Tongue Feels Too Big/Scalloped Tongue

This is a common complaint I hear frequently in my practice. There is an actual condition where the tongue is indeed too large for its own good called Macroglossia. It is common in people with Trisomy 21 (Down Syndrome). The tongue can swell due to hypothyroidism. Dehydration and dry mouth can cause the tongue to dry, become irritated and subsequently swell. The last two causes are less common. The most common reason why your tongue can feel too large for your mouth is from clenching and grinding your teeth. When the teeth are together for too long, the tongue does not have enough room. This can seem like your tongue is too big, but the real problem is that the space you are leaving for your tongue is too small. The teeth can leave an imprint on the sides of your tongue, giving a scalloped look. Other names for this condition are Lingua Indentada, crenelated tongue and pie crust tongue. The condition is usually never serious, and typically is not painful.

Linea Alba

Linea Alba is Latin for white line. A Linea Alba in the mouth looks like a raised whitish line on your cheek(s) along the plane your teeth are on. The line is caused by clenching, grinding, and habitual gum chewing. It is the result of continuous pinching and rubbing which results in hyperkerinization (callousing). The condition is usually not painful, although the teeth can occasionally bite the area causing painful trauma.

Achy Outer Ear

The causes of an achy outer ear (auricle) are numerous, ranging from infection, to sunburn, to trauma and are beyond the scope of this post. Most earaches are not due to infection, but if there is an infection present, timely treatment is critical. For this reason, I suggest starting with a primary care practitioner first to rule out infection. The most common cause of an ear that hurts to touch, yawn or swallow is musculoskeletal inflammation due to excessive grinding, clenching or gum chewing. The muscles of the jaw are intimately related to the ear canal and eustachian tube. When patients continually clench and grind, the muscles and tendons in the region of the ear can physically traumatize and inflame the cartilage of the outer ear and ear canal, as well as cause the eustachian tube to close, giving the impression of a clogged ear.

Tooth Sensitivity at the Gum Line

Many of my patients complain of areas on their teeth by the gum line that hurt to touch, are sensitive to sweets and/or cold, and feel like there is a small notch there. The technical term for these areas is an abfraction lesion, which I have posted about before here. Many people including dentists attribute abfractions to brushing too hard. The true cause is too much lateral force on the tooth from misalignment of the teeth, clenching, grinding, and habitual gum chewing.

All Together Now

The four symptoms discussed today taken individually should be treated singularly. Taken together, however, they can mean clenching, grinding and habitual gum chewing are likely causes. Patients are often unaware of clenching and grinding their teeth. Over time, habitual clenching, grinding and gum chewing can lead to problems, four of which I discussed today. The purpose of today’s post is not to diagnose or treat any condition, but if you have any two of these conditions, it may point to the beginnings of potential TMJ issues. See this post for more information. If you notice any or all of the above issues and you have not seen your dentist in six months, it is a good idea to schedule a check-up now.