrome, one of the chromosomes does not split properly. As a result the baby ends up with an extra copy of chromosome. This additional copy affects the baby’s mental and physical features from developing properly.

Beside genetic factors, there are a number of risk factors that can increase the chances of a parent to give birth to a baby with Down syndrome. Parents who are 35 years of age and above are more likely to have Down syndrome babies. Another risk factor is when you come from a family with Down syndrome; you are also vulnerable to this disorder.

Babies born with Down syndrome usually have a bulging tongue, flat face facial features, small neck, head and ears, among others.

Melkersson-Rosenthal syndrome

This is a rare condition that affects your nervous system. It is marked by swellings of the lips and face, formations of furrows and folds in the tongue, cyclic facial paralysis. Melkersson-Rosenthal syndrome starts during childhood or early in puberty or adolescence. After cyclic attacks of this disorder, swellings may continue forming and become permanent. This can cause your lips to crack and become fissured.

Causes of Melkersson-Rosenthal syndrome are unknown but studies associated it to genetic factors. It can also occur as a symptom of other underlying medical conditions such as Crohn’s disease.

Symptoms

People with a fissured tongue can have numerous fissures in their tongue. The tongue appears as if it is divided into two and sometimes it is cracked. The tongue usually has a large groove at the center which is visible. The central section of the tongue is usually affected but other parts of the tongue can be affected as well.
Apart from fissured tongue, you may also experience a geographic tongue abnormality. In this condition, your tongue will be missing papillae in some of its sections. The areas lacking papillae are smooth and red with partially raised margins.
Both fissured tongue and geographic tongues are not harmful and cannot be spread from one person to another. But they can make you unease and elevate your sensitivity to certain substances. Fissured tongue may become painful when food gets stuck in the groove.^{1, 3}

Diagnosis

Diagnosis of fissured tongue is done through a careful clinical analysis of the condition. Clinical analysis is also done to exclude other related conditions. In case Down syndrome is the cause of fissured tongue or your family members have a history of this condition, you may consider going for screening. Parents above 35 years can go for Down syndrome evaluation if they are expecting a child^{1, 5}.

The tests can be conducted during the first trimester and second trimester of pregnancy. In these tests, your doctor performs an ultrasound and blood tests to look for Down syndrome in the fetus during the first trimester. This can be followed by ultrasound evaluation and quadruple marker screen tests to spot Down syndrome and other abnormalities in the brain and spinal cord.

Another test your doctor can conduct during pregnancy is amniocentesis. In this test, your doctor takes a sample of the mother’s amniotic fluid and assesses it to determine the number of chromosomes the baby has.

After birth, the baby can undergo tests such as a blood test called karyotype to confirm diagnosis of Down syndrome.

Treatment/Cure/How to Get Rid?

Fissured tongue does not usually need any form of treatment. However, there are self-care tips that can help you prevent infections in the tongue: These self-care tips include^{2, 3}:

Brush your tongue regularly to eliminate any food material trapped in the groove that is causing pain and irritation. Microorganisms such as bacteria and fungi may be present in the fissures where they can cause tooth decay and bad breathe. Brushing your tongue will ease pain and stop infections in your tongue and other parts of your body as well as prevent tooth decay.
Visit a dental clinic near you for checkup at least once a year. This will help prevent infections and promote healthy teeth.

Successful management of fissured tongue is also based on treating underlying medical conditions such as Down syndrome. Although there is no cure for Down syndrome condition, you can manage it through a supportive therapy. Such supportive therapies are found in school institutions where your child can be supported to cope with this condition. Your child will be taught motor, sensory and social skills as well as language capabilities. This will offer your child with best socialization environment and help your child develop vital life skills⁵.

You also need to be close to your doctor if you are parenting a child with Down syndrome. Your doctor can help provide medical assistance that makes your baby lead a productive life.

For Melkersson-Rosenthal syndrome as a cause of fissured tongue, your doctor will inject steroids in the affected area to alleviate symptoms.

Pictures

Pics, Photos & Images of fissured Tongue

Reference List

https://www.sharecare.com/health/tooth-and-mouth-disorders/what-causes-fissured-tongue
https://www.dermnetnz.org/topics/fissured-tongue
https://www.healthline.com/symptom/fissured-tongue
Fissured tongue. http://emedicine.medscape.com/article/1078536-overview
Down syndrome. https://www.healthline.com/health/down-syndrome#treatment7