Sore or painful tongue

A sore tongue is usually the result of a burn, bite or ulcer but can sometimes be a sign of a more serious problem

A sore or painful tongue is usually caused by something obvious and visible, although there are a few less obvious causes you should be aware of that may need treating.

See your doctor or dentist if you have persistent pain and you haven't accidentally bitten or burnt your tongue.

There may be an underlying problem that needs treating, and your doctor or dentist may be able to advise you about pain relief.

This page outlines some of the most common causes of tongue pain, as well as a number of less common causes.

You shouldn't use the information on this page to diagnose yourself with a condition – always leave that to a healthcare professional.

Geographic tongue

Geographic tongue is a condition where irregular smooth, red patches that have a white or light-coloured border occur on the tongue. It's called geographic tongue because the patches have a map-like appearance.

The patches can vary in size, and may occur on one area of the tongue before moving to another area after a few days, weeks or months.

In some people, the patches can feel sore or sensitive when consuming certain foods and drinks.

Some people with geographic tongue find it improves over time, while for others it may be more persistent.

See your doctor or dentist if you have persistent, discoloured or painful patches on your tongue.

The cause of geographic tongue isn't clear and there's no specific treatment for it.

However, you may be able to manage the pain by taking over-the-counter painkillers – speak to your pharmacist for advice.

You should also avoid anything that makes it worse, such as acidic, spicy or hot foods.

Oral thrush

Oral thrush (oral candiasis) is an infection caused by a type of fungus called Candida.

It causes white patches (plaques) to develop in the mouth. You may experience a loss of taste or an unpleasant taste in your mouth. It can also be painful, making eating and drinking difficult.

Median rhomboid glossitis is a condition that can affect your tongue if you have oral thrush. It causes a red, smooth patch or lump to develop in the middle of the top part of your tongue, which can be sore.

You're more likely to develop oral thrush if you:

  • have recently taken antibiotics
  • take inhaled corticosteroid medication for asthma
  • wear dentures , particularly if they don't fit properly
  • have poor oral hygiene
  • have a medical condition, such as diabetes
  • have a dry mouth , either because of a medical condition or a medication you're taking
  • smoke
  • have a weakened immune system as a result of having chemotherapy or radiotherapy treatment for cancer

See your doctor if you think you have oral thrush. If it's left untreated, the symptoms will persist and your mouth will continue to be uncomfortable.

Oral thrush is treated with antifungal medicines , often in the form of a gel or liquid that you apply directly to the inside of your mouth.

You'll usually need to use it several times a day for around 7 to 14 days.

Aphthous mouth ulcers

Aphthous mouth ulcers are painful round or oval sores that can occur anywhere in the mouth and are common on the underside of the tongue.

Mouth ulcers are sometimes caused by damage to the mouth, such as accidentally biting your tongue or eating something hard and sharp.

Ulcers that keep recurring may be caused by stress, anxiety, eating certain foods, stopping smoking, or hormonal changes – some women develop mouth ulcers during their monthly period .

Read more about the causes of mouth ulcers.

Most mouth ulcers heal within a week or two without treatment. In the meantime, you may be able to manage the pain by taking over-the-counter painkillers and avoiding anything that makes it worse, such as eating spicy foods.

See your doctor or dentist if you have a mouth ulcer that doesn't improve within a few weeks or you develop ulcers regularly.

Less common causes

Less commonly, tongue pain may be caused by:

  • a viral infection – such as an infection that causes hand, foot and mouth disease or cold sores
  • vitamin deficiencies and anaemia – a sore tongue can sometimes be a symptom of iron deficiency anaemia and vitamin B12 or folate deficiency anaemia
  • glossodynia or "burning mouth syndrome" – a burning pain on the tip of the tongue that often affects people with depression
  • glossopharyngeal neuralgia – repeated episodes of severe tongue pain thought to be caused by nerve irritation
  • lichen planus – a long-term skin condition that causes an itchy rash and can also affect the mouth, causing a white lacy pattern and painful patches on the tongue
  • Behçet's disease – a rare condition that causes inflammation of the blood vessels and can also lead to painful mouth ulcers
  • pemphigus vulgaris – a rare and serious condition that causes painful blisters to develop on the skin, as well as inside the mouth, nose, throat, anus and genitals
  • medications – painful mouth ulcers can be a side effect of non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers; certain mouthwashes can also cause tongue pain in some people
  • Moeller's glossitis – a type of inflammation of the tongue
  • cancer of the tongue – although this is rare

If you have sores in obscure places as well as on the tongue, you may have a skin disease such as pemphigus vulgaris or lichen planus.

Common questions about sore or painful tongue

Content produced by Your.MD

Why does the bottom of my tongue hurt?

