Scalloped Tongue Causes, Diagnosis & Treatment to Get Rid of It

Your tongue may exhibit some characteristics that are unusual. It may show wavy lines, swell a bit or get inflamed.

The reason for this is its activity and the general condition of your body. It may reveal much more than you think. So, what do wavy lines on the edge of the tongue mean?

What is a scalloped tongue?

Also called a wavy tongue, crenated tongue, pie crust tongue or lingua indentata, a scalloped tongue is the name given to the rippled or wavy indentations which appear along the edge or sides of the tongue in persons affected by this condition.

Often, the indentations are not painful although the cause of the condition may lead to some pain.

Scalloped tongue anxiety
Anxiety and thyroid problems may cause scallping or wavy lines on the edge of your tongue.

This condition often leads to the sensitivity or redness of the lining of the mouth at the sides which are closest to the tongue. Although the redness or sensitivity is not common, it may be the case if you apply friction or pressure to the affected skin.

Most cases of a crenated tongue are nothing to worry about although others may lead to serious issues including cancer. It all depends on the cause of the condition and other factors affecting you.

Causes of scalloped tongue

When the tongue is swollen or inflamed, it will lead to a scalloped tongue in most cases. The swelling of the tongue is called macroglossia and it leads to other symptoms as per the cause of the swelling. The total sum of the symptoms will allow the individual to know what causes the scalloped tongue in the first place.

Among the most common causes of this condition include:

Temporomandibular joint disorder (TMJ/TMD)

The temporomandibular joint is the join linking the skull to the lower jaw. If this joint becomes misaligned or stuck in a way, it will fall upon the tongue to create the pressure required to hold the jaw in place.

To do this, the tongue must be pressed against the teeth and the lower mouth to provide the pressure needed to hold the jaw in place. A scalloped indentation will likely develop on the tongue.


When you are anxious or stressed over something, you will exhibit various signs in the body. A group of oral symptoms of stress and anxiety includes pressing the tongue against the teeth, grinding the teeth or pain in the jaw.

In the long haul, the tongue will become scalloped due to the consistent damage it endures from the teeth.

Finding calm during stressful moments may be a way of avoiding this kind of response to the situation.


This disease is characterized by the buildup of proteins in the organs of the body. Among the most likely places for the protein accumulation is the soft tissues such as the tongue.

As the amount of proteins increases in the tongue, you will likely notice a swollen and inflamed tongue. As it pushes against the teeth, it will cause a scalloped tongue condition.

Birth defects or genetic condition

This condition can also be caused by some birth defects such as:

  • Congenital hypothyroidism
  • Down syndrome
  • Apert syndrome

For such causes of a pie crust tongue, it is difficult to treat since most conditions affect the whole body in general. They are also not reversible.

Sleep apnea

Sleep apnea is a condition which affects you by making it difficult to breath when sleeping. Due to this difficulty, you may unknowingly push the tongue between the teeth to allow breathing. With time, it may become a habit which ends up damaging the tongue to cause lingua indentata.

Parafunctional habits

A parafunctional habit is simply a habit you develop overtime to an extent that you can perform it without thinking of it. For example, picking your nose, rolling your tongue, biting your tongue and many others are examples of parafunctional habits.

The problem with some of this habits is that they put you at risk of serious conditions once especially those that involve biting the tongue. With time, the biting will damage the tongue. If the habits are not rectified on time, they may lead to irreparable damage.

Stopping some of these parafunctional habits is a problem given that they may require occupational therapy or treatment for them to go away.


When the body has less water than it needs to function normally, swelling may be the result of such. As simple as it sounds, the lack of water in the body may be the reason behind your tongue being swollen.

Swelling from dehydration is often temporary and having a glass of water will make it go away. If not, the cause of the welling will be different.


Hypothyroidism is a condition in which you have low amounts of the thyroid hormone. Among the symptoms of low levels of the thyroid hormone include:

  • Fatigue and tiredness
  • Loss of hair
  • Bruises
  • Cramps and aches
  • Low levels of blood pressure.

If these symptoms appear and yet you have a swollen tongue, you need be checked by the doctor since the hypothyroidism would have caused the issue with the tongue.

All the causes explained here can occur either alone or as combinations of each other. Your doctor will check for the symptoms of each condition to ascertain the actual cause of the condition.

