Cracks in the middle, on the tip, on the edges of the tongue in adults and children: what it means and how to treat it

The tongue often reflects many problems inside the body. Normally, it should be clean and pink - and this indicates that everything is fine with the person's health. Plaque, and especially cracks on the tongue - this is the first "alarm bell" about problems in the functioning of the internal organs. Therefore, often when cracks appear, not only and not so much the tongue is treated, but the whole body.

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Epidemiology

There are no exact statistics regarding the frequency of tongue cracks. However, there is information that about 25% of all painful sensations in the oral cavity are caused by cracks.

Cracks in the tongue most often affect people over 40 years of age or small children.

This pathology almost never develops on its own, but accompanies other painful conditions: allergies (in 60% of cases), diseases of the digestive system (in 60% of cases), metabolic diseases (in 30% of cases), dental problems (in 50% of cases), anemia and vitamin deficiencies (in 20% of cases).

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Causes tongue cracks

Cracks in the tongue can be caused by many reasons, including:

• diseases of the digestive system;
• blood diseases;
• CNS dysfunction;
• helminthiasis;
• hormonal imbalances;
• vitamin deficiency;
• problems in the oral cavity.

Often, one patient may have several reasons for the appearance of cracks at the same time. For example, the presence of helminths in the intestines can cause vitamin deficiency and anemia, and liver or digestive diseases lead to impaired absorption of most substances necessary for the body.

Of course, cracks in the tongue are not always a consequence of internal organ damage. They can also appear against the background of inflammation in the oral cavity. In many patients, cracks are a manifestation of syphilis or lichen, or an allergic reaction.

Risk factors

There are a large number of known factors that can initiate the formation of cracks in the tongue:

• dental problems;
• chronic disorders in internal organs;
• metabolic disorders (diabetes, obesity);
• frequent stress and fears;
• failure to observe personal hygiene, improper and insufficient oral care.

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Pathogenesis

A large number of patients with cracks in the tongue are subsequently diagnosed with glossitis, an inflammatory reaction in the tissues of the tongue. In addition to cracks, whitish spots in the form of a thin coating are found with glossitis. The patient complains of a feeling of "goosebumps" in the tongue area, a burning sensation, and even pain.

• A tongue that is cracked from birth is called folded glossitis - this is a congenital defect that usually cannot be treated, but does not require it.
• Cracks in the tongue that have appeared throughout life are a clear sign of some kind of disorder: of the oral cavity, digestive organs, urinary organs, endocrine system, or immune disorder.

Diagnostics will show what specific disease caused the cracks in the tongue. Without it, no practicing doctor will undertake to make a final diagnosis.

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Symptoms tongue cracks

Symptoms of cracked tongue are in most cases specific. These are dry mucous membranes in the oral cavity, a burning sensation in the affected areas of the tongue, pain, swelling.

The patient himself may not notice small superficial cracks. But deep damage is almost impossible not to notice: they are clearly visible to the naked eye, they can be single or multiple, longitudinal or transverse. Deep cracks are often accompanied by inflammation, which is accompanied by redness and swelling of the tongue.

The first signs – cracks in the tongue – can be combined with other symptoms that are characteristic of various diseases.

