Mouth Diseases

Lines that Look Like the Lines on Leaves 10/12/2010

Question:

One of my preschool students who just turned four has a pointed shaped tongue that when extended, you can see lines that are similar to the veins of a leaf. He is suspected of being a fetal alcohol child. Is this common?

Answer:

What you describe sounds likely to represent two relatively common variations of the normal appearance of the tongue; not changes related to fetal alcohol syndrome. 

The pointed shape may be due to a high or prominent lingual frenulum, a band of soft tissue that connects the tip of the tongue to the inside of the lower jaw. In some cases, this can even interfere with speech development and has commonly been called a "tongue-tie." Minor surgical release of the "tie" can be helpful in some symptomatic patients. 

The leaf-like appearance sounds like fissured (plicated) tongue. Although more prevalent in older patients, it can be seen in children as well. No treatment is needed for fissured tongue. 

Although infrequently described, oral changes found in patients with fetal alcohol syndrome have mostly surrounded delayed tooth development or eruption and defects in the surface enamel of teeth. Hope this helps. 

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Response by:

John R Kalmar, DMD, PhD Clinical Professor of Pathology Associate Dean of Dentistry Administration College of Dentistry The Ohio State University