A scalloped tongue, also known as a crenated tongue, presents wavy indentations along the sides. These indentations, called crenations or scalloping, result from pressure from the adjacent teeth. When your tongue is compressed against the surrounding teeth, the edges bear the most pressure, leading to a wavy or scalloped appearance. Various health conditions can cause a scalloped tongue, including sleep apnea, anxiety, and certain autoimmune or endocrine disorders. However, it isn’t a major cause for concern in most cases.
What Does a Scalloped Tongue Look Like?
A scalloped tongue has edges described as rippled, wavy, or dented. Other terms include pie crust tongue or lingua indent. If you look in the mirror and see that your tongue’s sides have a wavy pattern, you likely have a scalloped tongue.
Symptoms of a Scalloped Tongue
Aside from your tongue’s appearance, you may not notice any other symptoms from a scalloped tongue. However, you may experience:
- Soreness or pain in your tongue, mouth, or throat
- Tongue numbness
- Other changes in the appearance of your tongue, such as redness or an unusually smooth surface
- Difficulty breathing (if your tongue is enlarged)
Depending on the underlying cause of your scalloped tongue, you may also have non-tongue-related symptoms.
Causes of a Scalloped Tongue
A scalloped tongue isn’t necessarily dangerous but can be a symptom of various medical conditions. We’ll discuss each of these below.
Stress and Anxiety
Chronic stress and anxiety can lead to bruxism and tongue swelling, both of which can contribute to a scalloped tongue. Bruxism is the unconscious habit of teeth grinding or jaw clenching, which can pressure your tongue. Many people experience bruxism during the day, while they sleep, or both. Bruxism can be caused by stress, anxiety, or other factors. Some people experience tongue swelling, or the feeling of swelling, as a symptom of anxiety. If your tongue is swollen for a significant period, it can appear rippled or scalloped due to being pressed against your teeth.
Nutritional Deficiencies
A scalloped tongue can be a sign of vitamin deficiency or dehydration. If you’re dehydrated or aren’t getting enough iron or B vitamins, your tongue may become larger than normal. This can lead to rippling or scalloping where your tongue touches your teeth. Dehydration, B vitamin deficiency, and iron deficiency can all cause other symptoms, such as:
- Lightheadedness or dizziness
- Weakness or fatigue
- Confusion
- Increased heart rate
You may also notice flushing, dry mouth, and darker urine with dehydration. An iron or B vitamin deficiency makes you more likely to notice pale skin, numbness or tingling, and shaky muscles.
Amyloidosis
Amyloidosis is a disease caused by a buildup of abnormal clusters of protein (amyloids) in different body parts. It can run in families or be a side effect of another condition, and most often begins between ages 55 and 60. Symptoms of amyloidosis include:
- Enlargement or swelling of the tongue
- Abdominal or leg swelling
- Unintended weight loss
- Fatigue
- Frothy urine
- Skin that bleeds or bruises more easily than usual, including under-eye bruises
Amyloidosis can harm your brain, heart, kidneys, and other organs. Treatment may include chemotherapy, stem cell transplants, and various medications. These are all aimed at reducing inflammation and the buildup of amyloids. Talk to your doctor immediately if you have any of the above symptoms.
Thyroid Disorders
The thyroid gland in your throat produces hormones and regulates metabolism. If you have low levels of thyroid hormone (hypothyroidism), you may experience tongue enlargement and scalloping. Other soft tissues, such as the lips and skin, may also be affected. Other symptoms of hypothyroidism include:
- Fatigue or low blood pressure
- Unintended weight gain
- Hair loss
- Dry skin, which may bruise easily
- Joint and muscle pains or cramps
- Sensitivity to cold
- Depression
- Irregular periods in females
An inflamed or overactive thyroid (thyroiditis or hyperthyroidism) may also affect your tongue. It may cause burning mouth syndrome. See your doctor if you notice any unusual changes to the feeling or appearance of your tongue, especially if you also have other symptoms of thyroid disorder.
Sleep Apnea
Some studies have found evidence of a link between a scalloped tongue and obstructive sleep apnea (OSA). One study found the link to be especially strong in people who were overweight. People with sleep apnea experience temporary pauses in breathing while they sleep. During these pauses, their tongue may push against their teeth as they struggle to breathe. Other possible symptoms include:
- Sleepiness or low energy during the day
- Irritability
- Morning headaches
- Waking up with a dry mouth
- Insomnia
Untreated sleep apnea can be life-threatening. If you suspect you have sleep apnea, see your doctor as soon as possible.
