Scalloped tongue is also called crenated tongue, crenulated tongue or pie crust tongue. These are terms that are simply used to describe a tongue that is having indentations or waves on the sides. The indentations normally occurs as a pressure from the teeth that compresses the tongue.
A swollen tongue may also develops scallops or wavy borders due to the pressures that is exerted against the teeth. Scalloped and Sore tongue can result from various causes and can be accompanied with inflammations, pain or a burning sensation.
Crenated tongue is usually accompanied with various symptoms. It usually becomes swollen, inflamed or enlarged with wavy or grooved boarders that resembles teeth marks. Although the color rarely change but it may develop some redness at the edges where pressure is exerted.
A crenated tongue is not harmful by itself. It is symptomatic to underlying conditions or causes. It is the underlying condition that may result to various symptoms like swollen tongue, enlarged lymph nodes, sore throat and inflammations among others.
What is the Cause of a Scalloped Tongue?
Some of the causes of pie crust tongue includes the following:
- Enlarged or swollen tongue
When the tongue is swollen, it tends to apply pressure against your teeth or dental arches. A swollen tongue usually becomes too big for your mouth. It will therefore develop some scalloped, grooved, or wavy edges that look like teeth marks.
There are various causes or underlying conditions that can result to a swollen tongue. Some of them includes, dehydration, allergic reactions, tongue or mouth cancer, canker sores, tongue piercing, scarlet fever, neoplastic growth, thyroid disorders, amyloidosis and injuries among others.
- Vitamin and mineral deficiency
Inadequate intake or poor absorption of vitamin B12 and folate into your body can lead to a blood disorder known as megaloblastic anemia. This disorder can lead to excessive or abnormal production of red blood cells and may result to various symptoms including scalloped tongue.
When trying to get rid of this condition, it is recommended to take vitamin-12 supplements. Alternatively, you can include the following food in your diet; dairy products, poultry, fish and other foods that are rich in vitamin B-12.
- Thyroid or hypothyroid
Various tongue problems like scalloping, coated, dryness, discoloration or pain can be symptomatic to underlying conditions like inadequate thyroid or hypothyroidism. Thyroid is a small gland that produces thyroid hormone. This hormones plays a very big role in body metabolism to produce energy.
It also affects how vitamins and minerals are absorbed and utilized in your body. Its deficiency in your body can cause your tongue to become too big for your mouth. It will therefore exert pressure against the teeth resulting to scalloped edges.
Apart from crenated tongue, thyroid condition can lead to other symptoms that includes fatigue, headaches, dry skin, hair loss, weight gain, body aches, cold hands and feet, constipation, brain fog, memory loss, allergies and other conditions like cancer and diabetes.
- Sleep apnea
Sleep apnea is also another condition that causes scalloped tongue. This condition is characterized with some disturbances in the pattern of breathing. When suffering from this condition, you may have 1 or more breathing pauses or swallow breath while sleeping.
Disruptions in sleeping patterns may cause the tongue to fall back into the oral cavities. When the tongue is in this state, the teeth can easily exert pressure on it to cause scallops or grooves at the edges. Sleep apnea causes pie crust tongue although in rare cases.
- Temporomandibular joint disorder
Temporomandibular disorder is a problem that affects the jaws and the muscles of the face that supports and controls it. The exact cause of this disorder is unknown but dentist believes that it results from injuries to jaw, joints and muscles of the neck and head
This disorder is also linked to other causes like grinding teeth that may exert a lot of pressure to the joints, arthritis in the jaw joints, movement of the disc between the ball and sockets of the joint and stress can also affects the facial muscles leading to this condition.
This condition causes instability of the jaws. Therefore, people who are suffering from this disorder will try to clench their teeth using the tongue to keep the jaw into position. This can result to scallops or grooves at the edges of your tongue.
- Dental issues
Narrow teeth arch can also lead to having sides of tongue wavy. Narrow teeth arch or ill-fitting dentures may compress the sides of the tongue to create teeth-like marks or a scalloped tongue. It is therefore important to go for well-fitting dentures to avoid wavy tongue sides.
