Fissured Tongue (Scrotal or Plicated Tongue)
A fissured tongue has deep grooves or cracks across the top, often one long crease down the middle with smaller ones branching off to the sides. Plenty of people only notice it when they catch it in the mirror, or when a dentist or hygienist points it out. It can look alarming the first time you really see it. It's almost always a harmless variation of normal, and it's one of the most common tongue findings we see.
Fissured tongue is a harmless variation in which the top of the tongue has deep grooves or cracks, often one down the middle with smaller branches. It isn't contagious or cancerous, and it tends to deepen with age. Most people need no treatment. Brush the grooves gently each day so food and yeast don't collect. See a dentist if it burns, hurts, or one crack looks like an open sore.
Not sure this is what you have? Answer five quick questions in our mouth spot checker. It compares what you see with more than 40 common conditions and tells you how soon to have it looked at.
- What a fissured tongue looks like
- Fissured tongue causes
- Fissured tongue vs. geographic tongue
- Other cracks in the tongue
- Does fissured tongue hurt?
- Can it go away?
- How to clean a fissured tongue
- Treatment and home remedies
- What a dentist can do
- Keeping the grooves comfortable
- Kids, dentures, and medical conditions
- When to see a dentist
- FAQ
What does a fissured tongue look like?
No two fissured tongues look quite the same. The grooves vary in number, depth, and direction. Common patterns include:
- One deep central groove running from the back of the tongue toward the tip.
- Smaller side grooves branching off the middle one, a bit like the veins of a leaf.
- Lots of shallow, crisscrossing creases that make the surface look wrinkled or pebbly.
The tissue in and around the grooves is usually the same pink color as the rest of the tongue. The tongue moves, tastes, and feels normal. If you gently spread a groove apart, the bottom should look pink and intact, not raw, bleeding, or white.
Searching for fissured tongue pictures can be confusing, because the photos range from barely-there creases to grooves deep enough to hide a grain of rice. Both ends of that range are normal. What matters more is the color and comfort of the tissue.
Fissured tongue causes: why the grooves form
Nobody knows exactly why some tongues fold into deep grooves and others don't. What we do know:
- It runs in families. If a parent has a fissured tongue, there's a good chance you will too. So yes, fissured tongue appears to be at least partly genetic.
- It deepens with age. The normal shallow line down the middle of the tongue tends to get deeper over the years. Fissured tongue is uncommon in young children and much more common in adults.
- It often goes along with geographic tongue. Some researchers think years of geographic tongue may lead to grooves forming. Our geographic tongue page covers those wandering red patches.
- Dry mouth seems to make it more noticeable. A dry tongue looks more cracked, and fissuring is more common in people with chronic dry mouth.
Conditions linked to fissured tongue
Most people with a fissured tongue are perfectly healthy. It is seen more often in people with:
- Down syndrome. Fissured tongue is one of the most common mouth findings in people with Down syndrome.
- Psoriasis. Studies find more fissured tongues in people with this skin condition than in people without it.
- Sjögren's disease and other causes of long-term dry mouth. See Sjögren's and the mouth.
- Melkersson-Rosenthal syndrome, a rare condition that combines a fissured tongue with recurring lip or face swelling and episodes of facial nerve weakness. If you have swelling or facial drooping too, tell your physician.
Cracks in the tongue and vitamin deficiency
Searches for "cracks in tongue vitamin deficiency" are common, and the answer is a little nuanced. Low B vitamins, iron, or folate don't typically cause the permanent grooves of a fissured tongue. They cause glossitis: a tongue that turns smooth, red, swollen, and sore as the tiny bumps on top flatten out. A swollen, inflamed tongue can make existing cracks look deeper and feel tender. So if your tongue is cracked and smooth, red, or sore, a deficiency is worth checking with simple bloodwork. Read more about glossitis and its causes.
Fissured tongue vs. geographic tongue (and other look-alikes)
These two get mixed up constantly, partly because so many people have both. The quick way to tell them apart: fissured tongue is about grooves that stay put. Geographic tongue is about smooth red patches that move.
| Fissured tongue | Geographic tongue | Glossitis | Scalloped tongue | |
|---|---|---|---|---|
| What you see | Grooves or cracks on top of the tongue | Smooth red patches with pale, wavy borders | Whole tongue smooth, red, often swollen | Wavy tooth-shaped dents along the sides |
| Changes day to day? | No. The grooves are permanent. | Yes. Patches shift over days to weeks. | Improves when the cause is treated | Can ease if the cause eases |
| Hurts? | Usually not. Sore if debris or yeast builds up. | Often painless. Can burn with spicy or acidic food. | Often sore or burning | Usually not |
| Common causes | Genetics, aging, dry mouth | Unknown. Runs in families. | Low iron or B vitamins, infection, irritation | Tongue pressing on teeth, clenching, swelling |
| What to do | Brush the grooves gently | Avoid triggers, bland toothpaste | Find and treat the cause | Look for the reason it's pressing |
Having fissured and geographic tongue together is very common and no more worrying than having either one. The grooves stay. The patches come and go. Our scalloped tongue page covers those wavy dents along the sides.