• A tongue with cracks from birth can be observed in children who have a hereditary predisposition to such a change. Usually, this phenomenon is simply a feature of the body and does not require treatment: it is called folded tongue syndrome.
• A crack in the tongue in the middle is observed most often and indicates a person's weak immunity. If we consider a crack in the middle as a symptom of a disease, then such a sign often occurs with rhomboid and folded glossitis - inflammation of the tongue.
• Plaque and cracks on the sides of the tongue may indicate liver and/or gall bladder diseases. This symptom often accompanies anemia, thyroid disease and digestive diseases. If there are additional traces of teeth at the edges of the tongue, this indicates swelling of the organ.
• Cracks on the tip of the tongue in many cases indicate a burn or stomatitis, or a disorder in the nervous system. Often the tip of the tongue becomes cracked after severe stress or depression.
• If the tongue hurts and cracks on the tongue are located chaotically, then this may be a symptom of a chronic intestinal disease. And if there is thirst and dry mouth, one can assume a disease of the endocrine system.
• Cracks in the tongue and burning are observed in all types of glossitis - desquamative, rhomboid, villous, scrotal, interstitial. Burning is especially pronounced if the cracks are deep.
• A red tongue with cracks is a sure sign of Hunter's glossitis. The tongue is unusually smooth and shiny, the papillae are flat, and the color of the front surface is red with a raspberry tint. This disease develops due to a lack of vitamins.
• Spots and cracks on the tongue accompany diseases of the digestive system, helminthiasis, metabolic disorders. If the spots look like lines, then they speak of the so-called "geographic tongue", which is a typical sign of desquamative glossitis.
• Cracks and ulcers on the tongue are a clear sign of stomatitis, the most common disease of the oral mucosa. Stomatitis can occur on its own or be a complication of other diseases.
• A loose tongue with cracks can often be observed in patients prone to nervous disorders. Such people usually suffer from depression and insomnia, and experience a lot of stress. A loose tongue is very typical for chronic fatigue syndrome.
• Dryness and cracks in the tongue in many cases indicate a disorder in the endocrine system. Such symptoms accompany thyroid disease, diabetes and other similar pathologies.
• If cracks on the tongue bleed, then this is a clear symptom indicating a weakened immune system and a lack of vitamins in the body. Such cracks are difficult to treat unless the underlying cause of the disease, vitamin deficiency, is eliminated.
• Yellow coating and cracks on the tongue are observed against the background of liver and biliary tract diseases (dyskinesia, calculous cholecystitis), chronic pancreatitis, gastroduodenitis. In addition, this symptom can simply give away a malicious smoker who smokes more than one pack of cigarettes daily.

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Cracks in the tongue during pregnancy

Pregnancy is a natural physiological period in a woman's life. However, it is necessary to take into account that during all nine months, the expectant mother shares with her child all the necessary substances, including vitamins, as well as immune protection - antibodies. As a result, a pregnant woman may develop hypovitaminosis, anemia. Due to the pressure that the growing uterus exerts on the digestive organs and liver, gastrointestinal diseases and circulatory disorders may occur. In addition, the female body undergoes hormonal changes, and the immune forces weaken.

All of the listed factors can influence the development of such a pathological condition as cracks in the tongue: it can occur both along with the inflammatory process and without it.

To prevent such complications, it is necessary to carefully monitor the woman’s health indicators throughout the entire pregnancy period and avoid borderline conditions – anemia, hypovitaminosis, etc.

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Complications and consequences

Under no circumstances should you ignore such a sign as cracks in the tongue. Treatment should be started and carried out in a timely manner, because otherwise complications may arise. For example, inflammation can spread to the gums, tonsils, and oral mucosa. The development of abscesses, which are treated only surgically, is not excluded.

The underlying causes of cracks, such as anemia and vitamin deficiencies, can lead to the appearance of other painful symptoms:

• dryness and flaking of the skin;
• dizziness;
• headache;
• deterioration of the condition of hair and nails;
• deterioration of vision;
• capillary fragility.

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Diagnostics tongue cracks

The doctor will begin any diagnosis with a survey and examination of the patient, with an assessment of his complaints. Additional questions will help to detect new signs of pathology, which the patient himself did not pay attention to before.

In addition, the person’s overall health status is assessed, as well as the presence of risk factors.

Auxiliary diagnostic methods will help to characterize the general condition of the body and find the true cause of the appearance of cracks in the tongue.

• Laboratory tests are considered mandatory for any cracks in the tongue:

1. general blood test – allows you to assess the state of the immune system, determine the presence of an inflammatory process and anemia;
2. blood biochemistry – makes it possible to evaluate the function of the liver, kidneys, and determine a number of other pathological conditions in the body (in particular, autoimmune);
3. blood test for HIV, RW and TORCH infections;
4. coprogram – examination of feces for the presence of worms and dysbacteriosis.

• Instrumental diagnostics is considered very important for making a correct diagnosis:

1. bacterial culture of a smear taken from the surface of the tongue allows us to identify the causative agent of the inflammatory process and determine further treatment tactics;
2. histological examination – used rarely, when structural changes in cells and tissues are suspected.

• Consultative diagnostics are prescribed to exclude or confirm diseases of other organs and systems. For example, the following may be very important:

1. consultation with an otolaryngologist;
2. consultation with a gastroenterologist;
3. consultations with an allergist, hematologist, rheumatologist, endocrinologist;
4. consultation with a pediatrician-venereologist, infectious disease specialist.

