A scalloped tongue gets its name from the wavy or rippled indentations that appear along the sides of a person’s tongue. A scalloped tongue is also known as:

  • wavy tongue
  • pie crust tongue
  • crenated tongue
  • lingua indentata

The notches of a scalloped tongue are rarely painful. Any pain may be the result of the underlying condition that’s causing the ripples.

The lining of your mouth, especially on the sides nearest your tongue, may become red or sensitive. This is rare, but more likely if you’re applying a significant amount of pressure or friction to the skin.

A scalloped tongue is rarely a sign of a very serious problem, such as cancer. However, that doesn’t mean a scalloped tongue is nothing to be worried about.

Understanding the causes of a scalloped or wavy tongue can help you stop the behaviors that are leading to it and know when to see your doctor.

In most cases, a scalloped tongue occurs due to swelling or inflammation of the tongue. Tongue swelling is also called macroglossia. Each cause of macroglossia or swelling of the tongue results in other symptoms too. Knowing the different symptoms can help you understand what might be at the root of your tongue issues.

Genetic condition or birth defect

Some disorders or diseases you’re born with may lead to macroglossia and a scalloped tongue. These include:

Each of these conditions has unique symptoms.

Hypothyroidism

This thyroid disorder is characterized by low levels of thyroid hormone. When thyroid hormone levels are low, you may experience the following symptoms in addition to tongue swelling and scalloped edges:

  • hair loss
  • tiredness
  • aches and cramps
  • bruising
  • low blood pressure

Amyloidosis

A buildup of proteins in organs characterizes this disease. The accumulation can occur in your organs and soft tissues, including your tongue. If it occurs in the tongue or mouth, you may experience swelling or inflammation. The large, swollen tongue can push against your teeth and create scalloped edges over time.

Dehydration

Dehydration can lead to swelling all over your body, including your tongue.

Anxiety

A variety of oral symptoms may originate from high levels of stress or anxiety. These include jaw pain, teeth grinding, and pressing your tongue against your teeth. Over a long period of time, pressing your tongue against your teeth can leave indentations.

Parafunctional habits

You can develop habits with your tongue or mouth that put you at risk for complications and side effects over the long term, including scalloped tongue. You may not realize you have some of these habits. It may take treatment and occupational therapy to be able to stop doing them.

Temporomandibular joint disorders (TMD or TMJ)

The hinge joint that connects your lower jaw to your skull can sometimes become painfully stuck or misaligned. When this happens, your tongue must work hard to hold your lower jaw in place. You may have to press your tongue against your teeth and lower mouth to create the necessary pressure. This can create a scalloped indentation pattern on the side of your tongue.

Learn more about temporomandibular joint disorders »

Sleep apnea

A scalloped tongue may be a sign of sleep apnea, due to difficulty breathing while you’re sleeping. You may subconsciously push your tongue down into your teeth to open the airway, which can lead to a scalloped tongue.

A scalloped tongue usually isn’t a sign of something serious. You don’t need to seek emergency care, but you should make an appointment with your doctor if you see the telltale indentations of a scalloped tongue.

The potential causes can lead to additional symptoms and complications if they’re not treated. If you notice you have a scalloped tongue, make a list of any other possible symptoms you think you may be experiencing. Knowing all signs and symptoms can help your doctor narrow down the list of likely causes.

A scalloped tongue is unlikely to result in any complications. The pressure or force on the tongue against your teeth may irritate the organ, and it may even become painful. However, a scalloped tongue isn’t dangerous or serious.

Any complications from a scalloped tongue are likely related to the underlying cause. Untreated conditions can lead to greater, more severe signs and symptoms.

For example, untreated sleep apnea can cause:

  • daytime sleepiness
  • fatigue
  • cardiovascular problems like high blood pressure

Untreated hypothyroidism can give rise to complications like:

  • enlarged thyroid gland
  • increased risk of heart disease
  • nerve damage

Getting a proper diagnosis is important. Diagnosing the underlying cause of a scalloped tongue helps you and your doctor make sure you’re using the correct form of treatment. It also reduces the likelihood of complications.

When you visit your doctor, the two of you will talk about your overall health, any changes you’ve recently experienced, and any symptoms you’ve noticed in addition to the scalloped tongue.

A symptom history may be enough to make a diagnosis. But to be sure, your doctor may request a series of tests. This includes blood tests to check for unusual levels of proteins, vitamins, minerals, or toxins. A biopsy, or tissue sample, may help check protein levels or look for other symptoms that can explain your symptoms.

Treatment for an enlarged tongue often relies on treating the underlying cause.

Genetic conditions

Surgery can reduce the size of your tongue. Dental or orthodontic procedures may be able to make more room in your mouth so that your tongue fits better.

Hypothyroidism

Prescription medications are usually the first line of treatment for this thyroid condition. They can work to restore healthy hormone levels, which will end or reduce symptoms.

Learn more: Your treatment options for hypothyroidism »

Amyloidosis

Treatment can’t cure this disease, but it can reduce symptoms. Common treatments include chemotherapy and a stem cell transplant.

Dehydration

Drinking plenty of fluids all day, every day can help prevent dehydration and eliminate any swelling or inflammation caused by it.

Anxiety

Prescription antianxiety medications and therapy may help ease anxiety and reduce or eliminate underlying issues that induce the behaviors leading to indentations on the tongue.

Read more: Drugs to treat anxiety disorder »

Parafunctional habits

These habits, such as tongue thrusting and tooth clenching, are often learned behaviors. Working with an occupational therapist can help you break them.

Home remedies

In addition to those treatments, some home remedies can help ease swelling and reduce possible pain or irritation. These include:

  • Heat compress: Warmth can soothe inflamed tissues and ease pain.
  • Ice pack or cold compress: Like heat, ice or a cold compress may help reduce inflammation and ease pain.
  • Dental devices: Mouth guards and other devices can reduce clenching and ease pressure. These are especially helpful when you’re asleep and can’t consciously control your tongue.

Get heat and cold compresses and a mouth guard now.

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