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Scalloped Tongue Causes, Pictures, Cures and Remedies

Crenated tongue, ‘pie crust’ tongue, scalloped tongue or lingua indentata are all terms used in describing a tongue with teeth marks on edges or whose sides are rippled, appear wavy or groove-like with ridges. Indentations is a common indicator of tongue scalloping. What do these indentations on edges of your tongue mean? We have information on scalloped tongue causes, symptoms, possible cures and remedies for tongue scalloping.

Scalloped tongue causes

What causes teeth marks on side of tongue or scalloped edges of your tongue? There are many reasons to account for an unhealthy scalloped tongue. Here is what could be causing your scalloped tongue:

1. Scalloped tongue thyroid and toxication

Are teeth marks on sides of tongue due to effects of hypothyroidism? Yes.  One of the possible reasons why you have a scalloped tongue is due to thyroid dysfunction i.e. defects of the thyroid gland functioning and to be specific, hypothyroidism.

How does hypothyroidism cause a scalloped tongue?

Insufficient thyroid hormone in the body means slow metabolism because the main function of this hormone is to regulate metabolism i.e. “all chemical reactions involved in maintaining the living state of the cells and the organism.” [News-medical.net].

Besides thyroid insufficiency, toxins can greatly affect the functioning of the thyroid. This includes blocking cell receptors or causing damage to thyroid itself.

One of the body organs that can act like a harbinger or signifier of body toxins is the tongue. According to Dr. Weston Saunders, too much toxins will result in tongue swelling or enlargement. When this occurs the tongue will be pushed against the inner surface of the teeth resulting to the indentations or teeth marks on the sides of tongue.

Hypothyroidism symptoms

Take some time to examine your tongue. Is it swollen or enlarged? What do the sides look like? Besides enlargement and increase in tongue size (attributed to build-up of toxins) here are more signs and symptoms.

Hair loss; fatigue, muscle aches, cramps and body weakness; rough and dry skin, weight gain. Individuals who have increased in body weight find it difficult losing it.

2. Macroglossia or unusually enlarged tongue

Macroglossia is medical term used to define an unusually swollen and enlarged tongue. Causes of macroglossia are wide. For instance it may be caused by congenital disease at birth, birth defect or acquired conditions. “The most common causes of tongue enlargement are vascular malformations (e.g. lymphangioma or hemangioma) and muscular hypertrophy (e.g. Beckwith–Wiedemann syndrome or hemihyperplasia)” [wikipedia.org]

Others include angioedema, tumors in mouth, multiple endocrine neoplasia (type 2B), myxedema, acromegaly, etc.

Macroglossia may occur without symptoms. However, depending on the severity the following are signs and symptoms.

  • Breathing described by a noisy, difficulty or sounding symptomatic of obstructive sleep apnea,
  • Breathing through mouth (mouth breathing),
  • Difficult swallowing,
  • Disrupted speech or dysphonia marked by unclear speech,
  • Pie crust tongue characterized by indentations on borders along sides of tongue caused by pressure from teeth,

Treatment for macroglossia would be complex if the underlying cause is not well established. Moreover, minor cases with minor symptoms may not require treatments but a regular health tongue diagnosis is necessary.

3. Temporomandibular joint syndrome or TMJ syndrome

What is Temporomandibular joint syndrome? Before we get to know what it is, this TMJ joint is a hinge that connects the lower jaw to the upper bones of the skull located just in front of both ears.

TMJ syndrome is a term for a muscle dysfunction causing pain in muscles that aid jaw movements which aid mastication. When there occurs a muscle dysfunction, the temporomandibular joints cease to function properly too. This results in instability in the lower jaw hence limiting opening of lower jaw for chewing. Thus the lower jaw can only be kept in position by the help of tongue. In efforts to keep teeth in alignment and avoid clenching or grinding of teeth, the tongue needs to continually press against the teeth and jaws for proper biting, chewing and swallowing.

An individual with this muscle disorder will eventually develop a scalloped tongue after a prolonged activity of pressing the tongue on teeth. Even if they don’t have enlarged tongue, the habitual process can result in formation of teeth marks or groove-like or crenated tongue on the sides. Scalloping of the tongue can worsen and be severe if your teeth are not well-spaced or have large spaces in between and your natural lower jaw narrower.

