Do You Have A 'Scalloped Tongue'? We've Got Important News For Your Health

Experts explain what those indentations or rippled edges might mean.

You probably don’t spend much, if any, time looking at your tongue ― but this body part can actually reveal a lot about your health.

Take its shape, for example. A scalloped tongue is when, as the name suggests, there is “scalloping or indentation of the sides of the tongue,” Dr. Neeraj Panchal, chief of oral and maxillofacial surgery at Penn Presbyterian Medical Center, told HuffPost. “It typically arises from the tongue persistently pressing against the teeth.” 

This condition, also known as a crenated tongue or pie crust tongue, can be seen when you stick your tongue out. Look for the presence of irregular ridges or waves along the lateral borders that “seem to imprint the shape of your teeth,” Dr. Soroush Zaghi, a Los Angeles ear, nose and throat doctor and sleep surgeon, told HuffPost. 

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A scalloped tongue has indentations from the teeth along the sides.

Below, experts explain some of the potential reasons your tongue may look like this and what it might mean for you:

1. You might have a vitamin deficiency. 

Being deficient in certain nutrients — especially B vitamins, such as B12, folate (B9) and riboflavin (B2) — can lead to a swollen tongue, said Zaghi, as well as other oral health issues like inflammation of the gums. 

“This swelling can cause the tongue to press against the teeth, creating a scalloped appearance,” he said. “These vitamins are crucial for cell regeneration and maintaining healthy mucosal tissues in the mouth.”

2. You might be clenching or grinding your teeth. 

Another potential cause of a scalloped tongue? Bad oral habits, such as teeth clenching or grinding (the medical term is bruxism). These behaviours are quite common in people who are dealing with significant stress or anxiety. Signs of teeth grinding and clenching include headaches, jaw pain, wear and tear of the teeth, and sensitivity to hot and cold foods. 

These conditions “exert extra pressure on the sides of the tongue, potentially leading to a scalloped appearance over time,” Zaghi said. “Similarly, tongue thrusting, where the tongue is pressed too hard against the teeth frequently, can contribute to the condition.” 

3. You could be dehydrated. 

Inadequate fluid intake can cause tissue in the body to swell, and that includes the tongue. 

“A swollen tongue may press against the teeth more frequently or forcefully, resulting in the characteristic scalloped edges,” Zaghi said. 

4. You may have limited tongue space.

“Anatomical factors, such as a narrow or high-arched palate, or a recessed jaw, can limit the space available for the tongue in the mouth,” Zaghi said. “This limitation forces the tongue to press against the teeth,” which leads to those indentations. 

5. You might have sleep apnea. 

Obstructive sleep apnea (OSA) is a disorder in which your breathing is repeatedly disrupted throughout the night due to a blocked upper airway. The condition, which includes symptoms such as loud snoring and daytime sleepiness, is more common among people with certain anatomical traits, such as a small or recessed jaw or large tongue.

When someone with OSA is struggling to breathe at night, they may unconsciously press the tongue against the teeth. 

“Conditions like obstructive sleep apnea, where the tongue may block the airway during sleep, are often associated with limited tongue space,” Zaghi said.

If left untreated, OSA can have serious health implications, like increasing your risk of cardiovascular problems or being involved in a car accident due to sleep deprivation.  

6. You could have a TMJ disorder.

Disorders of the temporomandibular joint (TMJ), which connects your lower jawbone to the skull, may cause symptoms like jaw pain, earaches or difficulty opening or closing the mouth.

“The misalignment or dysfunction associated with TMJ disorders can reduce the space for the tongue, contributing to a scalloped appearance,” Zaghi said. 

7. You might have a thyroid issue. 

Hypothyroidism is a condition in which your body does not make enough thyroid hormones. For some folks, an underactive thyroid can cause the tongue to swell so that it presses more forcefully against the teeth. Other symptoms include fatigue, weight gain, difficulty tolerating cold and thinning hair. 

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A chronic scalloped tongue can be a sign of an underlying health issue. So it's worth getting it checked out.

Is A Scalloped Tongue Cause For Concern? 

Having a scalloped tongue, in and of itself, is generally not harmful, Zaghi explained. However, chronic scalloping may be a sign of an underlying health issue that does need attention, he said. So it’s important to figure out the root cause. 

According to Zaghi, you should make an appointment with a health care professional if the scalloping is persistent over time, if you’ve developed sore spots on the tongue that are painful or slow to heal or if you have other symptoms, such as difficulty swallowing or trouble speaking, or have observed other changes to your oral health. 

Generally speaking, it’s a good idea to reach out to a medical or dental professional for an evaluation anytime you notice “unusual lesions of the mouth or tongue,” Panchal said, as “early diagnosis of lesions is essential.”

Additionally, if you’ve noticed potential symptoms of some of the other health issues discussed above — such as sleep apnea, a TMJ disorder or an underactive thyroid — that also warrants a call to a health care provider. Depending on the nature of your symptoms, that might be your primary care physician, a dentist or other specialist. 

“Treatment might involve dietary adjustments, orthodontic treatments to address limited tongue space, interventions for oral habits like bruxism, or managing any associated conditions, like TMJ disorders or sleep apnea,” Zaghi said.  

A health care professional can help you determine the cause of your scalloped tongue and find the right treatment options for you, Zaghi said. 

“This proactive approach ensures not only the resolution of the scalloping but also contributes to overall oral and general health.”