7 Reasons For A Scalloped Tongue & Treatments

7 Reasons For A Scalloped Tongue & Treatments

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH
Medical Reviewed on Oct 16, 2023
byDr. Matthew Hannan DDS
🔬 Evidence Based
7 Reasons For A Scalloped Tongue & Treatments

Do you have a scalloped tongue? Scalloping on tongue borders (on either side of your tongue) isn’t necessarily normal but it isn’t always a bad thing. If you have visible tongue ridges or a wavy tongue, read on to learn more about some of the most common causes. 

What Is A Scalloped Tongue?

A scalloped tongue is where there are noticeable, prominent tongue ridges on either side of your tongue (usually somewhere in the back,) closest to where it touches your teeth. You could think of it sort of like the edges around a pie crust, where it’s pinched together and makes a little wavey-shape. With scalloped tongue ridges, it’s basically your teeth making the up and down shapes on your tongue, either because you’re biting down on your tongue or you’re pressing it so hard into your teeth that it starts to take on the scalloped shape of your bite.

If you see scalloping on your tongue, it’s not necessarily something to freak out about. But it is a warning sign that something else is probably going on you’ll need to address. Plus, it just sets you up to accidentally bite your tongue more often when you’re eating, and who likes that?!

7 Reasons Why You Have A Scalloped Tongue 

Your teeth are what’s physically causing the scalloped shape along the sides of your tongue. Just look at the ridges; they follow the groovy pattern of the way your teeth bite together (occlude.) Your occlusion isn’t a flat line; it’s a little up and down pattern that runs from one side of your mouth to the other. The scalloped edges of tongue ridges are usually closest to your molars and premolars, but you might occasionally see it on the front of your tongue as well. The scalloping comes from a constant irritation against your tongue, making it build up a callous of sorts. If you were to run your finger over that area, it would feel slightly rougher than the part of your tongue next to it. 

woman with Scalloped Tongue

Usually, the reasons someone has a scalloped tongue are because of a condition that’s causing your tongue to swell or your teeth to bite down on your tongue without you realizing it. Some of the causes are easier to manage than others, with treatments ranging from vitamin supplements to corrective surgery, depending on the severity of the situation. 

1. Dehydration 

When you’re dehydrated, you might think that everything feels thinner and skinnier because of a lack of fluid. But in reality, some parts of your body will start to swell and become larger than it normally is. Your tongue is one of them! Foot swelling is also fairly normal. Other symptoms of dehydration include feeling light-headed, tired, experiencing a headache, flushed-looking skin, or having dry eyes and mouth. If you’re dehydrated, you’re also less likely to pass as much urine as you’re supposed to. Since dehydration can make your tongue swell, there’s a bigger chance that the sides of your tongue are going to press into your teeth, which then create scalloped edges. 


Depending on the severity of your dehydration, you might need to go to the emergency room to get some fluids through an IV. There are even mobile IV companies these days that will bring one to your home! Always be aware of your water and electrolyte intake, especially if you’re sick with a stomach bug or endurance training out in the heat. In addition to drinking water or something like Pedialyte, you can also get fluids from milk, sparkling water, and fresh fruits. Dehydration is one of those things you can try to stay ahead of by drinking plenty of water leading up to rigorous physical activity or sipping on a drink when you don’t feel well.

2. Stress & Anxiety  

Things like a stressful home or work environment can do a number on our mouths. Similarly, anxiety and depression can also affect our teeth. The most common oral side-effect of stress or anxiety is bruxism (teeth clenching and teeth grinding.) When we’re constantly clenching and biting our teeth together, our tongue can get in the way and start to build up a callous-like layer of keratin tissue where it’s always being irritated. This creates a white line or scalloped ridge on the side of your tongue. It’s almost identical to what you see with someone who has untreated sleep apnea.


It’s not always practical to cut stress or anxiety out of your life. But there are some lifestyle changes you can make to help with a scalloped tongue or worn teeth. Such as wearing a bite splint or mouth guard during the day while you’re concentrating, sleeping in a night guard, asking your dentist about Botox to relax your jaw muscles, and cognitive behavioral therapy to better manage the mental and physical effects of stress. Keep in mind that a lot of the prescription medications that are used for anxiety or behavioral medicine can increase your chances of clenching and grinding your teeth even more. 

3. Smoking

Smoking does two things that can increase your risk of a scalloped tongue: contribute to dehydration and causes swelling in your tongue. People who smoke also tend to experience hidden symptoms of periodontal disease, like pocketing under their gums and bone loss. The bad news is that smoking typically makes it harder for your mouth to heal, so issues like gum infections or mouth sores typically last longer than they would in a healthy non-smoker. It’s basically the result of atrophied blood vessels throughout your oral soft tissues, limiting your body’s immune response against bacteria. 


The very best thing you can do if you’re a smoker is to make a game plan to give up the tobacco habit altogether. It can be a long and stressful process, but it’s better for both your smile and your body overall. Ask your doctor about developing a cessation plan, including the use of medications to help you stop smoking. Just remember that you might have some dry mouth and clenching (from the stress) to deal with if you’re cutting yourself off from nicotine. 

4. TMD (TMJ Disorder)

People with TMJ disorder (TMD) usually have a “bite” that’s off. So, whenever they’re eating or biting into food, they’re having to adjust the way their jaw is moving. They might even struggle with the way their jaw is positioned whenever their mouth is at rest. Common symptoms of TMD include a clicking jaw, migraines, limited range of motion, flat or worn teeth, bruxism, and a scalloped tongue. Sometimes the muscle pain from TMD can even radiate through the face, neck, shoulders, and upper back. 


