While everyone’s oral anatomy is different depending on their genetics, lifestyle, and health, there are a few commonalities. One of these is a smooth-sided tongue. Turns out, this is actually not the case for everyone. Scalloped tongue is a generally harmless anomaly of the tongue that affects people of all ages. Here’s what you should know.

What is a scalloped tongue?

Scalloped tongue gets its name from the distinct wavy edges of the tongue. Other common names include:

  • Wavy tongue
  • Pie crust tongue
  • Crenated tongue
  • Crenulated tongue
  • Lingua indentata

The main symptom of scalloped tongue is its trademark wavy surface on the outermost edges of the tongue, but there may be other symptoms, including:

  • Pain that ranges from mild to moderate
  • Tenderness
  • Slight redness
  • Achy throat
  • Trouble swallowing (including eating and drinking)

While scalloped tongue itself is usually harmless, a scalloped tongue can be a sign or symptom of a more serious underlying condition.

What are common scalloped tongue causes?

Causes include those that are congenital and those that develop over time. When inflammation or macroglossia (tongue swelling) occurs, the tongue presses against the edges of the teeth. This develops wavy ridges on the sides of the tongue.

Some genetic conditions that might cause scalloped tongue include:

In each of these, swelling and inflammation in the body is persistent and causes this condition. There are other scalloped causes that have nothing to do with genetics.


Protein build-up in major organs is a hallmark of this disease.

Over time, these built-up proteins can also accumulate in the soft tissues, including the tongue. The resulting inflammation results in scalloped tongue.


Surprisingly, a lack of water can cause the soft tissues to swell. Lack of hydration is a common cause of this condition.


High levels of anxiety express themselves in our bodies in a variety of ways. For some, stress and anxiety can cause temporomandibular joint (TMJ) pain, bruxism, and other habits in the mouth, such as pressing the tongue against the teeth.

Over time, these actions can cause scalloped tongue.

Temporomandibular joint disorders (TMJ or TMD)

Temporomandibular joint disorders (TMJ or TMD) can cause scalloped tongue in the way we make adjustments and changes to our bite to “fix” misalignment.

If the temporomandibular joint becomes stuck or fixed in a painful position, some people will use their tongue as a lever of sorts to adjust it. Over time, pressing the tongue into the teeth in this way can cause changes to the tongue.

Sleep disorders

Sleep apnea and nighttime teeth grinding and jaw clenching may cause unconscious pressure on the tongue. In addition to resulting in daytime fatigue and an increase in other complications, this can lead to scalloped tongue.

Nutritional deficiencies

Lack of certain vitamins in a person’s diet can lead to scalloped tongue. These include vitamin B-12, riboflavin, niacin, and iron.

Allergic reaction, infection, or injury

A potentially dangerous scalloped tongue cause is allergic reaction or infection.

In some cases, the tongue can swell completely, blocking the airway. At this point, a crenated tongue is the least of your worries!


In general, smoking causes dehydration of the body and irritation of the tissues, including those in the tongue.

Other causes

Some types of cancer may cause scalloped tongue. People suffering from tuberculosis may also suffer from macroglossia.

While these are not the first two conditions that a doctor will check for, it is important to examine these as potential cause when no other cause is found.

How to get rid of scalloped tongue

Before scalloped tongue treatment can begin, a proper diagnosis of the cause is key.

Your doctor and dentist will work together to look for the root of the problem. Common diagnostic tools include taking a complete patient history and performing a thorough physical exam. Other tests, such as bloo