Scalloped tongue – a tongue abnormality

Introduction of the human tongue

The tongue is a muscular organ found in most mammals. It allows the food to get softer for easy digestion. It is the organ that has the sense of taste. It is covered with many taste buds in papillae over the tongue’s surface. The tongue is always moist with saliva and has many nerves and blood vessels. It also helps to clean our teeth. Another major function of the tongue is to enable speech in human beings and vocalize other animals.The human tongue has two parts – in the front, the oral part, and at the back, it is the pharyngeal part. The left part is separated from the right with a fibrous tissue strand known as the lingual septum. Though the tongue does not contain a bone, it is held in the proper position by some extrinsic muscles which anchor the tongue to the bone. Scalloped tongue-

How does Scalloped tongue condition look like?

The term scalloped tongue means highly indented and rippled edges on a tongue. The outer sides of the tongue are usually seen to be more noticeable at the outer sides of the tongue.This disease is also known as rippled tongue/ crenated or pie crust tongue or scientifically known as lingua indenta.  Sometimes, this condition is found painful, but it is mostly not painful and rarely shows serious complications. It may sometimes show any underlying improper health condition as a sign.

 Causes

Macroglossia causes a scalloped tongue characterized by indented, rippled, or scalloped edges along the sides of their tongue. It is an abnormal tongue enlargement due to macroglossia. Once the tongue starts compressing against one’s teeth, the result is tongue scalloping.

• The parafunctional or bad habits also lead to the disease known as the scalloped tongue. These habits include teeth grinding, cheek sucking, and picking at the teeth.
• Stress, systemic disease, sleep disorders, or improper alignment of teeth can also be reasons for the scalloped tongue.
• Due to the immune system, the reactions lead to swelling of the tongue due to injury, allergen, or infection.
• Due to the unusual swelling of the tongue, the pressure builds up against the teeth causing the tongue to be indented or pitted.
•  Vitamin and mineral deficiencies – A Scalloped tongue may be caused due to not having sufficient vitamins and minerals. The nutritional deficiencies commonly include vitamin B 12, riboflavin, niacin, iron, dehydration (this causes swelling, and the tongue is compressed against the teeth.)
•  Smoking also causes an immune response and makes the tongue and mucosal tissue irritated, causing swelling and inflammation.
•  Temporomandibular joint conditions- due to past injuries or chronic disease conditions, the jaw and the skull structure, including the temporomandibular joint connecting the both, may cause scalloped tongue.
• Sleep apnea also causes the scalloped tongue as the body retains more water due to lack of oxygen, leading to the fluid staying back in the head, neck, and tongue, causing scalloped tongue.
• People who have experienced prolonged chronic or long-term inflammation conditions have more chances of developing scalloped tongue.
• The condition where skin infiltration occurs, which causes a huge abnormal building up of cells, also causes scalloped tongue.
• Sometimes, the scalloped tongue is due to hereditary or congenital disability.

Here are the different inflammatory and infiltrative conditions which cause scalloped tongue:

• The patient may suffer from Down syndrome
• lipoid proteinosis
• hypothyroidism
• sarcoidosis
• amyloidosis
• angioedema
• tuberculosis
• multiple myeloma
• neurofibromatosis

Common symptoms 

• Pain
• Tenderness or soreness
• Overall slight redness
• Sore throat

How to diagnose this condition?

A doctor must look at the patient’s medical record and analyze the scalloped tongue and its underlying reasons. The tests usually recommended by the doctor include: blood tests, biopsy, computed tomography (CT) scan, magnetic resonance imaging (MRI)

The different ways of treatment of scalloped tongue include the following procedures:

• Teeth grinding should be prevented by a mouthguard.
• For some conditions caused by genetic or inflammatory and infiltrative conditions, tongue surgery is needed.
• By using anti-inflammatory medications
• Using dental devices, such as mouth guards, available for purchase online.
• Taking up thyroid hormone medications
• Using immunosuppressants
• Undergoing surgery to remove excess or abnormal deposits of cells and tissues
• Procedural surgery to reduce the size of the tongue or correct its shape
• By using continuous positive airway pressure (CPAP) machine
• Using prescribed nasal dilators
• If the patient is suffering from conditions like tuberculosis and cancer, the diseases need to be treated, and the scalloped tongue condition will automatically normalize.

Can Home Remedies help?

Not only the medical procedures but more natural methods can also treat the scalloped tongue, and therefore, here are a few home remedies:

• By drinking a lot of water.
• Having a healthy and balanced diet, including all necessary nutrients, can reduce the symptoms.
• Maintaining good oral hygiene by brushing and cleaning the tongue, using mouthwash, etc.
• Maintaining a healthy diet and beating obesity this in turn, maintains a healthy weight.
• Avoid the things which cause mouth allergy or aggravate the symptoms.
• By quitting smoking which causes scalloping.
• By checking on the stress and anxiety levels that lead to bad habits.
• Visiting an occupational therapist to retrain the tongue and check on the bad habits.
• By applying warm compresses
• Application of ice for ten-minute intervals with a 20-minute break intermittently several times daily.
• A few over-the-counter pain and anti-inflammatory medications can be taken to relieve, like ibuprofen and acetaminophen.

When is a doctor’s attention required?

 If there is a long-term painful symptom of the scalloped tongue, one has to seek medical help immediately to get relieved as soon as possible.   The rare and severe symptoms showing up on the scalloped tongue are a sure indication of a more serious underlying health condition that requires immediate doctor’s attention.  As a symptom of hypothyroidism, if a person’s thyroid hormones are very low in level, it will be marked by a scalloped tongue which can be a sign for the doctor to identify and treat the underlying disease.

To Sum Up

 Even after the habits are checked and ceased, if the symptoms persist, it is mandatory to go to the doctor if hydration and anti-inflammatory medications don’t show any improvement. A doctor can identify the habits, determine and assess practices that contribute to this condition, for example, teeth grinding, and provide a solution to break this habit.