Causes and Treatments of a Swollen, Scalloped Tongue

Here's what causes a scalloped tongue and how it's diagnosed and treated.

Scalloped Tongue Causes

1. Teeth Grinding or Clenching

When you clench or grind your teeth (also called bruxism), it can cause you to press your tongue into your teeth, according to Timberlake Dental. You may do this in your sleep or even during the day without realizing it.

It's not totally clear why some people grind their teeth, per the Mayo Clinic, but the habit may be caused by higher levels of stress, anxiety, anger or frustration. It's also linked to certain antidepressant medications, smoking, drinking caffeine or alcohol and using recreational drugs.

  • Chipped, fractured or flattened teeth
  • Worn tooth enamel
  • Sensitive teeth
  • Locked jaw or tight jaw muscles
  • Pain or soreness in the jaw, neck or ear
  • Dull headaches
2. Vitamin B12 Deficiency

According to a small May 2016 study in BMC Oral Health, vitamin B12 is one of the most important nutrients for oral health.

  • Numbness or tingling in the hands, legs or feet
  • Difficulty walking
  • Balance problems, like staggering
  • Memory loss
  • Difficulty thinking ("brain fog")
  • Weakness
  • Fatigue
  • Anemia

Because low vitamin B12 levels can cause such a wide array of symptoms, this condition can be tricky to diagnose. Early detection and treatment are important, though, because an untreated deficiency can lead to severe nerve damage and blood disorders, per Harvard Health.

3. Iron Deficiency

It's not just vitamin B12 deficiency that can cause indentations on the tongue. If you don't get enough iron, you may end up with a swollen, scalloped tongue and some other uncomfortable symptoms.

Although everyone is different, common symptoms of iron deficiency include the following, according to Johns Hopkins Medicine:

  • Feeling tired or having low energy
  • Looking abnormally pale
  • Being irritable
  • A higher heart rate
  • Enlarged spleen
  • A condition called pica, where you have a strong desire to eat non-food things like dirt
4. Hypothyroidism

A swollen tongue with ridges on the edges could be a sign of hypothyroidism, a condition where your thyroid gland function is lower than it should be, per the Center for Occupational & Environmental Medicine.

In the early stages, people with hypothyroidism may not notice any symptoms, according to the Mayo Clinic. But over time, the condition can cause:

  • Fatigue
  • Weight gain
  • Constipation
  • Hoarse voice
  • Puffy face
  • Muscle weakness or aches
  • Stiff, swollen or painful joints
  • Hair loss
  • Depression
  • Slower heart rate
  • Higher sensitivity to cold

If you notice these symptoms, it's important to tell your doctor and start treatment as soon as possible, because hypothyroidism can lead to obesity, infertility and heart disease.

Scalloped Tongue Treatments

How a scalloped tongue is treated depends on the underlying cause:

2. Foods or Supplements With Vitamin B12

If you're lacking B12, your doctor will likely conduct a series of tests to determine what's causing the deficiency and then recommend the best course of action. In most cases, a vitamin B12 deficiency is treated with either dietary supplements or vitamin shots.

If your diet was simply lacking adequate amounts of vitamin B12, you may be able to correct a deficiency with supplements. However, if you have difficulty absorbing vitamin B12 from food, you may need injections.

If your doctor recommends eating more foods high in B12, you could add the following to your diet:

  • Clams
  • Beef (especially beef liver)
  • Nutritional yeast
  • Greek yogurt
    • Milk Eggs
  • Chicken breast
  • Caned tuna
  • Fortified cereals, soy milk and tofu

In general, this nutrient occurs naturally in meat, fish and dairy. Therefore, vegans and vegetarians are more likely to develop deficiencies. Some cereal brands and other food products are fortified with vitamin B12, though, so make sure you choose those, especially if you don't eat animal foods.

3. Iron-Rich Foods or Supplements

For a swollen tongue caused by an iron deficiency, your doctor may prescribe a high-iron diet or iron supplements.

Foods high in iron include:

  • Meats (beef, pork, lamb, liver and other organ meats)
  • Poultry (chicken, duck and turkey — especially the dark meat)
  • Oysters and mussels
  • Leafy greens (spinach, kale, collard greens)
  • Lentils
  • Kidney beans
  • Black beans
  • Fortified cereals and bread
4. Hormone Therapy

Your doctor can order blood tests to see if hypothyroidism is the culprit behind your wrinkled tongue. If that's the case, he or she will probably have you start hormone therapy, in the form of a daily oral medication, per the Mayo Clinic.

Most people with this condition will need to stay on hormone therapy for the rest of their lives in order to control symptoms, but the dosage may change based on the results of regular blood tests.

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