4. Vitamin deficiency

Your tongue is definitely one of the target organs which doctors would want to examine for purposes of determining lack of nutrients or certain vitamin deficiency. In line with our focus which is tongue swelling and scalloping, there are two main vitamin deficiency we shall look at briefly. These are vitamin B-12 and folate deficiency.

A deficiency of B-12 and folate is likely to cause a condition known as Megaloblastic anemia which is associated with little production of red blood cells. Inadequate or reduced number of red blood cells greatly affects cell division. One way to detect a shortage of folate and vitamin B-12 in blood is by studying the symptoms of Megaloblastic anemia.

The most symbolic or common symptom is one of fatigue. Other symptoms produced in body processes include:

  • Glossitis or simply a swollen tongue,
  • Smoothness and tenderness of tongue,
  • Increased or fast heartbeat rates,
  • Loss in appetite among other symptoms,

Anyone could be a victim of vitamin deficiency. Pregnant women and mothers are quite affected because of a high demand of nutrients by the developing foetus in womb.

Secondly, another nutritional problem is iron deficiency.

5. Water retention

Water retention in body is another common cause of pie crust tongue or scalloped tongue. This condition may be due to various reasons like kidney problems, spleen deficiency, malnutrition, thyroid disease, allergies, and congested lymphatic system among many others.

A general increase in water retention in body tissues and cavities can cause swelling of organs like the tongue. This enlargement in turn makes your tongue feel thick because of an increase in lateral surface. In the end teeth marks will start to appear as it (tongue) gets pressed on teeth.

6. Can sleep apnea cause a scalloped tongue?

This is a sleep disorder in which normal breathing is interrupted during sleep. In untreated cases of sleep apnea, patients may have problems like snoring. Apparently, when it occurs the brain and rest of body gets insufficient supply of oxygen. This condition can affect any individual regardless of age or gender.

How is tongue scalloping related to sleep apnea? While there is an increased risk of sleep apnea occurrence in people who are overweight, other risk factors include:

  • Having a large tongue and tonsils
  • Small jawbone,
  • Large neck size,
  • Gastro-esophageal reflux,

It is important to take note of an enlarged tongue and small jawbone. If the jaw is too small for the normal tongue size, then one can equally end up having a tongue with scalloped edges marked by rather small ridges along the edges of tongue. According to Heal Cure, in the disrupted breathing while one is asleep often makes tongue ‘falls back into the oral cavity’ which can make it scalloped. Though a possible cause, sleep apnea is an uncommon condition for scalloping tongue.

Scalloped tongue pictures and signs

As you can see from the pictures below, a scalloped tongue is one characterized by wavy or groove-like marks on the sides of the tongue. They usually appear on either side of the tongue. These marks may be prominent if scalloping is serious.

tongue with scalloped edges
tongue with scalloped edges
swollen and enlarged scalloped tongue
swollen and enlarged scalloped tongue
severely scalloped tongue - pie crust tongue
severely scalloped tongue – pie crust tongue

The other sign is redness especially the area of crenation. In normal circumstance, the tongue is not supposed to turn red but reddening may occur due to friction or pressure exerted on edges of tongue.

Thirdly, swelling in tongue would occur if you have a scalloped tongue and suffer from hypothyroidism. In fact hypothyroidism is commonly associated with tongue scalloping. Sometimes the swelling could be accompanied with a sore throat. If that is the case then, mouth sores or lesions could also be present even at the back of tongue.

Swollen scalloped tongue

Swelling may be considered a health problem. One of the symptoms tongue swelling is tongue inflammation also referred to as glotisis. However, if you have a swollen and scalloped tongue at the same time, it means that the level of toxification in body which includes the tongue is high. The toxins may be due to a problem with the thyroid gland. We have already seen this while discussing the causes of scalloped tongue.

In addition, except Temporomandibular joint syndrome other causes of scalloped tongue we have discussed can be responsible for swelling of tongue.

Painful scalloped tongue

Do you have an aching and painful tongue with wavy edges? Go for tongue diagnosis if you have additional symptoms such as tongue sores and sore throat.

Diagnosis of scalloped tongue

Why is diagnosis of scalloped tongue necessary? As we have stated diagnosis is equally important in order to pave way to try establish prognosis (the likely cause) for not only tongue scalloping but also other mouth diseases or infections.

