Scalloped Tongue

Also called crenated tongue, crenulated tongue, pie crust tongue, or lingua indentata, a scalloped tongue is a term used to describe the presence of a tongue with indentations on the sides of the tongue. Such indentations often occur due to pressure exerted by the teeth which compresses the tongue.Some individuals have described a scalloped tongue as a rippled tongue border, indentations on the tongue’s lateral borders, wavy tongue borders, tongue ridges along the lateral borders, and teeth marks on the side edges, etc.

Increase in the size of the tongue can cause it to press against the teeth. This can give rise to the formation of indentations on the side edges of the tongue. The tongue may become bigger than normal along with soreness, paleness, and inflammation due to infections or varied underlying conditions.

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Symptoms of scalloped tongue

Some of the common signs and symptoms of a scalloped tongue are listed below:

  • A scalloped tongue tends to be swollen, inflamed and/or enlarged along with ridges on the sides of the tongue. These fissures or grooves look like teeth marks.
  • The tongue usually does not change color. However, friction or increased pressure along the sides of the tongue may result in redness.
  • Scalloped may occur due to varied ailments and patients may suffer from the symptoms of such underlying conditions, such as swollen tongue, sore throat, pain in tongue, and halitosis, etc.

Causes of scalloped tongue

A scalloped tongue is not harmful and is not a disorder by itself. It is in fact a symptom of some other underlying condition like arthritis, sinus problem, iron deficiency, anxiety, or digestive disorder, etc. Some of the common causes of a scalloped tongue are listed below:

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  • Hypothyroidism: It is a condition marked by an underactive thyroid gland or deficient production of the thyroid hormone. This hormone plays an important role in regulation of numerous body functions including metabolism. Hypothyroidism thus causes slowdown of varied body functions and enlargement of many glands including tongue enlargement. A larger tongue, as stated above, will trigger the onset of scalloped tongue. Other symptoms of hypothyroidism include mild to severe facial swelling, thickened lips, hoarseness,fatigue, depression,hair thinning, muscle aches,constipation, dry skin,swollen eyelids,and high sensitivity to cold. This thyroid condition can be congenital or occur due to thyroiditis, Hashimoto’s disease, etc.
    • Thyroid hormone replacement therapy is the most common treatment option for hypothyroidism. Additional treatments include stress management, radiation therapy, acupuncture, osteopathy, biofeedback,naturopathic and/or homeopathic medications, and intake of vitamin B-rich foods.
  • TMJ syndrome/Temporomandibular joint syndrome: It is a condition marked by a damaged temporomandibular joint which adversely affects the jaw muscles and nerves that connect the jaw and skull.
    • The joint anomaly or ill-fitting teeth can trigger instability of the lower jaw. Patients may then clench their teeth with the help of the tongue to support the jaw and keep it in position. In other words, the tongue will push up the teeth so as to make them stable when the bite does not come properly together so as to stabilize the jaw for swallowing. In the long run, such activity causes ridge marks on the sides and a scalloped tongue.It may be noted that a scalloped tongue may develop even if the tongue is not swollen due to factors like habitual pushing of the tongue against the dental arches and/or a lower jaw that is narrower than usual.Other symptoms of TMJ syndrome include nerve swelling, headaches, jaw clicking or popping, bruxism or teeth grinding, pain when chewing, and facial swelling on the sides.
    • Temporomandibular joint disorder is treated by surgical fixing and remodeling of the teeth that are not set well/properly.
  • Water retention: It is another common cause of a fissured or scalloped tongue. Increased water buildup in the body may be a symptom of spleen deficiency which can result in abnormalities in conversion of fluids and food into energy. This causes swollen tongue leading to teeth marks on its edges.
  • Sleep apnea: It is a sleep disorder marked by disturbances in the pattern of breathing when sleeping, wherein patients may take shallow breaths or experience 1 or more pauses in respiration. Such disruptions in the breathing pattern when sleeping can cause the tongue to fall back into the cavity of the mouth.Subsequently, the teeth exert increased pressure on the tongue, thereby causing ridges on its sides. Sleep apnea is not a well-known cause of scalloped tongue.
  • Macroglossia/swollen tongue: Excessive swelling of the tongue due to conditions like tongue cancer, oral cancer, amyloidosis, canker sores, angioedema, scarlet fever, allergies, and dehydration, etc., may make it too big for the mouth, cause the teeth to press against it, and result in a scalloped tongue with fissures on its sides.
  • Vitamins and minerals deficiency: Vitamin B12 and folate deficiency can cause megaloblastic anemia, a condition marked by excessive production of abnormal RBCs. The blood disorder causes swollen and scalloped tongue. Intake of folate and B12 supplements and foods like fish, poultry, dairy, eggs, etc., can help treat and prevent the condition.

Scalloped Tongue – Pictures

scalloped tongue picture

Scalloped Tongue pictures

 

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