Fissured tongue, dry mouth lead to bad, bad breath

Nearly every part of your mouth - from your gums and teeth to your palate and tonsils - can cause bad breath, and the tongue is no exception. For most people, the tongue is a prime breeding ground for odor-causing bacteria, but among people with lingua plicata, this problem can combine with dry mouth to create truly exceptional halitosis.

Unusual pleats

Also known as "fissured tongue," lingua plicata is a condition in which the surface of the tongue has many deep grooves in it. (Plicata comes from the Latin for "pleated.") It's not to be confused with geographic tongue, a similar condition that causes map-like cracks and discolorations on the tongue - though the two can occur together.

Fissured tongue is actually more common than you might think. According to Medscape Reference, between 2 and 5 percent of Americans have lingua plicata. Besides occurring in normally developed people, fissured tongue is especially prominent in individuals with Melkersson-Rosenthal syndrome and those with Down syndrome.

It can also happen spontaneously due to medical treatment. For instance, a study in the Canadian Medical Association Journal describes the case of a 30-year-old woman who developed lingua plicata and dry mouth after chemotherapy.

Fissured tongue does not cause any pain, fortunately, but it may entail other issues, including bad breath. The reason is plain: These grooves in the tongue give microbes shelter from many mouth-cleansing products.

Fissures ferment funk

As is the case with even a normal tongue, any little cracks or divots that microorganisms can squeeze into give them a place to set up shop. This is why dry mouth often leaves a scum on your tongue - the white film is a bacterial buildup that is best removed with a specialty tongue scraper.

For people with fissured tongue, these scrapers are more important than ever. Most oral health experts recommend that people with lingua plicata expand and flatten the tongue while using a scraper, for optimal gunk removal.

But the specialty regimen shouldn't end there. With even the most vigilant scraping routine, some microbes will remain deep in the pleats of a "plicated" tongue. Another method of attack is in order - namely, a specialty oxygenating mouthwash.

Such products make life hell for oral bacteria. Oxygenation is to the tongue as salt is to soil: It makes it difficult for anything to grow there. Then there's the fact that specialty mouthwashes avoid alcohol and sodium lauryl sulfate, two common irritants that do nothing more than cause dry mouth and canker sores. Instead, all-natural ingredients do all the dirty work, busting bacteria without causing redness or allergic reactions.

Does fissured tongue require treatment?

It doesn't. Most dentists say that lingua plicata is a harmless condition, since it isn't painful or degenerative. However, breath experts have a different take on this issue. After all, anything that allows bacterial growth and causes halitosis isn't harmless, even if it seems so.

Microbes are the cause of most instances of bad breath, assisted in many cases by a dry mouth. In patients with lingua plicata, both of these problems are more common.

In this context, then, a fissured tongue does need management (if not "treatment" in the curative sense). This means:

- Regularly brushing the tongue and teeth with an oxygenating toothpaste

- Using a specialty breath freshening tongue scraper

- Gargling with an alcohol-free mouthwash twice a day, and

- Using an oral care probiotics kit to discourage the growth of odor-causing microbes.