- Tongue pain is commonly caused by wounds, burns, irritation, or infections, but it can also be linked to nutritional deficiencies, nerve-related conditions, or chronic disorders.
- Many cases improve with simple measures like good oral hygiene, avoiding irritating foods, and treating the underlying cause, such as infections or vitamin deficiencies.
- Tongue pain that lasts longer than one week or occurs with swelling, bleeding, a persistent sore, or trouble swallowing may be a red flag and should be evaluated by a dentist or other healthcare provider.
Tongue pain is often caused by visible problems such as wounds, burns, or infections, but it may also be linked to less obvious conditions like nutritional deficiencies or nerve-related disorders. In some cases, tongue pain can be an early sign of chronic conditions or, more rarely, tongue cancer.
Common causes of tongue pain include canker sores, irritation from spicy foods or mouthwash, oral thrush, geographic tongue, and burning mouth syndrome. Medical treatments, lifestyle changes, and improved oral hygiene are often used to relieve symptoms, depending on the underlying cause.
Persistent tongue pain that lasts longer than a week or occurs with swelling, bleeding, or difficulty swallowing may require medical evaluation. Identifying the cause early allows for proper treatment and helps prevent complications that can affect eating, speaking, and overall oral health.
What causes tongue pain?
The most common causes of tongue pain include:
1. Wounds or canker sores
Tongue wounds are quite common and often occur from accidentally biting the tongue or chewing hard foods. Although usually small, they can be very painful because the tongue is a flexible muscle that moves constantly.
Canker sores can also lead to small lesions on the tongue. They are associated with many factors, such as excess stress, eating acidic foods, using braces or a weakened immune system.
What to do: One way to quickly relieve pain from wounds or canker sores is to gargle with warm salt water three times a day. Maintaining good oral hygiene is also important, including brushing your teeth after each meal to help prevent infection and ease discomfort.
2. Tongue irritation
Tongue irritation is nearly as common as canker sores. It can develop after vigorous tooth brushing or from exposure to irritating substances, such as alcohol-based mouthwashes. Eating too many spicy foods can also trigger irritation and a burning sensation that may last for several hours.
What to do: You should avoid drinking alcohol and other substances that can cause irritation. Sucking on an ice cube may also help relieve the pain.
3. Burns
A tongue burn can occur when you eat food straight from the oven or when your tongue touches a hot object. Although the sharp pain usually fades quickly, the area may remain sore for several days while it heals completely.
What to do: One helpful tip is to eat something cold, such as ice cream or suck on an ice cube, to help ease pain and burning.
4. Nutritional deficiencies
According to the National Institutes of Health (NIH), deficiencies in vitamin B12 and iron can affect the oral mucosa and are recognized causes of glossitis, which may present as tongue pain or burning.
Vitamin B12 deficiency is also associated with other symptoms like fatigue, pallor or excessive hunger.
What to do: If your tongue pain persists without an obvious cause, consult your primary care provider. They can order a blood test to check for anemia or other nutritional deficiencies.
5. Geographic tongue
Geographic tongue is a benign condition that often appears in early childhood and typically resolves by around age 7. It features red patches on the tongue with white or gray borders, which may cause pain or burning, especially when eating salty, acidic, or spicy foods.
If your child complains of tongue pain or a strange sensation on the tongue but no visible abnormalities are present, suspect possible ingestion of a chemical substance, such as detergent.
What to do: A pediatrician should diagnose this condition, which can be painful and is treatable with anti-inflammatory medications.
6. Oral thrush
Oral thrush is a fungal infection that, according to the CDC, is more likely to occur after antibiotic use or in people with weakened immune systems.
This infection commonly causes white patches and soreness on the tongue and inside the mouth. It may also cause difficulty swallowing.
What to do: Maintaining good oral hygiene is essential to remove excess fungus and bacteria. Avoid sugary or fatty foods as well. For more serious cases, medications like nystatin may be needed.
7. Burning mouth syndrome
Burning mouth syndrome causes a burning sensation in the mouth without an obvious cause. It may also lead to dry mouth or a bitter taste, so consult a dentist or ENT specialist for proper diagnosis and treatment.
What to do: Treatment depends on the underlying cause and focuses on managing symptoms. It often includes medications, lifestyle changes, or both.
8. Tongue cancer
Tongue cancer is a rare type of tumor that typically affects the top or bottom surface of the tongue. It often appears as a wound that doesn't heal and bleeds easily.
Tongue cancer can cause tongue pain, discomfort when swallowing or chewing, or a persistent lump on the tongue that does not go away over time.
What to do: To confirm a diagnosis, consult your primary care provider or a dentist for testing, which typically involves a biopsy. If confirmed, treatment may include surgical removal of malignant cells, along with chemotherapy or radiation therapy.
9. Chemotherapy or radiation therapy
Certain cancer treatments like chemotherapy or radiation can irritate the mouth, leading to a burning sensation on the tongue or inner lining, pain, taste changes, dry mouth, or infections in the mouth, gums, or throat.
Radiation therapy to the tongue can cause side effects like burning sensation, loss of taste, redness, pain, and sores in the mouth or throat. These issues often make chewing and swallowing more difficult.
Generally, side effects from chemotherapy resolve 6-8 weeks after the last treatment. With radiation therapy, however, taste buds may become damaged, potentially leading to permanent changes in taste.
What to do: Always follow your oncologist's specific instructions, which may include good oral hygiene practices such as frequent tooth brushing. Your doctor may also prescribe medications like topical oral anesthetics for pain relief or antibiotics to treat infections.
Additionally, your dentist or doctor may prescribe alcohol-free mouthwashes or sodium bicarbonate (baking soda) gargles. In some cases, they may also recommend laser therapy to treat mouth infections and relieve symptoms.