Many things can make your tongue hurt. These include biting your tongue or burning it with hot food or drink. A sore tongue may also be caused by conditions like oral thrush, a mouth ulcer, geographic tongue, lichen planus and leukoplakia. These conditions can cause pain in different parts of the tongue.

A type of ulcer, called an aphthous mouth ulcer or canker sore, is a common cause of pain on the underside of the tongue. It is a rounded sore (or sores) that can be caused by many things, including damage to the mouth, stress, and hormonal changes.

A viral infection or a deficiency in iron, vitamin B12 or folate can also make your tongue hurt. If you have tongue pain that will not go away or gets worse or you have white patches on your tongue see a doctor or dentist.

How long does it take for a tongue to heal?

The length of time it will take for a tongue injury to heal usually depends on many factors, such as the cause of the injury and how severe the injury is.

Minor injuries can heal on their own within a week. More serious tongue injuries may take longer to heal. Go to your nearest hospital or see your doctor if you have a severe tongue injury as it may need medical treatment, such as medication or stitches.

See your doctor or dentist if you have tongue pain or an itchy tongue that does not get better or if the pain gets worse. Also see your doctor or dentist if you have white patches on your tongue.

How can I heal a sore tongue fast?

Tongue injuries often heal in their own time. How long it will take to heal may depend on the type and severity of the injury. However, there are self-help techniques you can use to help a sore tongue, including:

  • avoiding hot and spicy food or any food that may irritate your tongue
  • avoiding alcohol
  • not smoking
  • brushing your teeth with a soft toothbrush
  • using a sodium lauryl sulphate-free toothpaste
  • using an antibacterial mouthwash for aphthous ulcers
  • drinking cold drinks through a straw

How can I numb tongue pain?

If your tongue pain is caused by an ulcer, a pain-killing mouthwash, gel or spray that contains a local anaesthetic (a numbing agent) may help to numb your tongue. Speak to your local pharmacist for advice on these numbing treatments.

You should also speak to a pharmacist if your tongue hurts but you don’t have a mouth ulcer. They can help you identify the cause of your tongue pain, recommend anything that may be able to help with the pain, and tell you if you need to see a doctor.

How to get rid of a canker sore on the tongue

A canker sore or aphthous mouth ulcer usually heals within 10 to 14 days. To help with the pain and speed up the recovery process, you can try self-help techniques, including:

  • avoiding spicy, salty or acidic foods
  • avoiding rough, crunchy foods, such as crisps or toast
  • avoiding hot or acidic drinks, such as fruit juice
  • avoiding chewing gum
  • avoiding alcohol
  • eating soft foods
  • brushing your teeth with a soft toothbrush
  • using a sodium lauryl sulphate-free toothpaste
  • using an antibacterial mouthwash
  • drinking cold drinks through a straw
  • eating a healthy balanced diet
  • seeing your dentist for a check-up

Your local pharmacist can advise you on the best treatment for managing pain and healing your canker sore. You can also buy non-prescription treatments that may help to reduce pain and speed up healing. These include antimicrobial mouthwashes that prevent infection, painkilling mouthwashes, gels and sprays, and corticosteroid lozenges.

Why does anaemia cause sore tongue?

If you have anaemia, you may also have a sore tongue. This is because iron, vitamin B12 and folate deficiencies cause anaemia and they also cause conditions that can make your tongue sore.

Low levels of vitamin B12 or iron can cause mouth ulcers, while a deficiency in folate and vitamin B12 can lead to a sore, red tongue (glossitis).

See your doctor if you think you may be suffering from anaemia as early treatment is important.

What does a white-coated tongue mean?

A white-coated tongue can be a sign of a health condition, such as lichen planus, leukoplakia, geographic tongue or oral thrush.

Small round white sores, rather than patches, may be caused by mouth ulcers.

How long does it take for a tongue piercing to heal?

The length of time it takes for a piercing to heal depends on your general health and how well you practise aftercare. A tongue piercing will typically take around 2-4 weeks.

See your doctor immediately if you develop signs of an infection, such as increased tongue pain or tenderness in the area, redness or swelling, or an unusual discharge (green or yellow) around the piercing that has a foul smell.

What do early signs of mouth cancer look like?

Mouth cancer can appear on most parts of the mouth, including the tongue, gums and lips. Less commonly it can develop in the throat.

Some of the most common symptoms of mouth cancer include:

  • red or white patches in the mouth or throat
  • a lump
  • ulcers

Other possible symptoms include:

  • pain in the mouth that does not go away
  • pain or difficulty when swallowing (dysphagia)
  • trouble speaking or changes in your voice
  • unexplained weight loss
  • swollen lymph nodes (glands) in your neck
  • unexplained loosening of a tooth or teeth
  • bleeding or numbness in the mouth
  • difficulty moving your jaw

You should visit your doctor if you have had any of these symptoms for more than three weeks, especially if you are a heavy drinker or smoker.

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