- Spleen QI deficiency
Spleen qi deficiency is also characterized with scalloped or swollen tongue, fissures, fatigue, pale tongue, low appetite and weight loss. This happens when the spleen fails to perform its functions that affects your digestion system.
- Bad habits and anxiety
Some people have developed bad habits that can result to crenated tongue. Grinding, clenching and pressing the tongue against the teeth arch for a long time can lead to waves or grooves on the boarders of the tongue. You can also press the teeth against the tongue when having anxiety.
Is a Scalloped Tongue Dangerous?
Tongue is a very important muscle that helps in chewing, swallowing and speech. However it may develop some problems that are symptomatic to underlying conditions like under active thyroid or hypothyroidism. A healthy tongue is supposed to be pink in color and moist.
However, some conditions like hypothyroidism causes the tongue to become scalloped, swollen, dry, coated or painful. These symptoms are trying to send a signal that is showing there is something wrong with your health.
Thyroid is a small gland found in the lower part of your neck that produces thyroid hormone. This hormone plays a very important role in metabolism to release energy. It also helps in cell differentiation, cell metabolism and regulates how other nutrients are used in your body.
Underactive thyroid is caused by pregnancy, problem of thyroid at birth, pituitary glands disorder of disorder of the hypothalamus. A part from having crenated tongue, hypothyroidism can lead to other symptoms that includes depression, fatigue, dry skin, unexplained weight gain, constipation, and changes in your menstrual cycle and memory loss among others.
If hypothyroidism is left untreated, it can lead to other various diseases like cancer, heart diseases, diabetes, arthritis, low or high blood pressure and many more. Treatment involves taking hormone replacement tablets daily, taking food rich in vitamin B, biofeedback, homeopathic medicine and radiation therapy.
How does a Scalloped Tongue look Like Edges
Crenated tongue usually appears at the edges. The indentations appears along the lateral borders of the tongue due to the compression by the teeth arch. The surface of the tongue may retain its normal pink color but in some cases, the edges may appear red due to friction or pressure that is exerted.
As you read earlier, this is a symptomatic condition that is harmless to your health. It is good to understand that this is not a disease. It only appears when the tongue is pressed against the teeth. That is why the scallops only appears at the edges of the tongue.
This problem is common among individual who have macroglossia. This is simply having an enlarged tongue that is unable to fit in your mouth well. It is a symptom that is characterized with individuals who are suffering from Down’s syndrome.
Scalloped or crenated tongue tends to be swollen, inflamed or enlarged with a wavy sides. These wavy edge resembles teeth marks. Since it is caused by different underlying condition, the patient may experience other symptoms depending with the cause.
Before treating crenated tongue edges, it is important to visit your doctor for diagnosis to determine the underlying condition. The doctor will check your mouth to find out if there is any other symptoms. He or she may also perform blood test before recommending for a treatment.
What is a Scalloped Tongue Sign of?
Having a tongue that is scalloped is the first sign of sleep apnea disorder. This is a more serious condition than snoring. Obstructive sleep apnea occurs when the airway is blocked by the tongue, tonsils or an enlarged uvula.
Sleep apnea is characterized with pauses in breath or lapses in breathing during sleeping. This happen when scalloped or crenated tongue falls back to obstruct the air way. When having this condition, you may experience 5 to 15 apneic episodes per hour. Severe condition can cause 30-100 episodes per hour.
Patients who are suffering from this sleep condition may experience various symptoms like loud snoring, gasping in the sleep, and lack of concentration, depression, decreased libido, tooth grinding or clenching, unexplained weight gain, frequent urination and chronic fatigue.
The dental signs includes acid reflux, enlarged tongue or tonsils, scalloped or pie crust tongue and tooth wear from bruxism. Obstructive sleep apnea can also lead to other body conditions that includes heart diseases, high blood pressure, diabetes, impotence and acid reflux.
The other symptoms includes excessive daytime sleeping that may be dangerous, having headache in the morning, insomnia, dry mouth and throat in the morning after waking up, shortness of breath, abrupt awakening and having difficulties to control high blood pressure.
