Scalloped Tongue Causes and Treatments

Published on: July 10, 2021 (Last modified on: May 5, 2023)

A man looking at his scalloped tongue in the mirror.

Do you have indents on the sides of your tongue? This condition is called a scalloped tongue, and is also referred to as pie crust, crenated, crenulated and wavy tongue. There are a wide variety of reasons for this condition – most involve swelling in the tongue that pushes the tongue into the teeth. If you have a scalloped tongue and want to know what is causing this condition and what treatments are available, here is what you need to know.

Scalloped Tongue Causes

The main symptoms of a scalloped or crenated tongue is the indented edges, but there are other symptoms. Patients may experience pain and tenderness in their tongue, difficulty swallowing, redness and a sore or achy throat. Scalloped tongue and the associated symptoms are usually a sign of another condition that is causing inflammation or swelling in the tongue, or due to the tongue pressing against the teeth. So, what causes scalloped tongue?

Congenital Disorder: There are some congenital, or birth, defects that can cause a crenulated tongue. Down syndrome, apert syndrome and congenital hyperthyroidism can all cause inflammation and swelling of the tongue that result in a wavy-edged appearance.
Nutrient Intake and Dehydration: If you are not getting enough nutrients or water, it can cause a scalloped tongue. If you are not getting enough iron, B12, riboflavin or niacin, it can cause scalloped tongue. Dehydration can also cause inflammation and swelling of tissue, including the tongue. Make sure you are eating a balanced diet and drinking enough fluids every day.
Sleep Apnea: If you have obstructive sleep apnea, your airway can be blocked and restrict breathing while you sleep. To open your airway, your tongue may press downward and against your teeth, causing wavy or scalloped edges.

Temporomandibular Joint Disorder (TMJ/TMD)

TMJ or TMD involves misalignment and functional issues in the jaw joint. When the jaw does not align or close correctly, your tongue can compensate by pressing up or down to help close the jaw. This can cause scalloped tongue.

Stress Habits

Stress can cause you to clench your jaw, grind your teeth or press your tongue against your teeth. These stress habits can result in a wavy tongue from constant pressure against the teeth.

Medical Conditions

Acquired hyperthyroidism, tuberculosis and amyloidosis are medical conditions that can cause scalloped tongue. Injuries and allergies can also cause tongue swelling and indentation on the sides. In rare circumstances, cancer can cause scalloped tongue.

Symptoms of Scalloped Tongue

In addition to the scalloped edges, other symptoms of scalloped tongue may include:

Bad Breath: Scalloped tongue can lead to bad breath due to the accumulation of bacteria and food particles in the indentations.
Tongue Pain: The indentations on the edges of the tongue can cause discomfort or pain.
Difficulty Swallowing: In severe cases, scalloped tongue can make it difficult to swallow.

Does Scalloped Tongue Go Away?

In most cases, scalloped tongue is not a serious condition and does not require treatment. However, if you are looking for ways on how to fix scalloped tongue, it is important to determine the underlying cause first. It may come and go depending on the cause. For example, if scalloped tongue is caused by dehydration, it may go away once you are properly hydrated.
However, if the underlying cause is a chronic condition like sleep apnea, scalloped tongue may persist until the condition is properly treated.

Scalloped Tongue Treatment

Pie crust, or wavy tongue, is caused by other conditions and is not a primary health problem. For scalloped tongue treatment, the cause must first be identified. The underlying medical condition or health problem should be addressed to reduce inflammation or tongue pressure. In some cases, seeing your doctor for a scalloped tongue may alert him or her to another disorder that is causing your wavy tongue.

When to See a Dentist for Scalloped Tongue Treatment

If your scalloped tongue is not caused by nutritional deficiencies, a congenital disorder or a medical condition, it may be an oral health problem. TMJ/TMD, bruxism and obstructive sleep apnea are all possible causes of scalloped tongue and may be treated by your dentist. Scalloped tongue treatment for these disorders may include wearing a customized mouthguard designed by your dentist.

A dental mouthguard or nightguard is an oral device that can be used for a few different oral health disorders that can cause crenated tongue. The mouthguard is designed from a mold or 3D image of your teeth in a dental lab, creating a perfect fit for your teeth and mouth. The mouthguard can be designed for treatment for TMJ, teeth grinding or sleep apnea, controlling these conditions while you sleep and reducing the chance of scalloped tongue.

TMJ/TMD. Wearing a dental nightguard can reduce pressure on the jaw joint for TMD relief and may also reduce the symptom of wavy tongue.
Sleep apnea. A dental mouthguard is an oral device that can shift the lower jaw forward while you sleep, opening the airway and reducing use of the tongue during sleep apnea episodes.
Bruxism, or teeth grinding. A dental nightguard can prevent teeth grinding that can put pressure on the tongue – it also protects the teeth from damage.

In many cases, your dentist can provide the needed oral treatment to resolve your scalloped tongue. If it is not an oral disorder, your dentist may refer you to your doctor to determine if the wavy tongue is caused by a medical condition.

The good news is that a scalloped tongue does not pose a risk to your health. However, it can be a sign of another medical or dental condition. To find the cause of your crenated tongue and determine the right scalloped tongue treatment, schedule a visit with your dentist for a checkup and exam.

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Scalloped Tongue Causes and Treatments