Tongue Pain: 9 Common Causes & What to Do

Updated in December 2023

Tongue pain is usually caused by visible abnormalities, like wounds or infections. However, tongue pain can be a sign of other less obvious conditions, like a nutritional deficiency. Learn about what causes tongue pain and what to do to resolve it 

Tongue pain can be felt as a result of tongue wounds, infections, burns, nutritional deficiencies, geographic tongue, burning mouth syndrome or tongue cancer. 

If you notice tongue pain and are unsure why, or if it does not improve within one week, you should see a dentist, family doctor or otolaryngologist for assessment and treatment as necessary. 

It is important to determine the underlying cause of the tongue pain, and to diagnose and treat it in its initial phases so that complications can be prevented. 

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Common causes

The most common causes of tongue pain include: 

1. Wounds or canker sores

Wounds on the tongue are very common and can happen due to biting your tongue or from chewing on hard food. These wounds tend to be small, but can be very painful, as the tongue is a very 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: A great way to quickly relieve pain from wounds or canker sores is to gargle warm water and salt, three times per day. It is important to maintain adequate oral hygiene by brushing your teeth after every meal. This will help to prevent infections and relieve symptoms. 

2. Tongue irritation

Tongue irritation is almost just as frequent as tongue canker sores. It can occur after vigorously brushing your teeth, or after using irritating substances, like alcohol-based mouth washes. Excessively eating spicy foods can also cause tongue irritation and burning for hours.

What to do: You should avoid consuming alcohol and other irritating substances. Placing an ice cube on your tongue can also help to relieve pain. 

3. Burns

A burn on the tongue can happen after eating foods immediately removed from the oven or if your tongue contacts a hot object. Although acute pain improves within a short time, the tongue can be sore for many days until it heals completely.

What to do: An excellent tip is to eat something cold, like ice cream or an ice cube. This will help to reduce pain and burning. 

4. Nutritional deficiencies

A nutritional deficiency, like a B12 deficiency or iron deficiency, can cause anemia, leading to a painful or burning tongue. This condition is also associated with other symptoms like fatigue, pallor or excessive hunger. 

What to do: If there is no other apparent reason for the tongue pain, you should see your family doctor for a blood test to assess the possibility of anemia or another nutritional deficiency. Read about the anemia blood tests that your doctor may order. 

5. Geographic tongue

Geographic tongue is a condition that can emerge in early childhood and normally resolves at around 7 years old. It is associated with red spot on the tongue with white or gray borders, which can cause pain and burning, particularly when eating salty or acidic snacks. 

If a child feels tongue pain or a strange sensation on the tongue, and no visible abnormalities are seen, you should suspect the possibility of having swallowed a chemical substance, like detergent.

What to do: This condition should be diagnosed by a pediatrician, as it can be painful. It can be treated with anti-inflammatories. 

6. Oral thrush

Oral thrush is a fungal infection that occurs when the immune system becomes weakened. It can emerge after a cold or after taking antibiotics, for example. In addition to tongue pain, this infection can cause other symptoms, like white spots on the tongue or difficulty swallowing. 

What to do: It is important to maintain adequate oral hygiene to help to eliminate any excess fungus or bacteria. You should also avoid eating very sugary or fatty foods. More serious cases will require medications, like nystatin. 

7. Burning mouth syndrome

Burning mouth syndrome is a condition that causes burning in the mouth with no apparent reason. This condition can also cause dry mouth or a bitter taste in the mouth, which should be assessed by a dentist or ENT specialist for diagnosis and treatment as necessary. Read more about the symptoms of burning mouth syndrome and what can cause it. 

What to do: Treatment should be prescribed depending on the underlying cause and is aimed at managing symptoms. It may involve medications and lifestyle changes. 

8. Tongue cancer

Tongue cancer is a rare type of tumor that can affect the top or bottom of the tongue. It is associated with a wound that does not heal and bleed easily.

Tongue cancer can cause tongue pain, discomfort when swallowing or chewing, or a tongue lump that does not resolve over time. 

What to do: You should see a family doctor or dentist for testing to confirm a diagnosis, which is primarily done through a biopsy. If confirmed, the doctor may prescribe treatment like surgical removal of any malignant cells, as well as chemotherapy or radiation therapy. 

9. Chemotherapy or radiation therapy 

Some cancer treatments, like chemotherapy or radiation therapy, can cause side effects and affect the mouth. They can lead to a burning sensation of the tongue or mucosal lining of the mouth, as well as pain, changes to taste, dry mouth or mouth, gum or throat infections. 

Radiation therapy completed on the tongue can cause tongue burning, loss of taste, redness, pain, and mouth or throat wounds, which can make chewing or swallowing more difficulty. 

Generally, chemotherapy side effects resolve after 6 to 8 weeks of the last treatment. With radiation therapy, taste buds can become damaged and taste can be permanently altered. 

What to do: It is important to follow instructions as per your oncologist, which may include maintaining adequate oral hygiene and brushing your teeth frequently. The doctor may prescribe medications to relieve pain, like bucal anesthetics and antibiotics to fight infections. 

In addition, the dentist or doctor may prescribe non-alcohol-based mouth washes with a sodium bicarbonate gargles. In some cases, the doctor may recommended laser therapy to help treat mouth infections and relieve symptoms.