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craked tongue
An_245750 posted:
I seem to get (for lack of better term) cracks on my tongue. Sometimes on the top, sometimes on the side. They almost look like a cut thats healing. I get them every now and again, but they usually disappear within 24-48 hours and then I don't get them for a while. They are VERY sore and it makes it tough to eat anything. Any idea what it could be? I was thinking perhaps some sort of allergy?!
Gwen Cohen Brown, DDS, FAAOMP responded:
Hi An_245750,
Although I cannot diagnose you online what you are describing sounds like Fissured tongue and/or Geographic tongue. Both are harmless conditions with a genetic component - so if you have siblings, children or parents nearby look in their mouths and ask if they have had similar issues with their tongue!

Geographic tongue and fissured tongue are often seen together, in fact 15% of people will have one or the other or both. Because you are describing occasional sores that come and go I would suggest that you investigate Geographic tongue first as it used to be called wandering rash of the tongue! Part of the diagnosis includes the fact that it gets better and worse.

If you have Geographic tongue it becomes uncomfortable because the tongue is exposed. If you look at the surface of your tongue you will notice small hairlike projections, filliform papilla. The filliform papilla are made of keratin (like your hair and nails) and they protect the tongue. When they fall off, like they do in Geographic tongue, the underlying surface is exposed and easily irritated. Don't worry, the will grow back but often as one area of filliform papilla grows back another falls off.

Patients with Geographic tongue report that acidic foods and spicy foods can be quite irritating.

There is no specific treatment or known etiology for Geographic or fissured tongue but you do need a confirmation of this clinical diagnosis. You do not need a biopsy. Your dentist can recommend an over the counter product or biofilm to cover the sores while you are eating.
Geographic tongue can easily be misdiagnosed as "thrush" (oral candidiasis) by clinicians unfamiliar with the condition so your dentist may be most qualified to properly assess and diagnose your tongue.

If you do not have a dentist you can look on the American Dental Educators Association website for information on Dental schools, Dental hygiene schools and hospitals with a dental residency program in your area.

I hope this helps!

Dr. Gwen Cohen Brown
fallen13 replied to Gwen Cohen Brown, DDS, FAAOMP's response:
Thank you for responding to my question Doctor, I think it is very kind of you to take the time out to post back to me.

I will defintely see my dentist ASAP!

Thank you again!

goresbridge replied to fallen13's response:
Doctor Brown,

I had a question on G.T also. About 6 years ago my tongue got really sore and had parts missing off of it. I have been to the dentist and an Oral surgeon and they never mentioned anything neither did I I should have , I was in for wisdom teeth extraction.

I have Psoriasis pretty severe and I have read that it is more common in that of Psoriasis patients. I get the red spots sometimes but not all the time my tongue looks pretty white though and feels really rough and I have 2 large fissure down the center in the back. Is Candida common with this ?

I dont have the creamy white patches though but one of my cheeks sometimes peels on the inside.

I have a heart condition (i,m 32) A Fib and take beta blockers but this tongue thing has been gong on since I was about 24.

Thank you for your time.
Gwen Cohen Brown, DDS, FAAOMP replied to goresbridge's response:
Hi goresbridge,

Geographic tongue is a variation of normal. It can be sore when it is in an active phase but in general it is annoying but nothing to worry about.

Anecdotally, I can tell you that in my patients stress seems to make geographic tongue more painful and slower to resolve.

Geographic tongue does have a relationship to psoriasis and many people believe that geographic tongue is an oral manifestation of psoriasis.?Microscopically it looks like psoriasis and may even show features of candidiasis. However, unless it is painful or is secondarily infected with candida most providers will not treat geographic tongue.

Geographic tongue is not typically associated with candidiasis and the raised slightly white halos that surround the areas of depapillation are a part of the diagnosis of geographic tongue but are often misdiagnosed as candidiasis especially by health care providers unfamiliar with the diagnostic criteria.

If it starts to act up or become painful speak with your dentist or pharmacist to find a product - either OTC or by prescription - which can help alleviate some of the symptoms.

I hope this helps!

Dr. Gwen Cohen Brown

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