Objectives: Recently, an increasing number of elderly patients have complained of tongue pain and fissured tongue, while atrophy of the lingual papillae with low nutrition has also become a commonly encountered condition. The viewpoint that lingual papilla atrophy reflects systemic and pathological conditions, such as diabetes and in the circulatory system abnormalities, is supported by many clinicians. The present study was conducted to clarify the relationship of degree of atrophy of tongue papillae with oral symptoms, with an aim to evaluate the usefulness of clinical diagnostic criteria for tongue papillae atrophy. Subjects and Methods: The subjects were asked to protrude the tongue forward. The tongue was held at rest and impressions were taken of the tongue dorsum 15 mm posterior to the apex of the tongue. Surface impressions were measured using a Surfcoder SE300 and the obtained values were used to define surface roughness (Ra). Multivariate analyses of the relationships between the Ra measurements and the living environment, subjective symptoms of oral health, and survey results of measurements were performed to examine factors associated with Ra. The tongue was photographed with a digital camera, then RGB color value of four random points 15 mm from the tongue apex was determined. Using those findings, redness was calculated. Results and Conclusions: One hundred and six subjects with a mean age of 79.5 ± 9.2 years were analyzed. In the smooth group, there was more redness in the tongue dorsum as compared to the rough group. Total and Sagittal Ra values of subjects with dysphagia were lower than those without dysphagia, suggesting that the degree of oral mucosal atrophy is related to subjective symptoms of dysphagia. Subjects with high water intake had higher Coronal Ra values, which was considered to be related to the edematous state of the lingual papillae.