TMJ disorder is usually treated with a combination of non-surgical treatments like bite splits, orthodontic therapy, Botox, occlusal (bite) adjustments, and sometimes physical therapy or massage. You can also take an anti-inflammatory for pain relief during flare-ups or apply moist heat to help with discomfort. Some dentists might also recommend myofunctional therapy to address muscle motions related to swallowing, chewing, or resting since they can tie back to TMJ function and health.

5. Genetic Condition Or Birth Defect

Sometimes a health history of certain genetic conditions can make a person more likely to have a scalloped tongue. Down Syndrome and Beckwith-Wiedemann Syndrome are classic examples. People with Down Syndrome tend to have enlarged tongues in general, which naturally press into the sides of the teeth, causing scalloped edges. We call it “macroglossia” when someone has an enlarged tongue. Normally we see issues like dry lips, dry tongue, and mouth breathing as well, simply because of a lack of space for the tongue to rest comfortably inside of the mouth.


Since genetic or medical conditions don’t have a specific “treatment”, the strategy is to manage the symptoms of macroglossia when it’s a concern. About 1 in 10 people with macroglossia will have a special type of reduction surgery to address the size of their tongue. Others may get orthodontic treatment to widen the arches of their teeth and create more space for their tongue. Some people respond well to corticosteroids, which help reduce the amount of tongue swelling overall. 

6. Nutritional Deficiencies 

Deficiencies in things like vitamin B12 can cause tongue swelling that’s so significant, it might even look like macroglossia. Iron deficiency (anemia) can do the same thing. You’ll probably need your doctor to order some bloodwork to nail down specific nutritional deficiencies. Some common signs of a nutritional deficiency include dry or brittle hair, misshaped nails, bleeding gums, anemia, and fatigue (which, by the way, is a common side-effect of an iron deficiency.) Low potassium? You might see muscle weakness or constipation. Calcium deficiency? Look for numb, tingly fingers. 


Anyone with a nutritional deficiency will want to work with their doctor and a dietician for a proper diagnosis and to modify their diet or add supplements that can be taken to help restore low nutrient levels. Mineral-rich and fortified foods are extremely important. Simple blood tests can check for proteins, vitamins, minerals levels.

If you’re experiencing other oral side effects like a burning mouth or burning tongue, talk to your dentist about getting a miracle mouthwash to help with discomfort. 

7. Sleep Apnea (Sleep disorders)

Someone with obstructive sleep apnea (OSA) typically has some sort of physical airway blockage related to soft tissues in their mouth. Like their tongue and/or tonsils. Whenever your body is oxygen deprived while you’re sleeping, your teeth tend to clench shut automatically. The result is that you’re biting into your tongue or your tongue is just pressing into your teeth too hard, causing the ridges on the sides of it. Other symptoms of obstructive sleep apnea include flat, worn, or broken teeth and a large neck circumference. You can ask your dentist about getting a take-home sleep study to get a formal sleep apnea diagnosis. 


Dental treatment for obstructive sleep apnea consists of a custom-fitted oral sleep appliance that’s called a “mandibular advancement device.” These mouthpieces position your lower jaw in a slightly anterior direction, preventing soft tissue blockage at your throat and your teeth from clenching shut. Oral sleep appliances are FDA-approved for OSA and can only be fitted by a trained sleep dentist. Some people are able to totally toss their CPAP machine for good.

Risks Associated With A Scalloped Tongue 

Any time you have a scalloped tongue or prominent tongue ridges, you’re going to be more likely to have issues biting into your tongue when you’re eating. That can mean open sores or recurring injuries on your tongue that take some time to heal. Also, there’s the chance that you could get an infection in one of the cracks or sores on your tongue, given the number of bacteria that are in your mouth at any given time. Also, if your tongue is swollen or scalloped, it might be interfering with your breathing (especially when you sleep) or make eating more difficult. 

Talk With Your Dentist 

Your mouth says a thousand things about you, without having to say a word. Having your dentist look at your oral tissues, be it your tongue or gums or something else, is a great way to nail down the possibility of some other co-existing health condition you don’t know about. Since there’s no scalloped tongue treatment for the tongue ridges themselves, your dentist will help develop a care plan that addresses the cause of the scalloping instead. Especially if it’s something that might damage your teeth, like bruxism, or a serious medical issue such as obstructive sleep apnea. 

Scalloped Tongue Causes

Having scalloping on tongue edges is usually the side-effect of some co-existing condition or lifestyle issue. From grinding your teeth and sleep apnea to genetic conditions and nutritional deficiencies, you’ll want to work with your doctor or dentist to identify the cause behind it is. Only at that point is it possible to manage or treat the symptom of tongue ridges. The good news is that the condition normally isn’t anything to freak out about. You still want to talk with your dentist though, just in case, to make sure nothing serious or life-altering is causing it. 

 Whitney DiFoggio BS, RDH
Written by Whitney DiFoggio BS, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Dr. Matthew  Hannan DDS
Medical Reviewed byDr. Matthew Hannan DDSDr. Matthew Hannan is a board-certified dentist and graduate of UT Health San Antonio School of Dentistry.
Last updated onOctober 18, 2023Here is our process

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