Macroglossia
Macroglossia is the technical term for an enlarged tongue. Some conditions we listed above can cause macroglossia to develop over time, but it’s also possible to be born with it. You may be perfectly healthy and have a slightly larger tongue than the average person. However, many people are born with macroglossia as a result of genetic disorders like the following:
- Down syndrome
- Acromegaly
- Apert syndrome
- Beckwith-Wiedemann syndrome
Each of these conditions has a variety of other symptoms, which are often present at birth. It’s also possible to have relative macroglossia—in this case, the tongue is normal, but a small lower jaw makes it appear larger.
Other Causes
Scalloping is often the result of tongue swelling or enlargement (macroglossia). With an increase in size, the tongue presses against the teeth more than usual. A swollen tongue can have various other causes, including:
- Allergic reactions or irritating foods
- Inflammatory or autoimmune conditions, such as Sjögren’s syndrome
- Other metabolic disorders, like mucopolysaccharidosis or lipoid proteinosis
- Certain cancers, including tongue cancer (though this is rare)
- An injury, such as a burn to the tongue
- An oral yeast infection
The conditions above typically involve significant oral pain and sometimes other bodily symptoms. If you notice wavy tongue edges but have no pain or other symptoms, these are unlikely to be the cause. Even if your tongue isn’t swollen, temporomandibular joint disorders may create scalloped edges due to teeth clenching. It’s also possible for your tongue to have rippled edges due to missing teeth.
How to Get Rid of a Scalloped Tongue
In most cases, a scalloped tongue isn’t a reason to worry. However, it can sometimes indicate a potentially serious underlying condition. The best course of treatment will vary from one condition to another.
Professional Treatments
Professional treatment will address the cause of your scalloped tongue. After arriving at a proper diagnosis, your doctor may recommend:
- Specific medications (for conditions such as amyloidosis or thyroid disorders)
- Chemotherapy (for amyloidosis or cancer)
- IV fluids (if you’re severely dehydrated)
- Anxiety medication
- Treatment for sleep apnea, such as a mouth guard or CPAP machine
- Tongue reduction surgery (if you were born with macroglossia)
Most of these conditions are rare (sleep disorders and anxiety being major exceptions). In addition, they’re likely to cause other symptoms and may have complications beyond tongue scalloping. If you have a scalloped tongue and no other symptoms or concerns, you don’t necessarily have a condition that requires professional treatment.
Home Remedies
If your scalloped tongue is due to dehydration or a nutrient deficiency, you can take steps at home to reduce it. Drinking more water throughout the day will help keep you from getting dehydrated. Consider drinking a sports drink or electrolyte solution (such as Pedialyte) if dehydrated. This will help replenish lost fluids and important minerals like sodium and potassium. If you’re deficient in B vitamins or iron, try adding more foods to your diet that contain these nutrients. Eggs, seafood, red meat, leafy greens, and fortified cereals can help raise your B vitamins and iron levels. Your doctor may also recommend oral supplements to replenish your body’s iron or vitamin B levels.
When to See a Doctor
See your dentist or doctor if you notice any unusual or unexpected changes to how your tongue looks and/or feels. While a scalloped tongue generally isn’t an emergency, a doctor can help you determine what may be causing it. Be sure to inform your doctor of any other symptoms you’ve been experiencing. If you have severe oral pain or difficulty breathing, seek emergency care.
How to Make Your Tongue Feel Normal Again
This depends on the underlying cause. A wide variety of conditions, some more serious than others, can cause changes in your tongue’s appearance and sensation. Many people with tongue indentations don’t notice them until they look in the mirror. They’re rarely painful. But if you notice changes in how your tongue feels, see your dentist or doctor.
Conclusion
A scalloped or crenated tongue has wavy indentations along the sides. These indentations are created by pressure, often due to a person’s tongue being larger than normal or tension in the jaw or teeth. In most cases, a scalloped tongue isn’t anything to worry about. However, tongue enlargement and crenation can sometimes be signs of a more serious illness. If this is the case, you’re likely to have additional symptoms. Talk to your doctor if you notice any unusual changes in how your tongue looks or feels. Let them know if you’re experiencing any other symptoms as well.
FAQs
1. Can a scalloped tongue be a sign of cancer?
While various conditions can cause a scalloped tongue, tongue cancer is rare. See a doctor for evaluation if you notice significant pain or other unusual symptoms.
2. Is a scalloped tongue always due to a medical condition?
Not always. Sometimes, a scalloped tongue can result from habits like teeth grinding or having a naturally larger tongue.
3. Can dehydration cause a scalloped tongue?
Dehydration can cause the tongue to swell, leading to a scalloped appearance.
4. Are there home remedies for a scalloped tongue?
Stay hydrated and ensure you get enough vitamins and minerals. If the condition persists, see a doctor.
5. Should I be worried if my child has a scalloped tongue?
Not necessarily. However, it’s best to consult a pediatrician to rule out any underlying conditions, especially if the condition is accompanied by other symptoms.