Our tongue is an essential organ that we need to speak, eat, and taste food. Your tongue can also tell a lot about your general health. If your tongue becomes unusually enlarged (medical name is macroglossia) it may develop a wavy pattern on the edges and this is called a scalloped tongue. The rippled effect around the sides of your tongue is caused by the enlarged or swollen tongue pressing against your teeth. A scalloped tongue is also called wavy tongue, crenated tongue, lingua indentata, pie crust tongue, crinkly tongue, and crenulated tongue.
If your tongue becomes enlarged for any reason it will push against the surrounding teeth creating a scalloping effect. Depending on the severity of the swelling, you may have pronounced ridges on the sides of your tongue, visible teeth marks, or indentations on the tongue edges.
A scalloped tongue isn’t a disease in itself but an indication of an underlying health condition. For example, low thyroid hormone levels, sleep apnea, vitamin deficiencies, and anxiety are all known to cause wavy tongue or scalloped tongue.
This article explores the many different causes of scalloped tongue and what this means for your general health. You will also find out how to get rid of the wavy pattern around the edges of your tongue and when the condition is serious enough to call a doctor.
Causes of Scalloped Tongue and How to Get Rid of It
In many cases, the only way to get rid of a scalloped tongue is to treat the underlying cause. The following information will help you know what could be causing your tongue to swell and push against your teeth.
Hypothyroidism can cause a crinkly tongue
Hypothyroidism is a very common cause of tongue scalloping. Hypothyroidism is a condition when your body doesn’t produce enough thyroid hormone. A lack of thyroid hormone in your body can cause your metabolism to slow down, increase weight gain, and make your face and eyelids appear puffy.
The Indian Journal of Endocrinology and Metabolism reported that thyroid disorders can affect the tongue. Among the effects of not having enough thyroid hormone is a large protruding tongue (macroglossia).1 This swelling can push the edges of the tongue against the teeth causing a wavy pattern.
Doctors in Japan have described the symptoms of Hashimoto’s disease, which is the most common cause of hypothyroidism. They report that hypothyroidism causes swelling around the face and an enlarged tongue.2
A doctor will be able to check for signs of hypothyroidism by taking a blood test. However, there are many ways to help your thyroid produce enough hormone naturally and you can read about then in my article about natural remedies to boost thyroid function naturally.
In some cases your family doctor can treat and monitor your condition, but in some situations you may need to consult with an endocrinologist, a doctor who specializes in treating hormonal imbalances.
Temporomandibular joint syndrome
Any problems in the muscles and joints around your jaw could cause a wavy and enlarged tongue. Problems with your jaw are called temporomandibular joint (TMJ) syndrome and can cause pain in your jaw, jaw clicking when you open your mouth, and changes in your bite. TMJ dysfunction can also lead to changes in your oral cavity and cause problems with your tongue.
For example, dental researchers found that temporomandibular joint dysfunction causes scalloping of the tongue, tooth sensitivity, and muscle tenderness and pain.3
According to the National Institute of Dental and Craniofacial Research, the best ways to treat TMJ disorders are to eat soft foods, avoid yawning wide and avoid chewing a gum.4 This will cause less irritation in your mouth and should help to reduce tongue swelling and scalloping.
Spleen QI deficiency
Traditional Chinese medicine (TCM) associates spleen disorders with a scalloped tongue. Your spleen helps to filter blood and is connected with your immune system. It can become enlarged because of infections and damaged through injury.
According to the Journal of Acupuncture and Meridian Studies, a swollen or scalloped tongue is one of the symptoms of a spleen QI deficiency.5 Other symptoms are digestive issues, easy bleeding, achy muscles, and tiredness.
For more information on how your spleen affects your health, please read my article on the signs and symptoms of spleen disease that you shouldn’t ignore.
A scalloped tongue could be a sign that you suffer from sleep apnea. Sleep apnea is a common chronic disorder affecting sleep patterns and is associated with loud snoring and shallow breathing. Because the symptoms of sleep apnea happen during the night, it can be difficult to know if you have this sleeping disorder. So, if you have a wavy tongue that is frequently enlarged, you should talk with your doctor about sleep apnea.
The American Academy of Otolaryngology published a study showing that tongue scalloping is connected with obstructive sleep apnea. They said that a scalloped tongue and snoring patterns are useful indicators in diagnosing abnormal sleep patterns.6
An enlarged tongue with wavy edges is one of the signs of sleep apnea. You could also try one of my 7 ways to stop snoring naturally if your sleep disorder is affecting your partner.
