Symptoms
A wrinkled tongue is a variant of the tongue surface. It often manifests as a central longitudinal furrow from which additional, smaller, often symmetrical transverse furrows extend on either side. The transverse furrows may also occur alone. The depth and number vary interindividually. Folded tongue is usually asymptomatic, but sensitivity to sharp, acidic, or spicy foods is possible, see discussed in detail under the article Map Tongue. Deviation from the norm may be a psychosocial problem in some circumstances.
Causes
The exact cause has not yet been elucidated. It is known that heredity plays a central role. The mode of inheritance appears to be autosomal dominant, meaning that clustering in families is observed and it is likely that offspring will also develop this tongue variant. A recent study identified several genes involved in its development (Kalifatidis et al., 2010). Folded tongue is also seen in Melkersson-Rosenthal syndrome, an inflammatory disorder with fascial palsy, and can occur in people with Down syndrome, psoriasis, Sjörgen syndrome, Cowden syndrome, acromegaly, and concomitant map tongue, in part due to a common genetic cause. Associations with diabetes mellitus, vitamin B deficiency, and autoimmune diseases have also been found. Folded tongue occurs more frequently with increasing age. Thus, a distinction can be made between a congenital and an acquired form.
Diagnosis
Many people are not aware that they have a folded tongue. Diagnosis involves ruling out other tongue disorders that cause a similar clinical presentation and identifying any underlying underlying diseases.
Treatment
Usually, no treatment is necessary because there is no discomfort and no complications are expected. If wrinkled tongue occurs in association with a disease, treatment of the underlying disease may also cause wrinkled tongue to disappear. Some authors point out that food debris can be deposited in the furrows, which can lead to inflammatory reactions and bad breath. In such a case, good oral and tongue hygiene is recommended. If map tongue occurs at the same time, the appropriate treatment suggestions should be followed.
