STICK your tongue out in the mirror. Do you see any deep grooves or cracks? If so, fear not. You may have a common condition known as a fissured tongue.

What does a healthy tongue look like?

To understand what a fissured tongue is, it’s important to get a good mental picture of a healthy tongue. A healthy tongue is pink in colour and covered in tiny bumps called papillae.

The majority of these papillae are filiform papillae, which fill in most of the top surface of the tongue. 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?

Fissured tongue is a descriptor used for the appearance of the tongue when there is a change in the growth of papillae on the tongue’s top surface. These crevices can be few or many, narrow or wide, and can vary in depth measurement. Sometimes, there is a prominent crack down the centre of the tongue.

While the exact cause is unknown, this condition is more common as a patient ages, especially for older adults with dry mouth.

Other tongue conditions

Geographic tongue (clinically called benign migratory glossitis) and median rhomboid glossitis are two additional conditions that affect the appearance of the tongue.

Geographic tongue occurs when the papillae are inflamed and form an abnormal pattern on the tongue that cause it to look like continents on the surface of the globe. The condition is closely associated with fissured tongue and may be hereditary.

Median rhomboid glossitis occurs when the centre section of the tongue is missing the papillae projections.

These conditions, as well as fissured tongue, are generally harmless and can be safely monitored with a routine assessment by a dental professional.

Conditions associated with fissured tongue

Fissured tongue is sometimes associated with certain syndromes, particularly Down syndrome and Melkersson-Rosenthal syndrome.

Down syndrome, also called trisomy 21, is a genetic condition that can cause a variety of physical and mental impairments. Those with Down syndrome have three copies of chromosome 21 instead of two.

Melkersson-Rosenthal syndrome is a neurological condition characterised by a fissured tongue, swelling of the face and upper lip, and Bell’s palsy, which is a form of facial paralysis.

In rare cases, fissured tongue is also associated with certain conditions, including:

• malnutrition and vitamin deficiencies;

• psoriasis; and

• orofacial granulomatosis, a rare condition that causes swelling in the lips, mouth, and area around the mouth.

Should you be worried if you see fissures?

If you ever stick your tongue out in the mirror and see some little deep cracks on the surface, it’s likely they are nothing to worry about. Most often there is no pain associated with the condition, and it is not contagious. However, since the deeper grooves can collect more bacteria, fungal species and food particles, it is very important for patients who experience these cracked areas to adequately clean the tongue at least once a day. Incorporate this habit as part of your routine of brushing your teeth twice a day and flossing daily.

Plus, good oral hygiene reduces the risk of bad breath that can stem from the growth of microorganisms on the tongue. Routine visits to your dental professional can provide you with early detection of deviations from normal tongue papillae and other oral conditions.

Dr Sharon Robinson, DDS has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.