Mineral or vitamin deficiency
Tongue swelling with ridges on the sides could indicate a mineral or vitamin deficiency. For example, a vitamin B12 deficiency can cause your tongue to swell, make it look very red, and give a smooth appearance on its surface.
Medline Plus reports that the medical name for a swollen tongue is glossitis. This can be caused by certain vitamin deficiencies, as well as hormonal factors, or allergic reactions. You may also have pain along with tongue swelling.7
According to Dr. Lawerance A. Mark on Medline Plus, usually, the tongue swelling goes away when the cause of the problem is addressed. Dr. Mark advises that you see a doctor if your tongue is swollen for more than 10 days. Also, if your tongue is severely scalloped or blocks your airways, you should seek medical advice immediately.7
In some cases, anxiety can cause your tongue to become enlarged and have a rippled effect along the sides. Tongue scalloping is just one of the ways that stress and anxiety affect your body. For example, extreme anxiety can cause you to clench or press your tongue against your teeth. If this happens over a long period of time or becomes a habit, you may notice ridges along the side of your swollen tongue.
It’s interesting because a study published in the West Indian Medical Journal reported that cases of scalloped tongue were much higher among psychiatric patients.8 Many people with psychological disorders also frequently suffer from temporomandibular joint (TMJ) disorder, which is another cause of tongue scalloping.
Other Causes of a Scalloped Tongue
There are some other conditions which can cause your tongue to swell and, depending on the severity, cause wavy edges around your tongue.
According to MedicineNet, some of the reasons for an enlarged tongue are:9
- Allergies can cause the tongue to swell, become enlarged, or have bumps on it. The allergies could be caused by food, medications, or an insect sting.
- Injury to your tongue could cause swelling for a short period of time. If your tongue becomes very swollen and starts pressing on your teeth, you will probably have a wavy, crinkly tongue.
- Medications can cause side effects that include swelling of the tongue and possibly a rippled effect along its edges.
- Inherited causes of macroglossia (unusually enlarged tongue) may include various syndromes such as Down syndrome and Beckwith-Wiedemann syndrom (BWS).
Scalloped Tongue (Wavy Tongue) – When to See a Doctor
Sometimes the tongue can become so swollen that it becomes a life-threatening emergency. Dr. Lawerence A. Mark says that you should contact your doctor about a swollen tongue in the following circumstances:7
- The swelling of the tongue is so severe that it blocks your airways.
- You have a scalloped tongue for more than 10 days.
- Normal activities like breathing, eating, speaking, and chewing cause problems.
- The tongue swelling is very bad.
Read my other related articles:
- 8 Warning Signs Your Tongue May Be Sending
- Bumps on Tongue: Causes and Natural Treatments
- Swollen Taste Buds: Causes and Effective Treatments
- How to Heal a Burnt Tongue Quickly
- Indian J Endocrinol Metab. 2011 Jul; 15(Suppl2): S113–S116.
- ItoHospital. Hashimoto’s disease.
- J Indian Prosthodont Soc. 2011 Jun;11(2):98-105.
- NIDCR. Less is often best in treating TMJ disorders.
- J Acup Mer Stud. 2014 April;7(2):76-82.
- Otolaryngol Head Neck Surg. 2005 Dec;133(6):966-71.
- MedlinePlus. Glossitis.
- West Indian Med J. 2012 Aug;61(5):549-54.
- MedicineNet. Tongue problems.
Most of the time, spots on your tongue aren't dangerous and they usually resolve without treatment. But certain spots on your tongue can indicate an underlying health issue, such as food allergies, autoimmune diseases or, less commonly, tongue cancer.What are warning signs on tongue? ›
A pink tongue is healthy and normal. A red tongue may indicate heat in the body like a fever or a hormonal imbalance. A reddish purple tongue is a sign that there may be inflammation or an infection in the body. A pale pink tongue may be a sign of a vitamin deficiency, a weak immune system or a lack of energy.What does a diseased tongue look like? ›
An unhealthy tongue. If your tongue is a different colour than pink, or has large patches of white, brown, black, or another colour, this might indicate a specific health issue. Similarly, if you have large bumps or no bumps at all, you may also want to speak to a doctor.Can your tongue show signs of illness? ›
For example, a black and hairy looking tongue can signal poor oral hygiene, or diabetes. If your tongue is bright red like a strawberry, it could signal a deficiency in folic acid, vitamin B12, or iron. But, it could also mean you have strep throat, or a fever.What does tongue carcinoma look like? ›
a red or white patch on the tongue that won't go away. a sore throat that doesn't go away. a sore spot (ulcer) or lump on the tongue that doesn't go away. pain when swallowing.How do you get rid of tongue marks? ›
- Brush your tongue. Using a soft toothbrush, gently brush your tongue twice a day to help manually remove dead skin cells and bacteria.