Other cracks in the tongue that aren't fissured tongue
- A single deep crack that's raw, white, or bleeding. This is different from a healthy groove. It can be an injury, an infected crack, or occasionally something that needs a biopsy. Any open sore on the tongue that hasn't healed in 2 weeks should be checked. Learn the signs of oral cancer so you know what to watch for, keeping in mind that most tongue changes are harmless.
- Dehydration lines. A dry tongue can look wrinkled and cracked, then smooth out after you drink water. True fissures don't go away with a glass of water.
- Thrush in the grooves. Creamy white material that collects in the cracks and wipes off, sometimes leaving a red, sore spot. See oral thrush.
- A coated tongue. A white or tan coating that sits on the surface and in the grooves, often from dry mouth or not cleaning the tongue. See white tongue.
- Lacy white lines that don't wipe off, sometimes with sore areas, can be oral lichen planus.
Does fissured tongue hurt?
Usually not. Most people have no symptoms at all. When a fissured tongue does hurt, the grooves themselves are rarely the problem. The usual culprits are:
- Trapped food and bacteria. Deep grooves collect debris that brushing misses. That can cause bad breath, discoloration, and a tender, inflamed spot at the bottom of a groove.
- Yeast. Candida likes the warm, sheltered bottom of a groove. In one study, people who had fungi on their tongue reported more burning and pain, and fungi were more common in people who didn't brush their tongue.
- Spicy, acidic, or salty food. Many people with fissured tongue notice that spicy food stings in the grooves, especially if they also have geographic tongue.
- Dry mouth. Without saliva to rinse and cushion the tongue, the grooves feel rough and sensitive.
If your tongue burns all over but looks normal apart from the grooves, the cause may be something else entirely, such as burning mouth syndrome.
Can fissured tongue go away?
The grooves themselves don't go away. A fissured tongue is part of the shape of your tongue, and the fissures usually get a little deeper as the years go by. That's normal and doesn't mean anything is getting worse.
What can go away is soreness, bad breath, or discoloration from trapped debris or yeast. Once the grooves are kept clean and any thrush or dry mouth is treated, most people stop noticing their tongue at all.
How to clean a fissured tongue
This is the single most useful thing you can do. A clean groove is a comfortable groove. Make it part of your regular home care routine.
- Use a soft toothbrush or a soft tongue brush. Stiff bristles can irritate the grooves. A clean, soft brush is all you need.
- Brush back to front, along the grooves. Start as far back as you comfortably can and sweep forward, following the direction of the main groove. This lets the bristles dip into the cracks instead of skating over them.
- Be gentle. Light pressure is enough. If your tongue feels raw afterward, ease up.
- Rinse well. Swish with water or an alcohol-free mouthwash to flush out what you loosened.
- Do it once or twice a day, when you brush your teeth. Rinsing with water after meals helps too, especially after sticky or spicy foods.
A tongue scraper cleans the surface well, but it can bridge over deep grooves. If you like a scraper, follow it with a few gentle strokes of a soft brush.
Fissured tongue treatment and home remedies
A painless fissured tongue doesn't need treatment. If yours is tender or prone to bad breath, these are the home remedies and drugstore products that actually help.
| Product | What it does | Things to know |
|---|---|---|
| Soft toothbrush or soft tongue brush | Lifts debris out of the grooves | Gentle strokes, back to front. Replace it every few months. |
| Alcohol-free mouthwash | Rinses out loosened debris and freshens breath | Alcohol can sting the grooves and dry the mouth. |
| Mild toothpaste | Less sting on sensitive grooves | Strong mint, cinnamon flavors, and whitening pastes bother some people. An SLS-free paste may be gentler. |
| Dry mouth products (xylitol lozenges or gum, saliva gels, moisturizing rinses) | Keep the tongue moist and comfortable | Especially useful if your medicines dry your mouth. Sip water through the day too. |
| Numbing gel (benzocaine, lidocaine) | Short-term relief for a sore spot, such as before a meal | Do not use benzocaine in children under 2. The FDA warns it can cause a rare but dangerous blood condition. Use as the label directs, and get ongoing soreness checked instead of numbing it for weeks. |
| Pain relievers (acetaminophen, ibuprofen) | Short-term relief | As the label directs. If you're pregnant, ask your OB or pharmacist before using medicated gels or pain relievers. |
Myths worth skipping
- You can't fill in or "heal" the grooves. Creams, oils, and supplements sold for this won't change the shape of your tongue.