Differential diagnosis

Differential diagnosis of cracks in the tongue is carried out with the following painful conditions:

• secondary recurrent syphilis;
• glossitis;
• lichen planus;
• flat form of leukoplakia;
• vitamin B ₁₂ deficiency;
• vitamin B1 _deficiency;
• systemic scleroderma;
• pathologies of the digestive tract (colitis, enterocolitis, chronic gastritis, stomach ulcer, etc.).

Treatment tongue cracks

Treatment usually consists of local and systemic effects on the body.

Systemic impact consists of the following activities:

1. Normalization of the digestive organs, treatment of existing diseases.
2. Visit to the dentist, oral hygiene, cleaning of tartar.
3. In case of stress, prescribe sedatives based on valerian root and motherwort.
4. Antiallergic treatment with Tavegil, Suprastin, Fenkarol.
5. Prescription of vitamins and multivitamins (vitamin B ₅, 0.2 g three times a day for 4 weeks, daily intake of Supradin, Vitrum).
6. Dalargin 1 mg in the morning and evening in the form of intramuscular injections for 10 days (has a significant analgesic effect and accelerates the healing of the mucous tissues of the oral cavity).
7. Biotrit-C tablets, 1 tablet sublingually three times a day after meals, for three weeks (has a biostimulating healing effect).
8. Products that improve capillary circulation – Trental, Cavinton, Tanakan – for a month.

Local treatment may include the following:

1. Use of local analgesics:

• 1-2% Pyromecaine;
• 5% Pyromecaine ointment;
• 2% anesthesin with glycerin.

2. Use of distracting agents that reduce the burning sensation in the tongue (irrigation with a citral solution of 30 drops per 200 ml of water).
3. Application of medicinal products with keratoplastic action (oil vitamin A, rosehip oil, Solcoseryl dental paste) up to five times a day, for 15-20 minutes.
4. Apply fish oil three times a day for 15-20 minutes.
5. Rinsing with the anti-inflammatory drug Tantum Verde – 4 times a day for a week.
6. Physiotherapeutic treatment – phonophoresis with analgin. A 50% analgin solution in the amount of 2 ml is mixed with 20 g of vaseline oil and distributed over the surface of the tongue. The procedure is carried out for 4 minutes, with an intensity of 0.1-0.2 W/cm². The mode is pulsed. The therapeutic course consists of 12 sessions.

Other Medicines Used for Cracked Tongue

	Method of administration and dosage	Side effects	Special instructions
Stomatophyte	Use for rinsing the mouth, up to 4 times a day (10 ml of the product is dissolved in 50 ml of water).	Allergy and temporary discoloration of tooth enamel are possible.	Stomatofit is not used to treat children under six years of age.
Sea buckthorn oil	The surface of the tongue is lubricated with a swab soaked in oil. The procedures are carried out daily for 8-10 days.	Allergy and short-term increase in salivation are possible.	Sea buckthorn oil is not recommended for use during pregnancy.
Methyluracil	In tablet form, take orally, with food, 0.5 g 4 times a day. The course of treatment is up to 1 month.	Headache and heartburn may occur.	Methyluracil in tablets is not used to treat children under 3 years of age.
Propolis	The affected surface of the tongue is lubricated with propolis tincture 1-2 times a day for 1-2 weeks. You can use rinsing with a solution of propolis tincture (1 teaspoon per 100 ml of water).	A short-term burning sensation and dry mouth may occur.	The drug is not used to treat children under 3 years of age.

Vitamins

To prevent and treat cracks in the tongue, it is very important to consume with food or take additionally the amount of vitamins necessary for the body.

• Vitamin A is responsible for the secretory function of the glands, eliminates dry mucous membranes and bleeding gums.
• B vitamins normalize the functioning of the nervous system.
• Ascorbic acid prevents the development of dental diseases and improves the protective properties of the mucous membrane.
• Vitamin E is responsible for the restoration of damaged tissues and their renewal.
• Vitamin K helps the body absorb calcium and vitamin D.
• Vitamin PP prevents the development of any inflammatory processes in the mouth.

