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What Does Having a Scalloped Tongue Mean? 5 Causes

Medically Reviewed on 11/2/2021

While a scalloped tongue rarely indicates serious problems, examining possible causes can help your doctor detect other medical conditions you may have

A scalloped tongue is a tongue with indentations, notches, or ridges along the edges. While the condition rarely causes pain or indicates more serious problems, understanding what causes scalloped tongue can help your doctor detect other medical conditions you may have.

5 possible causes of a scalloped tongue

1. Teeth clenching

Clenching or grinding your teeth frequently (bruxism) can lead to a scalloped tongue. This occurs due to pressing of the tongue against the teeth over time.

While scientists are still investigating the causes of bruxism, the condition is most likely to be associated with the following:

  • Inability to manage stress
  • Frustration
  • Anger
  • Smoking
  • Alcohol consumption
  • Recreational drug use
  • Depression medications

2. Nutritional deficiency

Vitamins that play an important role in maintaining oral health include:

  • Vitamin B12
  • Riboflavin
  • Niacin
  • Iron

Deficiency of these vitamins may not only lead to a scalloped tongue but also cause painful and inflamed tongue and mouth ulcers.

3. Hypothyroidism

When the functioning of the thyroid gland slows down (hypothyroidism), this can cause your tongue to swell and develop ridges on its edges.

4. Sleep apnea

According to a 2017 study that examined more than 1,000 Japanese adults, a condition known as nocturnal intermittent hypoxia, which is found in sleep apnea, can cause a scalloped tongue along with swelling of the tongue.

Tongue scalloping in combination with an enlarged tongue (macroglossia) may be associated with various conditions, including:

  • Down syndrome
  • Tuberculosis
  • Sarcoidosis
  • Amyloidosis
  • Multiple myeloma
  • Neurofibromatosis
  • Infection (such as syphilis)
  • Angioedema
  • Neurofibromatosis

5. Dehydration

Lack of adequate hydration can cause the tongue to swell and become dry, which can cause a scalloped tongue.

How is a scalloped tongue diagnosed?

Your doctor will ask you questions regarding your medical history and other signs and symptoms that may be associated with scalloped tongue. They will try to determine whether any underlying medical conditions may have caused the condition.

Tests ordered may include:

  • Blood tests
  • Biopsy
  • Imaging tests such as:
    • X-rays
    • Computed tomography scan
    • Magnetic resonance imaging scan

How is a scalloped tongue treated?

Although a scalloped tongue is unlikely to cause any problems with functions of the tongue such as taste, chewing, or swallowing, it may help your doctor detect other medical conditions you may have.

A scalloped tongue may be treated by a medical doctor, dentist, or collaboration of both. Treatment may involve medications or procedures depending on the underlying condition. These include:

  • Synthetic thyroid hormones (oral pills) for hypothyroidism
  • Antihistamines, anti-inflammatory, and immune-suppressing drugs for angioedema
  • Mouthguards for sleep apnea
  • Continuous positive airway pressure machine for sleep apnea
  • Surgery to remove excess tissue or abnormal growths on the tongue
  • Surgery to reduce the size of the tongue
  • Stress management in cases of bruxism


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Medically Reviewed on 11/2/2021


Image Source: LENblR / Getty Images

Khanal R, Pathak R, Young J, et al. Clue in the tongue. J Community Hosp Intern Med Perspect. 2015;5(1):26107.

Vinod KV, Reddy P, Pillai VM. Scalloped tongue: A rare finding in nocturnal bruxism. Natl Med J India. 2017 Sep-Oct;30(5):296.

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