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  Teeth Care

What Causes a Scalloped Tongue?

scalloped tongue

April is Oral Cancer Awareness Month and we can’t think of a better time to discuss an aspect of oral health that many people encounter. 

The scalloped tongue. 

Though a scalloped tongue is typically asymptomatic and rarely a sign of a serious problem, understanding the cause of a scalloped tongue can help you stop the behaviors that are leading to it. 

Why are the edges of my tongue wavy?

Your Tongue and Oral Health

Your tongue tells a story. The shape, color, texture and appearance of your tongue can serve as a marker for what’s happening in the rest of the body. 

For instance, a red, strawberry colored tongue can be a sign of an underlying condition such as a vitamin deficiency or an allergy. 

What does a  scalloped tongue look like?

A scalloped tongue has wavy surfaces on the outermost edge. It is often described to look like a pie crust. 

The indentations are from the swollen tongue pressing against the lingual side (backside) of your teeth. A scalloped tongue is also sometimes called wavy tongue, pie crust tongue, rippled tongue or crenated tongue.

The swelling of a tongue is called macroglossia

Why do I have a scalloped tongue?

Indication of infection

Usually if an infection is present, there are additional signs such as burning, bumps, pain or redness. 

Check with your doctor to determine if infection is present. 

Hypothyroidism

A condition in which your thyroid fails to produce enough of its vital hormone, thyroxine (T4), this vital hormone controls how your body uses and stores energy. Medication can be prescribed to treat hypothyroidism. 

Lower teeth arch/jaw is too narrow

A scalloped tongue could mean nothing more than a result of your lower teeth arch being too narrow. Your tongue simply might not have enough room. Your dentist can measure your teeth arch to determine if this is the case. 

Parafunctional activity 

Big word but this just means habits or movements that are not part of the normal function of that body part; in this case, biting or talking habits. A scalloped tongue can be caused by parafunctional activities. Parafunctional activities are believed to be the #1 reason for a scalloped tongue. 

Vitamin or mineral deficiency

When the body is not getting enough vitamins or minerals (especially B vitamins), tongue enlargement can occur. Low levels of B12 in particular are indicated to cause scalloping of the tongue. Other possible vitamin deficiencies include riboflavin, niacin and iron. 

Malocclusion

This can include the presence of an underbite, overbite and teeth crowding. Pain and discomfort can result from malocclusion as well as difficulty chewing, sensitive teeth and repeated biting of the cheek or tongue.

Smoking

Smoking affects the immune system and can irritate the tongue to cause swelling. 

Sleep Apnea 

In two separate comparative studies (one conducted in 2005 and another in 2017), tongue scalloping was deemed to be predictive of sleep pathology. In both studies, the physicians concluded that tongue scalloping is a useful clinical indicator of sleep pathology and that its presence should prompt the physician to inquire about snoring history. If you snore, grind your teeth at night, or have a scalloped tongue, consider a visit with your physician about a sleep study to rule out sleep apnea.

Inflammatory conditions

Inflammatory conditions cause long term inflammation and increase the potential for a scalloped tongue to occur. 

Some genetic conditions such as down syndrome, congenital hypothyroidism, ipoid proteinosis, sarcoidosis, amyloidosis, angioedema, tuberculosis, neurofibromatosis, and multiple myeloma are associated with tongue scalloping. 

How can I make my scalloped tongue go back to normal?

If the scalloped tongue is a result of a parafunctional activity (remember, parafunctional activity is the #1 cause of a scalloped tongue) a mouth guard for teeth grinding may be recommended. 

Prescription medication

If the scalloped tongue is caused by an overactive immune system or thyroid issue, immunosuppressants can help to regulate the body’s inflammatory response. 

Natural ways to reduce the symptoms of a scalloped tongue

Stay hydrated– Drinking lemon water first thing in the morning is an excellent way to start your day on the right foot. Lemon water has excellent benefits and promotes hydration. Continue to drink water throughout the day. The U.S. National Academies of Sciences, Engineering, and Medicine suggest 2.7 liters of water per day for women and 3.7 liters for men. 

Practice good oral hygiene– Brush and floss your teeth regularly. The ADA recommends that you brush and floss your teeth twice a day. Use a tongue scraper to remove debris, bacteria and dead cells. 

Healthy lifestyle– Quitting smoking, reducing alcohol intake, getting plenty of sleep, reducing anxiety, exercising, healthy eating and practicing good oral hygiene are all excellent ways to naturally reduce inflammation in the body (i.e. your inflamed, scalloped tongue).

Warm & Cold Compresses– applying alternating warm and cold compresses to the area may help to reduce the swelling. Applying ice to the area several times a day no longer than 10 minutes with 20 min. breaks in between can reduce swelling. Warm compresses (not too hot) can also relieve the inflammation. 

Take an over the counter anti-inflammatory medication such as ibuprofen and acetaminophen

Wear a custom night guard

If your scalloped tongue is the result of bruxism, TMJ issues or sleep apnea, a mouth guard may be recommended to be worn nightly. The custom night guard will protect your teeth from clenching or grinding (parafunctional activity). A sleep apnea mouth guard can open your airway for a corrected breathing pattern. 

Using a lower teeth mouth guard will allow the tongue to return to a normal shape. 

upper and lower mouth guards

Do I need to see a doctor? 

If you’re experiencing pain or discomfort, you should schedule a visit with your doctor. A doctor can diagnose and treat the issue. If a more serious cause is afoot, your doctor can implement a treatment plan. 

Because tongue scalloping can be linked to many different aspects of your health, it’s important to visit your dentist for checkups and take care of your mouth and teeth. Remember, to brush and floss regularly and use a tongue scraper to remove bacteria and other particles. If you smoke, talk to your doctor about quitting.

Resources:

https://www.medicalnewstoday.com/articles/scalloped-tongue#causes

https://www.healthline.com/health/scalloped-tongue#_noHeaderPrefixedContent

https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/causes/

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256

https://pubmed.ncbi.nlm.nih.gov/16360522/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318817/

Author

Ashely Notarmaso

Ashely Notarmaso is the author behind the Sentinel Mouth Guard Blog. She is the CEO and founder of Sentinel Mouth Guards (Founded in 2012) Her long-time work in the dental mouth guard arena and her excellent ability to listen to customer concerns in this often contradictory field has laid the groundwork to explore night guard/mouth guard fabrication in-depth and address real concerns. With the help of her team, she has created a unique fabrication method that promises a great fitting custom oral appliance every time. Amazon’s choice for #1 mouth guard! Visit the online store http://sentinelmouthguards.com

Verified By

medically verified by dr greg grillo dds
Dr. Gregory Grillo, DDS

Doctor of Dental Surgery
UW School of Dentistry

Dr. Gregory Grillo, DDS is a dentistry practitioner in Omak, WA. Dr. Grillo completed a residency at United States Naval Dental Corp. He currently practices at Troy Robeck DDS Pllc.