Folk remedies

In addition to the herbal remedies that we will discuss below, cracks in the tongue can be treated with improvised means - potatoes, garlic, horseradish. Potatoes are rich in starch, so they provide an enveloping effect and relieve pain. Garlic is known for its antiseptic properties. Horseradish disinfects and inhibits the activity of many pathogenic microorganisms.

• The juice from freshly grated horseradish root is diluted in half with water, brought to a boil and cooled, after which it is used to rinse the mouth.
• It is recommended to hold potato juice in the mouth for 1-2 minutes. This should be done several times a day.
• Grate a fresh potato. Place the pulp in gauze and apply to the tongue for several minutes, 2-3 times a day.
• Crush the garlic cloves and add warm boiled water (1:5). Keep the mixture in your mouth for several minutes, 3-4 times a day.

Treatment with folk remedies will be more effective if you know the exact cause of the cracks in the tongue. By acting on the cause, you can overcome the disease much faster and better.

Herbal treatment

External treatment of cracks can be carried out using herbal decoctions and infusions:

1. A decoction prepared from chamomile flowers will help to quickly heal the wound and disinfect painful areas of the mucous membrane. To prepare the decoction, pour 1 tbsp. chamomile with 200 ml of boiling water and leave for 60 minutes. Use the medicine to rinse the mouth several times a day.
2. Sage decoction is considered one of the best herbal antiseptics. Rinse your mouth with the decoction 3 times a day, after letting it sit for about an hour.
3. Coriander decoction will help to cope with infection in the oral cavity. Coriander is well and successfully combined with sage.
4. A decoction of bedstraw is a good antiseptic that accelerates the healing of wounds and cracks on the tongue. The decoction is prepared in the standard way: 1 tbsp. per 200 ml of boiling water, infused until cool.

Homeopathy

Many people use homeopathic remedies for cracked tongues - in the vast majority of cases, their use is not accompanied by side effects, they have no contraindications and are quite effective.

• Vinzel oral spray – provides local anti-inflammatory effect, strengthens local immune defense, restores the mucous membrane of the oral cavity and tongue. Usually the drug is sprayed on the affected surface of the tongue three times a day.
• Ginseng compositum N is an oral solution that is successfully used to treat inflammatory infectious diseases and degenerative-dystrophic changes in the mucous membrane. The drug is recommended to be taken 10 drops three to six times a day 20 minutes before meals. The maximum daily dose of the drug is 60 drops.
• Mukosa compositum is an injection solution for intramuscular or subcutaneous administration. The drug helps to cope with inflammatory and ulcerative-erosive processes in the mucous tissues of the digestive system and oral cavity, and also eliminates dysbacteriosis in the intestine. Injections are carried out 1-3 times a week, 1 ampoule.
• Echinacea compositum C is an injection solution used for the complex treatment of acute and chronic forms of inflammatory and purulent-inflammatory pathologies of mucous tissues. The drug is administered intramuscularly or subcutaneously once every 2-4 days, for 14-45 days.

Surgical treatment

Surgical treatment of cracks in the tongue is used very rarely.

Indications may include:

• deep damage to the tissues of the tongue with the development of an inflammatory process;
• abscesses of the tongue and oral cavity.

Prevention

Prevention of all diseases, including cracks in the tongue, consists, first of all, in maintaining proper nutrition and a healthy lifestyle. Daily oral hygiene also plays a huge role.

There are a number of basic preventive measures that can be taken to prevent cracks in the tongue:

1. Daily brushing of teeth with toothpaste and mouthwash, regular use of dental floss, regular consultation with a dentist.
2. Proper nutrition with sufficient amounts of vitamins and other beneficial components.
3. Wash your hands regularly, especially before eating.
4. Giving up bad habits that are harmful to our health.
5. Physical activity, walks in nature.
6. Activities to harden and strengthen the immune system.
7. Timely visits to doctors and treatment of diseases.
8. Prevention of diseases that can be transmitted through sexual contact.
9. Avoid self-medication with any medications.
10. Avoiding contact with possible allergens.

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Forecast

In most cases, cracks in the tongue do not pose a threat to the patient's health. The likelihood of malignant degeneration of such damage is practically excluded.

In order for the outcome to be particularly favorable, it is necessary to find and eliminate the reason why cracks appeared on the tongue.