- Don't scrub hard or use a stiff brush. Irritating the tissue makes it more sensitive, not cleaner.
- Don't take leftover antibiotics. If the grooves are sore, the cause is more often yeast or irritation, and antibiotics can make yeast worse.
What a dentist can do for a fissured tongue
For most people, the main thing we do is look and reassure. If your tongue is bothering you, we can help find out why.
- Confirm what it is. We check the color, texture, and pattern of the grooves and look for geographic tongue, thrush, or anything that doesn't fit, as part of a routine exam.
- Treat yeast. If thrush has settled into the grooves, we can prescribe an antifungal such as a nystatin rinse or clotrimazole troches, or fluconazole tablets when needed.
- Help with dry mouth. We look at your medicines and habits and recommend products or prescription options.
- Look for sources of irritation, such as a sharp tooth, a rough filling, or a denture that rubs the tongue, and smooth or adjust them.
- Suggest bloodwork through your physician if the tongue is also smooth, red, and sore, to check iron, B12, and folate.
- Biopsy or refer for biopsy if one area looks or behaves differently, such as a crack that stays raw, a lump, or a white or red patch that doesn't wipe off. Our oral medicine diagnosis visit is set up for spots like this.
- Coordinate with your physician if your fissured tongue comes with lip or face swelling or facial weakness.
Keeping the grooves comfortable
You can't prevent a fissured tongue. You can prevent most of the problems that come with one.
- Clean your tongue daily as described above.
- Stay hydrated and treat dry mouth. Sugar-free xylitol gum or lozenges help get saliva flowing.
- Notice your food triggers. If spicy, acidic, or very salty foods sting, cut back on them when your tongue feels sensitive.
- Don't smoke or vape, and go easy on alcohol. They dry and irritate the tongue.
- Keep up regular dental visits so changes get noticed early.
Fissured tongue in kids, denture wearers, and people with medical conditions
Children
Deep fissures are uncommon in young children and usually become noticeable in the teens or adulthood. If your child has one, it's most likely inherited. Teach them to brush their tongue gently along with their teeth. A child whose tongue is red, swollen, or sore should be checked by a dentist or pediatrician.
Down syndrome
Fissured tongue is very common in people with Down syndrome. It doesn't cause problems on its own, but the grooves can hold food. Caregivers can help with gentle daily tongue brushing, and we're glad to show you an easy technique.
Denture wearers
People who wear dentures are more prone to thrush, and yeast can settle into tongue grooves. Take dentures out at night, clean them daily, and tell us if your tongue feels sore or burns.
Diabetes, cancer treatment, and weakened immunity
Diabetes, chemotherapy, head and neck radiation, steroid inhalers, and immune-suppressing medicines all raise the risk of thrush and dry mouth. Both make a fissured tongue more likely to get sore. If you're going through head and neck cancer treatment, keep the grooves clean and let your care team know about any burning or white patches. People with diabetes can read more about diabetes and the mouth.
Psoriasis
Fissured tongue is more common in people with psoriasis. It needs the same gentle cleaning as anyone else's and doesn't usually change psoriasis treatment.
When to see a dentist about cracks in your tongue
Make an appointment if:
- Your tongue burns, stings, or hurts, especially in the grooves
- You see white or yellow material in the cracks that comes back after brushing
- You have bad breath that doesn't improve with tongue cleaning
- Your tongue has also become smooth, red, or swollen
- You're not sure whether it's fissured tongue, geographic tongue, or something else
Get care quickly if:
- One crack is raw, bleeding, or looks like an open sore, and it hasn't healed in 2 weeks
- You feel a lump or a firm, hard area in the tongue
- You have a red or white patch that doesn't wipe off
- Your lips or face swell, or one side of your face droops (see a physician the same day for sudden facial weakness)
- Your tongue swells quickly or you have trouble swallowing or breathing (call 911)
Fissured tongue FAQ
What causes fissured tongue?
The exact cause isn't known. Fissured tongue tends to run in families and usually deepens with age. It's more common in people who also have geographic tongue, psoriasis, Down syndrome, or chronic dry mouth. It isn't caused by an infection, and it isn't a sign of poor hygiene.
Is fissured tongue serious?
No. For almost everyone, a fissured tongue is a harmless variation of normal, not a disease. It isn't contagious and doesn't turn into cancer. The only common problem is that the grooves can trap food and yeast, which gentle daily brushing usually prevents.
