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Thursday, May 23, 2013
Tongue fissures and bleeding
My tongue develops deep fissures and bleeding on contact with the majority of foods I eat - ranging from yoghurt, fruit, vegetables, ice cream, dressings etc. It occurs fairly instantly - used to take about 15 mins for the cracks but now they are virtually permanent. My tongue is very painful most of the time now and getting to the stage where I no longer want to eat. It was just on the front third of the tongue but now spreading further back as well.
There is a morphological phenomena of the tongue referred to as “fissured tongue” or “scrotal tongue”. The cause is unknown but may have a hereditary component. Most people only complain if the fissuring occurs on the dorsal (top) portion of the tongue. Some complain of burning and this may be related to entrapped food and debris that may collect in the furrows.
Fissured tongue has been reported to occur in 2-5% of the population, and may increase with age. Based on your report, you may be describing a localized contact stomatitis, especially given that you describe reactions to a number of dairy products.
I do not know why there was a time element in your complaint (15 minutes) but that may be related to development of symptoms (pain) and not the fissuring.
One very off-the-wall lesion syndrome that is associated with fissured tongue is oral facial granolomatosis (Melkersson-Rosenthal Syndrome). This is associated with tongue fissuring and more severe symptoms such as edema, paratheisa, ulceration, erosion of the tongue surface, and taste alteration. The lips are the most common site of involvement with pebbly surface characteristics and enlargement.
Treatment for this relatively rare syndrome is removal of noxious agents (if they can be identified) and corticosteroids.
For your concerns, I would suggest you see your dentist or primary care provider to have this evaluated.You may be experiencing nothing more than a local reaction to food products. But to be sure, let your health care provider examine your tongue and surrounding oral mucosa.
Richard J Jurevic, DDS, PhD
Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University