DARE TO ASK: A forked tongue is more serious
By PHILLIP MILANO, The Times-Union
I've noticed that some people have cracks on their tongues. Why is this?
Walter S., 50, Houston
Hanging their heads out the window like dogs maybe?
Ron S., 60, Stockton, Calif.
I believe I read that one reason is a deficiency of a certain B vitamin.
Laurie B., 55, Boston
I have such a tongue. It causes weird patches and sometime fissures as a
result of the papillae wearing off. It is exacerbated by spicy and acidic foods
Tracy, 27, Dallas
My dad has cracks on his tongue, and he was told it was caused by his mouth
being overly dry. The condition may also have a genetic component: I also have
cracks, although not as bad as his.
Daniel, 26, Colorado Springs, Colo.
Here's a mouthful: benign migratory glossitis. It's an inflammatory
condition, more typically known as geographic tongue.
There are actually two separate conditions to be aware of here, says Robert
D. Kelsch, an oral pathologist at NorthShore LIj Health System in New Hyde Park,
One is "fissured" or "cracked" tongue, which can go hand-in-hand with
geographic tongue. Beyond cracks, the latter can lead to red patches on the top,
sides and underside of the tongue, with surrounding patches of white borders
that are irregular-shaped.
Sounds like . . . a map. Which is where it gets its name.
It can happen in about 20 percent of adults, likely has a hereditary cause
though a specific cause is unknown, has no demographic disposition and usually
goes away in about seven to 10 days, Kelsch said.
"It has nothing to do with diet or not eating or eating certain foods or
vitamin deficiencies or infection or cancer," he said.
However, that doesn't mean if you see something nasty in the mirror when you
stick out your tongue that you should just blow it off.
"One of the high-risk sites for oral cancer is the tongue, and it can present
as red and white patches, too. Since there can be some overlap in clinical
appearance between geographic tongue and oral cancer, it would be a good idea to
have it looked at."
Assuming it's geographic tongue, the most common thing to do is just wait for
it to go away, though in some more severe cases, a topical steroid can be
prescribed, Kelsch said.
And, if acidic foods like tomato juice or vinegar increase the burning
sensations of the affliction, then stay away from them during the outbreak.
"Really, the most bothersome thing is not knowing what it is," he said. "Many
patients have seen other specialists, some of whom may assume this is some kind
of pre-cancerous or fungal or viral infection, and they get put on all sorts of
meds, have biopsies done and it doesn't resolve it. By the time they see me,
they're very anxious and think it's some more serious disease that's incurable."
Phillip Milano, author of I Can't Believe You Asked That! (Perigee),
moderates cross-cultural dialogue at Y? The National Forum on People's
Differences. Visit www.yforum.com to submit questions and answers.