Smooth or Scalloped? Understanding Tongue Scalloping

This article has been checked and updated for accuracy on 04/02/2023

Have you ever looked at your tongue and noticed that the edges look a bit wavy or scalloped? If so, you might be experiencing a condition called tongue scalloping. Tongue scalloping, also known as crenated tongue or pie crust tongue, is a condition in which the edges of the tongue appear indented or rippled.

While tongue scalloping is usually harmless and doesn’t cause any pain or discomfort, it can be a sign of an underlying health condition. That’s why it’s important to understand what tongue scalloping is, what causes it, and how it can affect your overall health.

That’s where this article comes in! Our goal is to help you understand everything you need to know about tongue scalloping. We’ll explain what it is, why it’s important to know, and what you can do to prevent or treat it.

So whether you’re experiencing tongue scalloping yourself or just curious about this interesting oral condition, keep reading to learn more!

What is a Scalloped Tongue?

A scalloped tongue is a condition where the edges of the tongue appear to have indentations or scallops along the sides. These indentations are often most noticeable towards the back of the tongue.

Definition of tongue scalloping

Tongue scalloping refers to a condition in which the sides of the tongue display wave-like or grooved patterns that resemble the curves of a scallop shell. The severity of the condition can vary, ranging from slight indents to more pronounced scalloping patterns.

Now that we’ve established what tongue scalloping is, let’s take a closer look at what causes it and what symptoms you should be aware of.

Causes of tongue scalloping

One of the most common causes is a condition called bruxism (grinding or clenching of teeth). Bruxism exerts pressure on the tongue, resulting in its distinctive rippled appearance at the edges.

Other causes of tongue scalloping may include:

Dehydration: Insufficient hydration can cause the tongue to become swollen, which may lead to scalloping.

Enlarged tonsils: When tonsils are enlarged, the tongue may push against the teeth, causing scalloping to occur.

Sleep apnea: In sleep apnea, breathing repeatedly starts and stops during sleep. This condition can cause the tongue to shift around and become scalloped.

Symptoms of tongue scalloping

Aside from the visible scalloping on the edges of the tongue, there are typically no other symptoms associated with tongue scalloping. However, if the condition is caused by an underlying health condition, other symptoms may be present.

For example, sleep apnea may cause loud snoring, gasping for air during sleep, and excessive daytime sleepiness. Dehydration can cause dry mouth, fatigue, and dizziness. Enlarged tonsils may cause difficulty swallowing, sore throat, and ear pain.

If you’re experiencing tongue scalloping and are unsure of the underlying cause, it’s always a good idea to consult with your healthcare provider. They can help diagnose the cause of your scalloping and recommend appropriate treatment. 

Why does my tongue have waves on the sides?

The presence of waves or ridges on the sides of the tongue is a common occurrence and typically not a cause for concern. These waves are known as scalloped or indented edges, and they can appear as gentle or pronounced indentations along the lateral borders of the tongue.

The primary reason for scalloped edges on the tongue is the interaction between the tongue and the teeth during normal swallowing. As you swallow, your tongue pushes against the teeth, exerting pressure. In individuals with larger tongues or smaller oral cavities, the tongue may press more forcefully against the teeth, causing the tongue’s lateral edges to indent or form waves.

Several factors can contribute to the development of scalloped tongues:

1. Tongue size and shape: Individuals with larger tongues may be more prone to having scalloped edges, as the larger tongue size creates more contact with the teeth during swallowing.
2. Teeth alignment: Irregular teeth alignment or malocclusion, such as overcrowding or misalignment, can increase the likelihood of tongue and teeth contact during swallowing, resulting in scalloped edges.
3. Bruxism: Teeth grinding or clenching, known as bruxism, can put excessive pressure on the tongue and lead to indentations on the sides. Bruxism is often associated with stress or a misaligned bite.
4. Tongue thrusting: Habitual tongue thrusting, where the tongue pushes against the teeth while at rest or during swallowing, can contribute to the development of scalloped edges.

It’s important to note that while scalloped edges are usually harmless and do not require treatment, they can sometimes indicate an underlying issue. If you experience other symptoms such as pain, discomfort, changes in taste, or difficulty speaking or swallowing, it is advisable to consult a healthcare professional or a dentist for a thorough evaluation.

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 does it occur?

Tongue scalloping can stem from various causes, but certain factors are particularly common contributors. Among these, pressure on the tongue is a major culprit, which can result from bruxism (grinding or clenching of teeth), enlarged tonsils, or sleep apnea.

Additional factors that may play a role in tongue scalloping include:

Dehydration: When the body becomes parched, the tongue can become swollen and scalloped.

Nutritional deficiencies: If certain nutrients, such as iron or vitamin B12, are lacking in the diet, the tongue may become inflamed and scalloped.

Medications: Some medications, such as diuretics, can lead to dehydration and contribute to tongue scalloping.