There are various factors that increases the risk of developing sleep apnea. They include the following:
- Excessive weight or obesity
- Male are more prone to sleep apnea as compared to women
- Having large or scalloped tongue
- Huge neck muscles or fats of greater than 17 inches in male or 16 inches in females
- Having a history of asthma or allergic reaction in the childhood
- Enlarged tonsils that have not been removed
- Difficulties in breathing
- Family history of sleep apnea
- Oral piercings
- Having diabetes
- Smoking nicotine
- Excessive alcohol consumption and using tranquilizers
It is important to seek for treatment when you experience the above symptoms. There are different treatment that you may use. They include the use of continuous positive airway pressure, surgery, shedding some weight and use of oral appliances.
It is also recommended to make some life changes that includes avoiding smoking nicotine, quite alcohol consumption and use of tranquilizers, sleeping by the side or stomach and avoiding fatty and junk foods. You should also keep the nasal passages open by using saline nasal sprays.
How to Treat a Scalloped Tongue
A scalloped or crenated tongue is a harmless condition and therefore it does not require direct treatment. It is recommended to get diagnosed to find out the underlying cause. Therefore treatment will be determined by the cause. However, there are various treatments and home remedies you can use depending with the underlying cause of the crenate tongue. They include:
- Treat the swollen tongue
A tongue can become swollen for a number of reason. The common causes of swelling are allergies, tongue piercing or injuries and some medical conditions. Once you have identified what causes your tongue swelling, it will become easier to relieve the swelling.
Taking over the counter antihistamines helps to alleviate tongue swelling that results from allergic reactions. Identify and avoid food, drugs or tongue piercing jewelries that triggers allergic reactions.
If swelling is accompanied with some pain, place some ice chips on the surface of the tongue and allow it to melt. It helps to relieve pain and swelling. Don’t allow the ice chips or cubes to overstay on your tongue as it may cause burning.
- Take vitamin B-12 supplements
As you read earlier, Vitamin B-12 deficiency in your body can lead to scallops at the edges of the tongue. Digestive system problems increases the risk of developing deficiency of this type of vitamin due to poor absorption.
Therefore, if you are diagnosed with deficiency of vitamin B-12, your doctor may give you a hydroxocobalamin injection regularly for a number of weeks. Alternatively, you can increase intake of food like daily products, poultry, eggs and fortified breakfast cereals among others that are rich in this type of vitamins.
- Treat hypothyroidism
If the underlying condition is found to be thyroid hormone deficiency or hypothyroidism, there are various treatments that can be done to restore the normal production of thyroid hormone in order to get rid of scalloped tongue.
You can consider to go for hormone replacement therapy or administration of thyroid hormone supplements followed by some dietary changes to include foods that are rich in vitamin B. Other treatments includes traditional Chinese medicine, osteopathy, biofeedback therapy and acupuncture.
- Avoid clenching or grinding teeth
In some cases, crenated tongue results from the pressure created on the border of the tongue from the teeth. It is therefore important to keep space between the teeth and tongue when you are not chewing or swallowing food.
If you are having misaligned teeth and are causing pressure at the border or edges of the tongue, you can visit your dentist for proper alignment of the teeth. This will help to reduce the pressure that is created between the teeth and your tongue.
- Treat sleep apnea disorder
Sleep apnea being one of the causes of crenated tongue, it is therefore important to find treatment when your tongue problems results from this condition. You can simply make some changes to your lifestyle that contributes to sleep apnea.
Some of the life changes to make includes having enough sleep every night, quit smoking and excessive consumption of alcohol, refrain from taking sleeping pills or tranquilizers, sleep by your side or stomach or avoid sleeping while facing upward and also shed some weight to prevent constrictions in the throat.
- Manage your stress
Some studies have linked stress to pie crust tongue. Poor stress management can lead to various health problems. Stress can lead to bad habits like clenching teeth, grinding teeth or compressing the tongue against the teeth.
Stress can also lead poor food habits. Some people prefer junk foods, sugary and fatty. This can lead to nutritional deficiencies that can result to various tongue problems. It is therefore important to manage stress by sharing your problem with your best friend, try to be humorous, have enough sleep, and avoid being perfectionist among other tips.