Complications of scalloped tongue

Contrary to popular belief, a scalloped tongue is not a serious or dangerous issue. Neither is it likely to cause any complications. However, the friction between the tongue and the teeth often irritates the tongue leading to inflammation.

When you have any complications from this condition, it is often due to the cause of the condition. If you do not have the scalloped tongue treated on time, it may lead to severe conditions which may affect other parts of the body as well.

If Temporomandibular joint disorders is not treated early enough, it will lead to symptoms such as:

  • Having pain from one or both Temporomandibular joints.
  • Your jaw may be painful or tender.
  • Pain or aching in and around the ear.
  • Having facial pain.
  • Pain when you chew on something.
  • The joint may lock at the joint making it difficult to open and close the mouth.
  • Pain in the ear
  • Popping sounds may be heard in the ears

If anxiety or stress is not deal with, it may cause the following signs and symptoms:

  • Agitation, frustration and moodiness
  • Difficultly with relaxing the mind
  • Craving solitude
  • Headaches
  • Tense and painful muscles
  • Insomnia
  • Low libido
  • Difficulty with swallowing and a dry mouth
  • Worrying consistently
  • Being forgetful
  • Lack of focus
  • Overall pessimism
  • Avoiding responsibilities and many other signs

The lack of treatment of amyloidosis leads to various symptoms like the following:

  • Being weak and fatigued
  • Having the carpal tunnel syndrome which involves pain, tingling and numbness in the hands (wrists) or feet
  • Your legs or ankles may become swollen
  • You may have shortness of breath
  • You either become constipated or you have diarrhea
  • Your tongue will become enlarged
  • You could lose weight significantly
  • The heartbeat may be irregular
  • Skin changes among them bruising and purple patches around your eyes
  • Difficulty with swallowing

Birth defects such as the Down syndrome do not have treatment as such. However, they require proper management to avoid their respective complications. The symptoms of Down syndrome include:

  • Having a small head and ears
  • Flat facial features
  • A short neck
  • The eyes may be slanted upwards
  • A bulging tongue
  • Having a poor muscle tone
  • The ears have an atypical shape
  • Poor judgement
  • Slow learning capabilities
  • Impulsive behavior
  • Short attention span and others.

When you have sleep apnea, it is often not a serious case. However, if left untreated, it will lead to various symptoms among them the following:

  • Momentary breathing cessation during sleep
  • Loud snoring
  • You may have abrupt awakenings
  • Headaches in the morning
  • Having a dry throat and mouth upon waking up
  • Issues with staying asleep
  • Having attention deficit
  • Daytime sleepiness called hypersomnia
  • Being easily irritability

For parafunctional habits such as biting the tongue or grinding teeth, occupational therapy and at times treatment using medicine may be the required remedy. If there is a habit you are used to and it has consequences, you need to see a doctor about it.

Dealing with dehydration should be a simple process of having a glass of water. However, if you are dehydrated to the extent where some of your organs start having difficulty functioning, it requires medical attention. For most people, it is a simple routine of drinking as much water as reasonably possible during the day. 8 glasses is the recommended amount for adults.

Both hyperthyroidism and hypothyroidism may require hormonal interventions to restore normalcy in the working of the body. Among the symptoms of hypothyroidism are:

  • Being highly sensitive to cold
  • Fatigue
  • Constipation
  • Weight gain
  • Dry skin
  • Having a puffy face
  • Hoarseness
  • Having high levels of blood cholesterol
  • Muscle weakness
  • Having stiff, tender and painful muscles
  • A slower heart rate
  • The joints may become swollen, stiff and painful
  • Thinning hair
  • Having irregular periods that are heavier than normal
  • Impaired memory
  • Depression

In all these situations, the attention of a doctor is required even in the mild forms of the condition. Seeing a doctor early helps in preventing the advancement of the disease.


Proper diagnosis of the actual cause of a scalloped tongue is paramount to the provision of care when you have this condition.

Scalloped tongue
Syptoms of a scalloped tongue

First of all, it helps in the realization of which complications to expect and what to do to prevent or live with them.

Besides this aspect, having a proper diagnosis will ensure that you get the right treatment for your condition.

The diagnosis process begins with a review of your medical history and general health to ascertain what ails you. The doctor will then establish the underlying cause of your condition and advise on the way forward.

Lab tests are also to be carried out to check for any anomalies such as for toxins and amounts of minerals, vitamins, proteins and others. Tissue samples may also be put to the test to ascertain the underlying cause.

