Cracked Tongue (Fissured Tongue): Causes, Care and When to Worry

01Basics

What a fissured tongue is

In a fissured tongue, the top surface has grooves that can run in different directions, often with a deeper central groove. The grooves are usually painless and may be more visible when the tongue is stretched out. The rest of the tongue looks and works normally, and taste is not affected.

Fissured tongue can be present from childhood and often becomes deeper with age. It is considered a variation of normal rather than a disease.

02Causes

Why the tongue cracks

• Genetics and age: the most common factors; it often runs in families.
• Geographic tongue: smooth red patches that change position; the two often occur together.
• Psoriasis: fissured and geographic tongue are more common in people with psoriasis.
• Genetic conditions: such as Down syndrome and, rarely, Melkersson-Rosenthal syndrome.
• Dry mouth: a very dry tongue can look cracked; causes include mouth breathing, medicines and Sjögren’s syndrome.

03Other cracks

Cracks that appear suddenly

• Dehydration and dry mouth: the tongue looks dry and fissured, often with thirst.
• Vitamin deficiencies: low iron, vitamin B12, folate or riboflavin can cause a smooth, sore or cracked tongue.
• Oral thrush: white patches and soreness, sometimes with cracks.
• Irritation: from very spicy or acidic foods, strong mouthwashes or toothpaste ingredients.

See also mouth breathing and bumps on the back of the tongue.

04Symptoms

Symptoms

• Grooves on the top of the tongue, usually painless.
• Sensitivity or burning with spicy, salty or acidic foods in some people.
• Bad breath if food and bacteria collect in the grooves.
• Occasional soreness if the grooves become inflamed or infected.

05Care

How to care for a cracked tongue

• Brush the top of the tongue gently with a soft toothbrush or tongue cleaner once or twice a day.
• Rinse with water after meals to clear food from the grooves.
• Drink enough water and avoid mouth breathing at night if possible.
• Use a mild toothpaste and alcohol-free mouthwash if the tongue is sensitive.
• Limit very spicy, salty and acidic foods if they cause discomfort.
• See a dentist regularly.

See home remedies for bad breath.

06Treatment

Does a fissured tongue need treatment?

No specific treatment is needed for a harmless fissured tongue. When it is sore, the cause of the irritation is treated: antifungal medicines for thrush, supplements for confirmed deficiencies, saliva substitutes and treatment of the cause of a dry mouth, or avoiding irritating foods.

A doctor, dentist or ENT specialist can examine the tongue and order blood tests if a deficiency is suspected.

07Children

Cracked tongue in children

Fissured tongue can be seen in children and is usually harmless. A cracked, dry tongue in a child with fever, reduced drinking or fewer wet nappies can be a sign of dehydration and needs prompt attention. A very red tongue with fever in a child may need assessment for other conditions; see strawberry tongue.

08Diet

Diet and hydration for a sore, cracked tongue

• Drink water regularly through the day and keep a glass by the bed if your mouth gets dry at night.
• Include foods rich in iron, B12 and folate: meat, fish, eggs, dairy, legumes, leafy greens and fortified cereals.
• Choose soft, cool foods when the tongue is sore.
• Limit alcohol and tobacco, which dry and irritate the mouth.
• Sugar-free gum can stimulate saliva.

09Dentist

What a dentist or doctor checks

At a check-up, the dentist looks at the tongue, gums and mouth lining, and can tell a harmless fissured tongue from other conditions. If cracks are new, painful or come with other symptoms, a doctor may take a swab for thrush or order blood tests for iron, B12 and folate.

11Summary

Key points to remember

• Fissured tongue is common, harmless and often runs in families.
• It is often seen with geographic tongue and in people with psoriasis.
• Gentle tongue cleaning prevents soreness and bad breath.
• Persistent sores, patches or lumps on the tongue need checking.