B. Health conditions associated with tongue scalloping

While tongue scalloping itself is usually harmless, it can be a sign of an underlying health condition. Some of the health conditions associated with tongue scalloping may include:

• Sleep apnea: As we mentioned earlier, sleep apnea can cause the tongue to move around and become scalloped.
• Hypothyroidism: Hypothyroidism is a condition in which the thyroid gland doesn’t produce enough hormones. Hypothyroidism can cause the tongue to become enlarged and scalloped.
• Sjogren’s syndrome: Sjogren’s syndrome is an autoimmune disorder that can cause dry mouth, leading to dehydration and scalloping.

Although tongue scalloping is not typically a serious condition on its own, it can be an indicator of an underlying health issue with potential health implications. For instance, sleep apnea has been linked to an increased risk of heart disease, high blood pressure, and stroke. Hypothyroidism can cause a variety of symptoms, including fatigue, weight gain, and depression.

Can anxiety cause a scalloped tongue?

While anxiety itself doesn’t directly cause a scalloped tongue, it can contribute to the development or exacerbation of certain habits or conditions that may lead to scalloping. Here’s some information to address the relationship between anxiety and a scalloped tongue:

1. Bruxism: Anxiety and stress can often lead to bruxism, which is the clenching or grinding of teeth. Bruxism can put excessive pressure on the tongue during sleep or wakefulness, leading to indentations on the sides. In some cases, this prolonged pressure can result in a scalloped appearance.
2. Tongue thrusting: Anxiety or stress can sometimes manifest as a habit of tongue thrusting, where the tongue pushes against the teeth while at rest or during swallowing. Habitual tongue thrusting can contribute to the development of scalloped edges on the tongue.

What Can an Individual Do to Fix Scalloped Tongue?

If you have a scalloped tongue, it is essential to find out the root cause to determine the right course of action. Here are some steps to fix a scalloped tongue:

1. Address the underlying cause: Scallop tongue is often a symptom of an underlying health issue. The most common causes include sleep apnea, allergies, and vitamin deficiencies. To fix your scalloped tongue, it is important to address the underlying cause. Consult with a medical professional to get an accurate diagnosis and treatment plan.
2. Practice good oral hygiene: Good oral hygiene can help alleviate some of the symptoms associated with a scalloped tongue. Brush your teeth twice a day, floss daily, and rinse your mouth with an antiseptic mouthwash to prevent bacterial growth.
3. Drink plenty of water: Drinking water can help prevent dehydration, which can exacerbate the symptoms of a scalloped tongue. Drinking water can also help flush out toxins and improve overall oral health.
4. Change your diet: Certain foods can trigger allergies and cause inflammation in the mouth, leading to a scalloped tongue. Eliminate foods that may be causing an allergic reaction or inflammation. Incorporate foods rich in vitamins B and C to help promote healthy oral tissue.
5. 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. 

Additional ways to reduce the symptoms of a scalloped tongue

 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. 

Home remedies for tongue scalloping

• Good oral hygiene: Maintaining good oral hygiene can help prevent tongue scalloping caused by infections or inflammation. Brush your teeth twice a day, floss regularly, and use mouthwash to keep your mouth clean and healthy.
• Saltwater gargle: Gargling with warm salt water can help reduce inflammation and alleviate symptoms of tongue scalloping. Mix a teaspoon of salt in a cup of warm water, then gargle for 30 seconds before spitting it out.
• Herbal remedies: Some herbs, such as aloe vera or chamomile, have anti-inflammatory properties and may help reduce swelling and alleviate symptoms of tongue scalloping. Consult with a healthcare provider before using any herbal remedies.

Lifestyle changes to prevent tongue scalloping

• Weight management: If tongue scalloping is occurring because of sleep apnea, losing weight may help alleviate symptoms by reducing pressure on the airway.
• Sleep position: Sleeping on your side instead of your back may help prevent tongue scalloping caused by sleep apnea.
• Avoiding tobacco and alcohol: Tobacco and alcohol use can irritate the tongue and throat and contribute to tongue scalloping. Quitting smoking and reducing alcohol intake may help prevent tongue scalloping caused by these factors.

It’s important to note that while home remedies and lifestyle changes may help alleviate symptoms of tongue scalloping, they are not a substitute for medical treatment. Consult with a healthcare provider before trying any home remedies or making significant lifestyle changes. They can help you identify the best treatment plan for your specific needs and circumstances.

In conclusion, tongue scalloping is a condition characterized by indentations or grooves on the sides of the tongue. Tongue scalloping can be caused by a variety of factors, including structural abnormalities, inflammation, and underlying health conditions such as sleep apnea or hypothyroidism.
It’s important to seek medical attention if you are experiencing tongue scalloping, as it can be a symptom of a more serious health condition. Your healthcare provider can help you identify the underlying cause of your tongue scalloping and recommend an appropriate treatment plan.
In addition to seeking medical attention, there are steps you can take to maintain your oral health and prevent tongue scalloping. These steps include:
-maintaining good oral hygiene
-Avoiding tobacco and alcohol use
-making lifestyle changes to address any underlying health conditions such as sleep apnea.

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/