Getting rid of scalloped tongue

The solution to this condition depends on the underlying cause. Depending also on the severity of the condition, the following are the most likely solutions to the issue.

Surgery for TMJ

For this condition, there are various methods available for its treatment and soothing of the pain. They include:

  • Dental splints can be used to prevent the grinding of the teeth. It can be a bite guard, stabilization splint or occlusal splint all of which are in the form of a mouth guard.
  • The use of physical therapy which entails jaw exercises can help with the increase in the range of motion, flexibility besides strengthening the muscles.
  • At times, Botox can be used in relaxing the muscles of your jaw.
  • The pain from this condition can be reduced by biobehavioral management with such methods as biofeedback and cognitive behavioral therapy being used.
  • Medical marijuana has also been used to relieve pain during this condition.
  • Surgery on the affected jaw may be required in severe cases. The jaw may even require total replacement.
  • Medicine may be used for the same issue such as muscle relaxers, tricyclic antidepressants, anti-inflammatory medicine, steroid injections, nerve pain medications, sleep medications, benzodiazapines and opiate medications.

At home, you can manage this condition by reducing stress, not chewing often, massage and using ice packs on the jaw.

Improve your sleep quality

If the cause of the wavy tongue is sleep apnea, the following methods can be put to use to treat the condition:

  • Using a continuous positive airway pressure (CPAP) machine that helps you breathe easily using positive airway pressure.
  • Making some lifestyle changes such as the loss of weight is beneficial to dealing with sleep apnea.
  • Some oral breathing devices like nasal dilators can also be used to provide easy breathing.
  • Surgery may be required in some cases.
  • You may use medicine to sleep at night and stay away during the day.

Manage anxiety and stress

The management of stress should be a lifelong skill to maintain good health at all times. For one, stress is simply a matter of knowing what to do and what not to do. Given that stress and anxiety are causes for a lot of issues including death if left untreated, the need to manage stress is an important part of treatment.

When stressed, avoid the following:

  • Using drugs as a way of relaxing
  • Smoking
  • Resorting to alcohol use
  • Eating unhealthy food
  • Withdrawal from social circles
  • Procrastinating activities
  • Appearing busy when you are not by filling up your schedule with trivial matters
  • Focusing on addictions rather than important things
  • Being irritable with others

You can however practice the 4 A’s of managing stress as follows:

  • Avid stress when you can.
  • Alter the situation or the way you respond to the situation.
  • Adapt to the aspect stressing you up.
  • Accept that which you have no power over. That means accepting the situation if you cannot change it.

Amyloidosis management

A scalloped tongue caused by Amyloidosis presents a complex issue given that the disease itself cannot be treated. There are however ways in which the symptoms and signs can be managed to provide relief for the patient. They include:

  • The use of chemotherapy medicine to inhibit the growth of abnormal cells.
  • Liver transplant may be required.
  • Anti-inflammatory medicine.
  • Kidney transplant or dialysis.
  • Avoiding stress.
  • Eating a balanced diet.

The problem with having genetic disorders is that they cannot be treated. Given that they occur at the genetic level and only the outward results are visible, it is difficult to treat them. They are thus only managed as the individual grows.

The management of these conditions focuses on managing the symptoms caused by these diseases and disorders.

Occupational therapy

With the kinds of parafunctional habits, occupational therapy is required to retrain the mind into refraining from them. At times, it may require the use of medicine to stop the habit.

Drink plenty of water

Dealing with dehydration is as simple as taking enough water on a regular basis. Most people make the mistake of thinking they need to be thirsty before taking water.

Simply have a schedule whereby you are taking water often to keep dehydration at bay.

Hormonal therapy

If your kind of scalloped tongue is due to hypothyroidism, there is the need to have medicine or hormonal therapy to restore the levels of the thyroid hormone in the body.

Having a scalloped tongue can be temporary as in the case of dehydration or permanent as is the case in having Down syndrome and other major diseases. Proper management of this condition will go a long way in ensuring you live as normal a life as possible.

When to call a doctor

Although cases of scalloped tongue are not life threatening, there are times when the attention of a medical doctor will be required. To stay on the safe side, you need to first of all detail out all the symptoms you are having when you have an enlarged or scalloped tongue.

Given that this condition results from a myriad of causes, you will need to have knowledge on which ones are the most likely ones to cause scalloped tongue.