Scalloped Tongue

What is a scalloped tongue? Are the causes related to TMJ, sleep apnea, spleen Qi deficiency, a swollen tongue or hypothyroid issues?

What are the symptoms of scalloped tongue, and how are they diagnosed and treated?

What does a Scalloped Tongue Mean?

A scalloped tongue is also called a pie crust tongue, lingua indentata, crenated tongue or crenulated tongue. Regardless of what you call it, you’re describing the appearance of your tongue if it has indentations on the sides. It’s caused by compression of your tongue against your adjacent teeth.

Some other descriptive terms used to describe the look of a scalloped tongue include:

  • Teeth marks on the sides of the tongue
  • Ridges on sides of the tongue
  • Rippled edge of tongue
  • Indentations on the sides of the tongue
  • Wavy tongue edges

Serious tongue scalloping

If your tongue swells or otherwise becomes larger, it presses into your teeth. This may cause indentations. Traditional Chinese Medicine (TCM) says that a scalloped tongue is caused by “QI vacuity” (lack of energy). Homeopaths say it is caused by high blood pressure.


Symptoms of Scalloped Tongue

If your tongue is scalloped, it will appear swollen or enlarged, and have fissures and groove-like tooth impressions on its sides. Your tongue may retain a natural color, or there may be redness if your tongue is under pressure from friction.

Other symptoms may accompany scalloped tongue. They include:

  • Bad breath
  • Tongue pain
  • Swollen tongue
  • Sore throat

The images in this post, including the one just below, will help you in visualizing how you’ll look if you develop a tongue that becomes scalloped.


Why is your tongue scalloped?

A crenated or scalloped tongue is benign, and is not a disease by itself. Rather, it is an issue that results from other diseases or conditions. Some of the most common causes include:

Fissured, Painful Indented Tongue

If your tongue is scalloped, it may be caused by oral cancer, especially if you also have sores or painful fissures. Cancer does not have a high likelihood, though, and you’ll have many other symptoms if you have oral cancer.

Deficiency in Vitamins & Minerals

Vitamin B-12 and folate deficiencies may cause a problem in the production of red blood cells. This is called megaloblastic anemia and it can lead to a crenated, swollen tongue. To solve this issue, take folate and B-12 supplements. You can also eat foods like dairy, fortified plant foods, eggs, fish and poultry, which are high in B-12.

Iron deficiency has been associated with scalloped tongue, too. To avoid this, eat plenty of foods like fortified cereals, beans, leafy greens, poultry, fish and meat. This will increase your intake of iron every day.

Scalloped Tongue Anxiety & Bad Habits

The development of habits like pressing, clenching or grinding your tongue against your dental arch over long time periods can result in scalloping of the tongue. Anxiety also makes some people press their tongue up against their teeth, causing muscle tension and possibly leading to scalloped tongue.

Sleep Apnea

In this disorder, you pause in your breathing during the night while you’re sleeping. This disruption in breathing while you’re asleep may make your tongue fall into your oral cavity and this can cause it to become scalloped.

article-5-pic-3Spleen QI Deficiency

According to TCM, if you have a tongue that is scalloped and also fissured and swollen, the cause could be spleen QI deficiency. If this occurs, your spleen cannot handle its usual digestive functions, like transforming the food you eat into energy. Your face and tongue will be pale, and you’ll feel tired. You may also lose your appetite and lose weight.

Temporomandibular Joint Syndrome (TMJ)

This disorder affects the jaw muscles and nerves that control the jaw and skull, due to injury of the temporomandibular joint. Characterizations of the disorder include jaw clicking or popping, pain while chewing, swollen sides of the face, nerve inflammation, headaches and tooth grinding.

TMJ causes the teeth to lose their good fit, and this leads to instability in the jaw. Most people try to clench their teeth by using the tongue to maintain proper jaw position, if their bite isn’t coming properly together. Their tongue pushes against the teeth to aid in their stabilization. This can cause the tongue to have grooves or teeth marks.

As a side note, if your tongue isn’t swollen but you do have teeth marks on it, you could have a narrow lower jaw, or you may have developed the habit of pushing the tongue on your dental arch.

If your scalloped tongue is caused by TMJ, fixing teeth that don’t fit well and surgical remodeling of the jaw may be viable solutions.

Thyroid Disease

Thyroid issues are often caused by congenital hypothyroidism, Hashimoto’s disease or thyroiditis. In addition to a swollen and scalloped tongue, you also will have other symptoms, including:

  • Increased cold sensitivity
  • Depression
  • Muscles aches
  • Constipation
  • Dry skin
  • Thinning hair
  • Hoarseness
  • Fatigue

Hormone replacement medication is helpful in treating thyroid conditions. In addition, you should eat foods that are rich in vitamin B, and manage your stress levels. Other helpful treatments include Traditional Chinese Medicine, acupuncture, osteopathy, biofeedback and homeopathic medicine.

Hypothyroid Scalloped Tongue

If your thyroid gland is underactive or non-functional, you will have a lack of or deficiency in thyroid hormone. This may affect the normal functioning of your body, since the thyroid hormone is responsible for regulating the ways by which your body utilizes energy. Without enough thyroid hormone, your bodily functions will slow down.

If you have low thyroid function, you may have swelling in the tongue and face, including an enlarged tongue, swollen eyelids and thickened lips. As we already know, a swollen tongue is a major cause for scalloping.

Macroglossia or Swollen Tongue

If your tongue swells to the point that it pressures your dental arch, this will cause it to become scalloped or swollen, or both. When your tongue swells so that it is too large for your mouth, teeth marks will be found around the edges.

A swollen tongue may be caused by dehydration, angioedema, scarlet fever, canker sores, tongue cancer, hypothyroidism or amyloidosis, in addition to allergies.

Other Causes for Scalloped Tongue

If you have a white or pale scalloped tongue, this could indicate a sinus, digestive or arthritis problem.

Diagnosing Scalloped Tongue

Before you try to treat the problem, you need to have it properly diagnosed. The underlying cause will let you know what to target to fix the problem. Examine the other symptoms that accompany your scalloped tongue. Your physician may recommend testing for various causes, to determine what’s at fault.

Treatment for Scalloped Tongue Edges

Treating your tongue if it has scalloped edges involves thorough treatment of the underlying issue. Once you have a physician’s diagnosis, the condition responsible for the problem can be treated. Maintain good oral care in addition to the treatments you are prescribed, to ensure full recovery.


  1. Tongue with scallop is inflammation. Ayerveda practice will clear it and also explain why you have inflammation and what foods to eat to reduce. This is the only method I have tried that actually worked. TCM can solve with Accupuncture but you have to pay, Ayervada will teach you which foods to eat and if you follow the advice you will have a healthy looking pink tongue with no dents.

    • Thank you for sharing your experiences and insights. It is certain that your supportive comment will help many members of our community. Please share more of your thoughts and feelings in the future. Have a great day, Angelina!

Leave a Reply to Angelina Alice Cancel reply

Please enter your comment!
Please enter your name here