- Use a tongue scrapper. ...
- Brush after eating. ...
- Brush after drinking. ...
- Stop using tobacco products. ...
- Floss before bed. ...
- Schedule a cleaning. ...
- Drink plenty of water.
Geographic tongue, fissured tongue, and hairy tongue are the most common tongue problems and do not require treatment.What illnesses affect your tongue? ›
Common tongue diseases and problems include canker sores, thrush, oral lichen planus, and tongue trauma. Other problems or conditions that can impact the tongue include tongue cancer, transient lingual papillitis, geographic tongue, vitamin B12 deficiency, Sjögren's syndrome, neuralgia, and allergic reactions.What does your tongue look like with liver problems? ›
Most often, yellow tongue is an early sign of a disorder known as black hairy tongue. Rarely, yellow tongue may be a sign of jaundice, a yellowing of the eyes and skin, which sometimes indicates liver or gallbladder problems.What do doctors look for on your tongue? ›
Ryan Kauffman, M.D., an ear, nose and throat specialist at Piedmont, says most physicians go through a checklist when they inspect a patient's tongue. “We start with the worst case scenario and look for anything concerning, like ulcers, lesions, masses, and firmness,” he says.
Geographic tongue, fissured tongue, and hairy tongue are the most common tongue problems and do not require treatment.Do I see a doctor or dentist for tongue issues? ›
Make an appointment with your doctor or dentist if: You're concerned about changes in your tongue. Your tongue hurts. Your white tongue persists for longer than a few weeks.Does your tongue show liver problems? ›
Oral manifestations such as lichen planus, ulcers, xerostomia, erosion and tongue abnormalities seem to be particularly prevalent among patients with chronic liver disease.What color is stress tongue? ›
Furthermore, muscles such as the masseter (mastication muscle) are activated during stress and several aspects of saliva are changed (e.g., cortisol levels, flow rates) . As a result, any of these changes could potentially contribute to the increase of purple color in the tongue.Can your tongue show liver health? ›
Tongue thickness measured by ultrasonography, correlates significantly with the severity of liver disease, as assessed by CTP and MELD scores. The patients with a CTP score ≥ 10 have significantly reduced tongue thickness as compared to normal individuals and those with less severe liver disease and CTP scores of 5-9.Where do most tongue cancers occur? ›
Tongue cancer is a form of cancer that begins in the cells of the tongue. Several types of cancer can affect the tongue, but tongue cancer most often begins in the thin, flat squamous cells that line the surface of the tongue.What are the symptoms of lymphoma of the tongue? ›
The most common symptoms of lymphoma include pain due to swelling, difficulty in speech due to ulceration and difficulty when swallowing. Physical examination may reveal a submucosal mass, a polypoid mass covered with a smooth mucosa or an ulcerated lesion (3).What is the survival rate of tongue carcinoma? ›
Tongue cancer survival rates
In general, early diagnosis and treatment lead to better outcomes. For tongue cancer, the NCI calculates the five-year relative survival rate as 82.9 percent for localized, 69.4 percent for regional and 41 percent for distant, with a combined rate of 68.1 percent for all stages.
Oral melanomas may present as flat, painless, dark brown or black discolored macules or nodules, sometimes with erythema or ulceration. As the disease progresses, bony erosion is common.What are the dark marks on my tongue? ›
Excessive pigmentation can result in dangerously high pigment concentrations in the tongue, causing harmless dark patches or spots. A case study released in the Journal of Community Hospital Internal Medicine Perspectives stated that black spots on the tongue might indicate a hyperpigmentation disorder.
Lie bumps are not usually a cause for concern and tend to go away on their own after 2 or 3 days. A person should speak to a doctor if the bumps on the tongue do not go away after a week, frequently recur, bleed when touched, or are very painful.When should I worry about my tongue? ›
As a good rule of thumb, see your doctor if you notice any significant changes in the color of your tongue, especially if it lasts longer than 2 weeks. Also call your doctor if you have pain, swelling, or lumps on the tongue.When should I be concerned about a tongue problem? ›
When should I worry about my tongue? Schedule a visit with a healthcare provider if you have severe pain or symptoms that don't resolve within a few weeks. Most tongue problems improve over time. Symptoms that don't improve may signal an underlying condition that requires treatment.How do you know if you have a bacterial infection on your tongue? ›
Signs of Extreme Tongue Bacteria
If your tongue develops white patches, it's usually a sign that something is wrong with your oral hygiene. White patches are a collection of bacteria and dead cells that get stuck on enlarged papillae.
