The presence of teeth marks along the sides of the tongue, medically known as crenated or scalloped tongue, is a common observation. These indentations appear as wavy, rippled edges that mirror the shape of the adjacent teeth. While scalloping is not a disease, its appearance signals that the tongue is pressing against the dental arches more frequently or forcefully than normal. This suggests an underlying issue is causing the tongue to enlarge or a habit is increasing pressure within the oral cavity.
The Physical Mechanism of Scalloping
The characteristic wavy pattern of a scalloped tongue results from constant pressure exerted by the tongue tissue against the edges of the teeth. The tongue is a pliable muscle, and when confined by a space too small for its size, the teeth act like a mold. Repeated compression leaves semi-permanent impressions along the lateral borders.
This impression occurs when the tongue tissue expands to fill the space between the upper and lower teeth, conforming to the dental structure. The issue is not with the teeth, but with the volume of the tongue relative to the size of the jaw and oral cavity. A swollen or enlarged tongue, termed macroglossia, is the primary driver behind this constant pressure.
Systemic Conditions Causing Tongue Swelling
One common reason for tongue enlargement and scalloping involves systemic hormonal imbalance, specifically hypothyroidism. When the thyroid gland produces insufficient hormone, the body’s metabolism slows down, and a specific type of swelling called myxedema can occur. This condition involves the accumulation of hyaluronic acid and other mucopolysaccharides in the soft tissues, causing the tongue to swell and push against the teeth.
Nutritional deficiencies also contribute to tongue enlargement and inflammation, known as glossitis. A shortage of certain micronutrients can cause the tongue tissue to become inflamed and swollen:
- B12
- Riboflavin
- Niacin
- Iron
These micronutrients are important for cellular health, and their deficiency leads to changes in the oral mucosa. When the tongue is inflamed, its increased volume makes contact with the teeth inevitable, creating the scalloped appearance.
Less common systemic causes of macroglossia include amyloidosis, a condition where abnormal proteins accumulate in soft tissues, including the tongue. This protein buildup causes the tongue to become progressively larger, harder, and less mobile, forcing it into the surrounding teeth. Allergic reactions and infections can also cause acute, temporary swelling of the tongue, which, if persistent, creates the scalloped pattern.
Behavioral Habits and Lifestyle Contributors
Beyond systemic medical issues, daily habits and lifestyle factors contribute to the formation of teeth marks on the tongue. Increased anxiety and stress often manifest as subconscious oral habits, such as pressing the tongue forcefully against the teeth or clenching the jaw. This habit provides the consistent pressure required to mold the tongue’s edges.
Sleep-related issues like obstructive sleep apnea and habitual snoring are also factors in tongue scalloping. During sleep, a person with sleep apnea may subconsciously thrust their tongue forward or press it against the lower teeth to open the restricted airway. This repetitive, nocturnal pressure causes the tongue to swell slightly and conform to the shape of the teeth.
Bruxism, or the chronic grinding and clenching of teeth, increases overall tension and pressure within the mouth. While bruxism primarily affects the teeth and jaw joint, the associated muscle tension often forces the tongue into a limited space. Dehydration can also cause the tongue tissue to retain water and swell slightly, making the scalloping more noticeable.
When to Consult a Healthcare Professional
Although the scalloped tongue is generally harmless, its presence signals that an underlying physiological or behavioral issue may need attention. Consult a healthcare provider if the teeth marks appear suddenly, are accompanied by pain, or do not resolve after addressing behavioral factors like hydration and stress. A professional evaluation is necessary to rule out or diagnose more complex conditions.
Warning signs that necessitate a doctor’s visit include difficulty swallowing, persistent soreness, or a noticeable change in the tongue’s color or texture, such as developing white or red patches. If the scalloping is accompanied by other systemic symptoms like chronic fatigue, unexplained weight changes, hair loss, or general body aches, this suggests a medical cause, such as a thyroid disorder. Diagnosis typically begins with a physical examination and may involve blood tests to check for vitamin deficiencies, iron levels, or thyroid hormone function.