The 6 things a ‘scalloped pie crust tongue’ could say about your health – from teeth grinding to deadly sleep condition

WHEN it comes to oral health, most of know to be on the lookout for signs of disease or decay on our teeth.

But other parts of your mouth – such as your tongue – can offer you clues about your health.


swollen enlarged white tongue with wavy ripple scalloped edges (medical name is macroglossia) and white lie bumps on tongue tipCredit: Getty

You might not think to pay much attention to the fleshy organ all of us for tasting, licking and articulating.

However, it can be worth taking note of its shape.

A “scalloped tongue” is exactly what it sounds like – when you have indentations or ridges along the edge of your tongue like a pie crust.

According to Dr Neeraj Panchal – chief of oral and maxillofacial surgery at Penn Presbyterian Medical Center – this “typically arises from the tongue persistently pressing against the teeth”, resulting in tooth-like indentations.

You should be able to spot whether your tongue has a ruffled edge when you stick it out.

While a pie crust tongue in itself isn’t harmful, it could be the sign of an underlying health issue that’s worth getting checked out.

This could be anything from a vitamin deficiency to night-time teeth grinding or sleep apnoea – a hard-to-spot sleep condition that could have deadly long-term consequences.

Here, we break down why your tongue might have a scalloped edge and when it’s worth seeing a health professional.

1. You have a vitamin deficiency

Strangely enough, being deficient in B vitamins like as B12, folate (B9) and riboflavin (B2) can leave your gums inflamed and your tongue swollen, according to Dr Soroush Zaghi, an ear, nose and throat doctor and sleep surgeon.

He told HuffPost: “These vitamins are crucial for cell regeneration and maintaining healthy mucosal tissues in the mouth.”

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The swelling in your tongue can cause it to press against your teeth, causing a lettuce edge appearance.

2. You’re clenching or grinding your teeth

Teeth clenching or grinding could also be behind your pie crust tongue, both of which are common if you’re anxious or stressed.

These conditions “exert extra pressure on the sides of the tongue, potentially leading to a scalloped appearance over time,” Dr Zaghi said.

You might find yourself grinding your teeth when you’re awake but it can also happen when you’re asleep.

As well as indentations in your tongue, the following symptoms might tip you off to your teeth-clenching habit:

  • Face, neck and shoulder pain
  • A painful jaw, which can lead to a condition called temporomandibular disorder (TMD)
  • Worn-down or broken teeth, which can cause increased sensitivity and loss of teeth and fillings
  • Headaches
  • Earache
  • Disturbed sleep

3. You’re dehydrated

Not drinking enough water and liquids can cause tissues in your body to swell, including your tongue – this’ll lead your tongue to press harder against your teeth, resulting in that pie crust edge.

4. You have sleep apnoea

Sleep apnoea is a sleep condition that causes your breathing to stop and start as you slumber.

It can hard to spot if you sleep alone, but a partner might notice these telltale symptoms:

  • Breathing stopping and starting
  • Making gasping, snorting or choking noises
  • Waking up a lot
  • Loud snoring

But symptoms of sleep apnoea can occur in your waking moments too.

Sufferers may notice that they feel very tired throughout the day, despite supposedly getting a full night’s sleep.

You may also find it hard to concentrate, experience mood swings and wake up with a headache.

Aside from all these symptoms, this sleep condition could also be giving your tongue a distinctive scalloped edge.

The most common form of sleep apnoea is obstructive sleep apnoea (OSA), caused by a blocked upper airway – this is common among people who have a small or recessed jaw, or large tongue.

When you’re struggling to breathe at night due to OSA, you may unconsciously press your tongue against your teeth, according to Dr Zaghi.

The NHS advises you see a GP if you suspect you have the disorder or someone has noticed these symptoms as you sleep.

The condition can put you at risk of other health issues, like high blood pressure, type 2 diabetes, heart disease, depression and stroke – so it’s important you get it diagnosed and treated.

5. You have a TMJ issue

The temporomandibular joint (TMJ) connects your lower jawbone to the skull.

Disorders affecting it may cause symptoms like jaw pain, earaches or difficulty opening or closing the mouth.

Dr Zaghi added: “The misalignment or dysfunction associated with TMJ disorders can reduce the space for the tongue, contributing to a scalloped appearance.”

6. You have a thyroid issue

An underactive thyroid or hypothyroidism is a condition where your body does not make enough hormones.

Typical symptoms of the condition are tiredness, weight gain, sensitivity to the cold, dry skin and hair and feeling depressed.

But for some an underactive thyroid can cause the tongue to swell, making it press more forcefully against the teeth – hence leaving them with a scalloped-edged tongue.

See a doctor?

It’s worth seeing a health care professional about the scalloping on your tongue if the scalloping persists over time or you’ve developed sore spots that are slow to heal, Dr Zaghi advised.

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Other symptoms that could be a cause for concern include difficulty swallowing or trouble speaking, as well as other changes to your oral health.

It’s also worth flagging symptoms of other health issues mentioned above – like sleep apneoa, an underactive thyroid or a TMJ disorder.

Signs of tongue cancer

TONGUE cancer is a type of head and neck cancer.

The most common type of tongue cancer is squamous cell carcinoma (SCC), according to Cancer Research UK.

Symptoms include:

  • 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
  • Numbness in the mouth that won’t go away
  • Pain or burning feeling over the tongue
  • Problems moving your tongue or speaking
  • A lump in the neck
  • Unexplained bleeding from the tongue (that’s not caused by biting your tongue or another injury)
  • Pain in the ear (rare)

It’s important to remember that these symptoms might be due to a less serious medical condition.

But it’s best to check symptoms with your GP just to make sure.

Source: CRUK


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