When should one go for heath tongue diagnosis? There are many factors to determine but it is basically for getting particular symptoms especially when other symptoms are presented together. The process may require blood tests or just close examination of the tongue or as your doctor may instruct. For instance, one blood test that may be carried out is the Schilling test whose results is to evaluate the ability of your body to absorb vitamin B-12.

Chinese medicine and scalloped tongue meaning

Besides scientific explanations, what perceptions and meaning is there when the side of your tongue is wavy? In traditional Chinese medical studies, many cultural connections have been made as far as tongue and problems with tongue are known. There are variations in meaning attached to the Chinese traditions and beliefs.

Well, a scalloped tongue in Chinese medicine concept means a lack of an active life force which should be a part of living things. Perhaps you know what this Chinese meaning suggests. Do you? Feel free to let us know it in essence.

Elsewhere in homeopathy practices, a scalloped tongue is an indication that you have a high blood pressure. Are you scared? Don’t even panic since these are only beliefs and claims which should not be substitutes of scientific facts about diseases or practical diagnoses.

Scalloped tongue cure and tongue scalloping remedies

Does tongue scalloping have cure? Read on to find out possible treatments and remedies for scalloped tongue. Some cases like sleep apnea is a bit complex and require much patience.

Treating the underlying cause

The various causes which result in tongue scalloping dictate the need to get a proper diagnosis followed by appropriate treatments to curb the problems causing victimization. These comprise use of medicines and other cure methods like surgery where required.

For instance, patients with hypothyroidism tongue can take oral medication on prescription such as Levothroid and Synthroid which restore hormone levels to normal.

For patients who have temporomandibular joint dysfunction can take medications to relieve of muscle pain and reduce swelling. At times anti-anxiety (prescription-only) medications could be necessary if patients show additional signs like being stressed.

In some cases a surgery may be required to address the problem properly. Other simple remedies to apply include heat compress on the sides face to help in reducing swelling. Alternatively, patients can use ice to reduce pain.

Enhancing detoxification

Detox is another remedy to help deal with removal toxic substances from body. This ensures the risks of causing damage to the thyroid gland are minimal.

There are several ways of achieving it but the easiest and cheapest is taking sufficient water. Some patients may also undergo a liver dialysis or drug detoxification depending on the level of toxins presently accumulated in body.

Use of dental devices

dental appliances for people with sleep apnea
dental appliances for people with sleep apnea

Apart from medical treatments, use of specialized dental devices is also a good way to go. This is relevant to individuals who exhibit symptoms of sleep apnea or grind and clench teeth even while asleep. For more accurate information on use of devices contact your physician or doctor who can guide or advise you accordingly.

Dietary changes and oral supplements

To conclude, one of the clues to show you need a change in diet is positive results of deficiency symptoms. In our discussions, tongue swelling may be one of the common signs of scalloped tongue. Therefore, in the case of vitamin deficiency such as B-12, patients are advised to include categories of food such as eggs, chicken, red meat and shellfish. Alternatively, any individuals who have digestion problems with proteins, or allergy oral supplements and injections can serve the similar purpose.

CAUTION: A physician must be consulted before administering any medicines by injecting.

Recommended Reading
  1. Scalloped Tongue Causes, Pictures, Hypothyroid, Diagnosis & Treatment http://www.healcure.org/tongue/tongue-problems/scalloped-tongue-causes-pictures-hyperthyroid-diagnosis-treatment/
  2. What Your Tongue Tells You About Your Thyroid, Dana Trentini, http://hypothyroidmom.com/what-your-tongue-tells-you-about-your-thyroid/, published on October 16, 2014.
  3. Sleep apnea: http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea, Reviewed by David T. Derrer, MD on Sep. 2, 2014.
  4. Temporomandibular Joint Disorders (TMD, TMJ): http://www.webmd.com/oral-health/guide/temporomandibular-disorders-tmd?page=3
  5. Tongue Scalloping: A Simple Marker for Sleep Apnea: http://doctorstevenpark.com/tongue-scalloping-a-simple-marker-for-sleep-apnea
  6. http://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/treatment/txc-20155362
  7. http://medicaltreasure.com/scalloped-tongue/
  8. Macroglossia, https://en.wikipedia.org/wiki/Macroglossia, last modified on August 14, 2016.

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