From the Guidelines
Fissured tongue typically does not require specific treatment as it is generally a benign, asymptomatic condition. For patients experiencing discomfort, the primary recommendation is gentle oral hygiene practices, including regular brushing of the tongue with a soft toothbrush and mild toothpaste to remove debris from the fissures.
- Patients should rinse with warm saltwater (1/2 teaspoon salt in 8 ounces of water) 2-3 times daily to reduce bacterial load and inflammation.
- If the patient experiences pain or burning sensations, avoiding spicy, acidic, or hot foods may help reduce irritation.
- For persistent symptoms, over-the-counter oral analgesics like benzocaine gel (Orajel) can provide temporary relief when applied to symptomatic areas. In cases where secondary fungal infection is present, particularly in deeper fissures, antifungal medications such as nystatin oral suspension (100,000 units/mL, 4-6 mL swish and swallow four times daily for 7-14 days) or clotrimazole troches (10 mg dissolved in mouth five times daily for 14 days) may be prescribed 1. The condition itself is often genetic or associated with certain syndromes and cannot be cured, but maintaining good oral hygiene prevents complications and manages symptoms effectively. It's also important to note that the provided evidence mainly discusses anal fissures and other unrelated conditions, but the most relevant information for fissured tongue is focused on maintaining good oral hygiene and managing symptoms 1.
From the Research
Treatment for Fissured Tongue
The treatment for a patient with a fissured tongue is largely dependent on the underlying cause of the condition.
- According to 2, fissured tongue, along with geographic tongue and hairy tongue, does not require treatment.
- However, if the fissured tongue is associated with other conditions such as nutritional deficiencies, treatment may involve addressing the underlying issue, as seen in the case of atrophic glossitis which is often linked to an underlying nutritional deficiency of iron, folic acid, vitamin B12, riboflavin, or niacin and resolves with correction of the underlying condition 2.
- In some cases, good oral hygiene practices such as tongue brushing and mouth rinsing may be recommended as basic treatment measures, similar to those used for halitosis 3.
- There is no direct evidence to suggest a specific treatment for fissured tongue, but rather an emphasis on identifying and addressing any associated systemic diseases or conditions, such as hypertension or diabetes 4, or immunological deficiencies 5.
- It is also important to note that some studies have found associations between fissured tongue and certain nutritional deficiencies, such as lower levels of serum vitamin B12, ferritin, and folate 5, although these findings are not consistent across all studies 6.