Vitamin B deficiencies are one of the most common deficiencies that can affect mouth and teeth. A common oral effect of vitamin B deficiency is a burning sensation in the mouth, especially on the tongue. People with this deficiency can also have trouble swallowing. The tongue may feel swollen.What autoimmune diseases affect the tongue? ›
Oral Lichen Planus: This oral autoimmune disease occurs when the immune system attacks the mucous membranes inside your mouth, according to The Mayo Clinic. It will appear as lacy white patches, sometimes accompanied by painful sores on the lining of the cheeks, tongue, and gums.What does a dehydrated tongue look like? ›
When someone is dehydrated, the tongue appears dry and typically has a white or white-to-yellowish coating. In some cases, the tongue can appear patchy or splotchy. If your tongue commonly sticks to the roof of your mouth, you are dehydrated!What are the first signs your liver is struggling? ›
yellowing of the skin or whites of the eyes (jaundice) swelling in the legs, ankles and feet caused by a build-up of fluid (oedema) swelling in your abdomen caused by a build-up of fluid known as ascites. a high temperature and shivering attacks.What are the 4 warning signs of a damaged liver? ›
- Skin and eyes that appear yellowish (jaundice)
- Abdominal pain and swelling.
- Swelling in the legs and ankles.
- Itchy skin.
- Dark urine color.
- Pale stool color.
- Chronic fatigue.
- Nausea or vomiting.
- A general unwell feeling. ...
- Jaundice or yellowing of the skin and eyes.
- Frequent gassy sensation. ...
- Confusion. ...
- Fluid retention: A weak liver can result in swelling due to fluid retention, especially of the feet and ankles.
The appearance of your tongue may indicate whether or not your altered taste buds stem from a thyroid issue. A healthy tongue is slightly pink, moist, and mostly smooth. If your tongue is dry, discolored, coated, or painful, you may suffer from hypothyroidism.What vitamin deficiency causes spots on tongue? ›
You may get these ulcers on your gums or tongue. They could be a sign of low B12, anemia, or another condition. The sores usually clear up on their own, but it helps to avoid ingredients that might be irritating or painful, like vinegar, citrus, and hot spices like chili powder.
Excessive pigmentation can result in dangerously high pigment concentrations in the tongue, causing harmless dark patches or spots. A case study released in the Journal of Community Hospital Internal Medicine Perspectives stated that black spots on the tongue might indicate a hyperpigmentation disorder.How do I know if I have thyroid problems on my tongue? ›
Symptoms can include fatigue, shortness of breath with exercise, and decreased ability to exercise. Hypothyroidism can also lead to swelling of the tongue, hoarse voice, and sleep apnea.What are early warning signs of thyroid problems? ›
- Feeling tired or lacking energy even after getting enough sleep.
- Sudden weight loss or weight gain that cannot be explained by changes in diet or exercise.
- Mood swings, irritability, anxiety, or depression.
- Sleep disturbances, insomnia, or excessive sleepiness.
B12 deficiency will also make the tongue sore and beefy-red in color. Glossitis, by causing swelling of the tongue, may also cause the tongue to appear smooth. Among women, low-estrogen states may cause a “menopausal glossitis”.What are the symptoms of vitamin B12 deficiency on the tongue? ›
a sore or red tongue, sometimes with mouth ulcers. problems with memory, understanding and judgment (cognitive changes)What does an iron deficiency tongue look like? ›
Pernicious anemia causes the tongue's surface to look smooth and appear red instead of the pinkish color of a normal tongue. The tongue might also appear thick or beefy in texture. Some tongues might even be swollen or seem to have cracks.How do I get rid of black marks on my tongue? ›
The first step in trying to remove black spots on the tongue is improving oral hygiene. Aside from brushing twice a day with a soft-bristle toothbrush and flossing daily, brush your tongue too. If the spots disappear after brushing, they may not need any further treatment.Should I be concerned about a black spot on my tongue? ›
Black spots on the tongue can be worrying. Though the spots, marks or patches are harmless in some cases, only a dentist or physician can make an accurate diagnosis of their cause. Book an appointment if you have black spots that don't go away or are accompanied by other symptoms like lumps or swelling.