Why is Tongue Scalloping seen with Obstructive Sleep Apnea?

Tongue scalloping refers to the series of indentations along the sides of the tongue that occur due to pressure from the molars. This condition is typically caused either by an imbalance between the tongue and palate size or in conjunction with an enlarged tongue (macroglossia).

Multiple studies have identified it as a clinical sign predictive of OSA. Its presence should prompt the physician to inquire about snoring history. However, other causes could include: hypothyroidism, dehydration, and vitamin B12 deficiency.

References

1. Weiss TM, Atanasov S, Calhoun KH. The association of tongue scalloping with obstructive sleep apnea and related sleep pathology. Otolaryngol Head Neck Surg. 2005 Dec;133(6):966-71.
2. Bailey BJ Head and neck surgery-otolaryngology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 579.
3. Zonato AI, Bittencourt LR, Martinho FL, Júnior JF, Gregório LC, Tufik S. Association of systematic head and neck physical examination with severity of obstructive sleep apnea-hypopnea syndrome. Laryngoscope. 2003 Jun;113(6):973-80.
4. Kanti V, Aparna MK. Obstructive sleep apnea in a patient with orofacial pain secondary to cervical fixation. J Am Dent Assoc. 2017 Mar;148(3):185-189. doi: 10.1016/j.adaj.2016.08.019. Epub 2016 Dec 21. PMID: 28012558.