SCROTAL tongue is a condition in which fissures develop in the tongue, making it look wrinkled. The condition is also called furrowed tongue, lingua fissurata, lingua plicata, lingua scrotalis, plicated tongue, or grooved tongue.

There can be many fissures or a single groove down the middle of the tongue with fissures branching off from it. Scrotal tongue affects as much as 21 per cent of people worldwide.

People usually are born with this condition, but may not notice it until they get older. It becomes more noticeable as you age. Sometimes, scrotal tongue develops as a result of infection or malnutrition. It also is seen in people with certain health conditions, such as Melkersson-Rosenthal syndrome (a neurological disorder characterised by facial swelling, especially of the lips, nerve palsy and scrotal tongue), Down syndrome, and benign migratory glossitis, or geographic tongue, in which irregular patches of smooth or bald tongue are interspersed with rougher areas where the taste buds are normal.

Symptoms

Scrotal tongue is a harmless condition. It usually has no symptoms. Sometimes, if the grooves are deep enough, you may get a burning sensation when you eat certain spicy or acidic foods. However, this is fairly rare and if the grooves are deep enough, they may harbour colonies of bacteria or bits of food. This can lead to bad breath or fungal infections of the tongue.

Generally, people don’t even know they have scrotal tongue until their dentist tells them. Your dentist or physician can diagnose this condition by looking at your tongue. There is no way to prevent scrotal tongue. There is no treatment for scrotal tongue.

If your tongue burns when you eat, you should avoid the foods that bother you. This should include cleaning your tongue daily with your toothbrush or a tongue scraper. Scrotal tongue is a lifelong condition, but it usually does not cause discomfort or problems.

Causes

Fissured tongue may appear to occur as a primary isolated condition, as a familial disease entity, and/or in association with various underlying conditions or syndromes.

In some cases, fissured tongue is apparent at birth (congenital) due to incomplete fusion of the two halves of the tongue. In other instances, the condition may develop due to malnutrition, low levels of vitamin A, certain infections, or trauma.

Fissured tongue may also occur in association with certain underlying syndromes, including Melkersson-Rosenthal and Down syndromes.

Melkersson-Rosenthal syndrome is a rare disorder that often becomes apparent during childhood. It is characterised by paralysis of one or both sides of the face; chronic facial swelling, particularly of the lips; and fissured tongue. The syndrome usually appears to occur randomly for unknown reasons (sporadically); however, some familial cases have also been described, suggesting autosomal dominant inheritance.

Down syndrome, also known as trisomy 21 syndrome, is the most common chromosomal abnormality syndrome. In those with Down syndrome, all or a portion of chromosome 21 is present three times rather than twice in all or some cells of the body. Affected individuals commonly have a fissured tongue that appears relatively large.

In addition, reports suggest that many individuals with fissured tongue also have geographic tongue. The latter is characterised by rapid loss and regrowth of the threadlike elevations (filiform papillae) of the tongue surface, leading to the development of smooth, pinkish red patches with surrounding, thickened, whitish borders.

Treatment

No treatment is necessary except to encourage good oral hygiene, including brushing the top surface of the tongue to remove any food debris from the fissures.

Cleansing of the tongue helps prevent irritation and possible bad breath that may occur from food getting trapped in the grooves. In addition to regular toothbrushes, numerous specific devices to clean the tongue are available at most major pharmacies.

Dentists can assist patients by making recommendations concerning devices for tongue cleansing.