Does fissured tongue hurt?
Usually not. Most people with fissured tongue have no pain at all. When the grooves do hurt, the cause is usually trapped debris, a yeast infection (thrush), dry mouth, or sensitivity to spicy or acidic foods. A dentist can find out which and treat it.
Is fissured tongue genetic?
It appears to be at least partly inherited, because it often runs in families. Aging also plays a part, since the grooves tend to deepen over the years. Having a parent with a fissured tongue makes it more likely, but not certain, that you'll have one.
How do you get rid of a fissured tongue?
You can't get rid of the grooves, because they're part of the shape of your tongue. What you can get rid of is the soreness, bad breath, or discoloration that sometimes comes with them. Brush your tongue gently with a soft brush, back to front along the grooves, rinse well, and treat dry mouth or thrush if they're present.
How do you clean a fissured tongue?
Use a soft toothbrush or soft tongue brush and sweep gently from back to front, following the direction of the grooves so the bristles reach into them. Rinse with water or an alcohol-free mouthwash afterward. Do this once or twice a day when you brush your teeth.
Can fissured tongue go away?
The grooves don't go away and often deepen a little with age. That's normal. Symptoms like soreness or bad breath, though, usually clear up once the grooves are kept clean and any yeast or dry mouth is treated.
Is fissured tongue caused by a vitamin deficiency?
Not usually. The permanent grooves of a fissured tongue aren't caused by low vitamins. Low iron, vitamin B12, or folate can cause glossitis, where the tongue becomes smooth, red, swollen, and sore, and that can make cracks look deeper. If your tongue is cracked and also red or sore, ask about bloodwork.
What does it mean when your tongue has cracks in it?
Most of the time it means you have a fissured tongue, a common and harmless variation that often runs in families and deepens with age. Temporary cracks can also come from dehydration or dry mouth. A single crack that's raw, bleeding, or not healing is different and should be checked by a dentist.
Can you have fissured and geographic tongue together?
Yes, and it's common. Many people with geographic tongue also have a fissured tongue. The grooves are permanent, while the smooth red patches of geographic tongue move around over days to weeks. Both are harmless and are managed with gentle cleaning and avoiding foods that sting.
Why does spicy food burn my fissured tongue?
Spicy, acidic, and salty foods can sting tissue at the bottom of the grooves, especially if it's irritated by trapped debris or yeast, or if you also have geographic tongue. Keeping the grooves clean and treating dry mouth usually helps. Cutting back on trigger foods during sensitive stretches helps too.
What is Melkersson-Rosenthal syndrome?
Melkersson-Rosenthal syndrome is a rare condition in which a fissured tongue comes with repeated swelling of the lips or face and episodes of facial nerve weakness. Not everyone has all three. Nearly everyone with a fissured tongue does not have this syndrome, but if you have swelling or facial weakness as well, see your physician.
Should I see a dentist for a fissured tongue?
If it doesn't bother you, you can simply mention it at your next checkup. Come in sooner if your tongue burns or hurts, if white material keeps building up in the grooves, or if one crack looks like an open sore that hasn't healed in 2 weeks.
Questions about the cracks in your tongue?
If you're in the Jacksonville area and your tongue has deep grooves that are sore, hard to keep clean, or just make you wonder, we're glad to take a look. Dr. Henley sees all kinds of tongue changes, from everyday fissures to spots that need a closer look.
Related conditions
Sources
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- Ehsan H, Azimi S, Yosufi A, et al. The prevalence and significance of fissured tongue in Kabul City among dental patients. Clin Cosmet Investig Dent. 2023;15:21–29.
- Dudko A, Kurnatowska AJ, Kurnatowski P. Prevalence of fungi in cases of geographical and fissured tongue. Ann Parasitol. 2013;59(3):113–117.
- Monshi B, Grabovac S, Gulz L, et al. Psoriasis is associated with fissured tongue but not geographic tongue: a prospective, cross-sectional, case-control study. J Dtsch Dermatol Ges. 2021;19(8):1170–1176.
- Al-Maweri SA, Tarakji B, Al-Sufyani GA, et al. Lip and oral lesions in children with Down syndrome: a controlled study. J Clin Exp Dent. 2015;7(2):e284–e288.
- Dhawan SR, Saini AG, Singhi PD. Management strategies of Melkersson-Rosenthal syndrome: a review. Int J Gen Med. 2020;13:61–65.
This page is for general education and isn't a diagnosis. Every mouth is different. If you have a sore you're worried about, see your dentist or physician. Photos marked Wikimedia Commons are used under their listed licenses and may have been cropped or resized.