Tongue Pain: Causes & Common Questions
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Understand your tongue pain symptoms, including 7 top causes and how to treat them.
Tongue pain symptoms
Tongue pain is commonly caused by lesions to the tongue, which can be due to infectious or a variety of non-infectious causes. Commonly, tongue pain symptoms are due to a viral infection or a non-infectious sore. Rarely, tongue pain is due to cancer or a serious allergic or hypersensitivity reaction. Some systemic medical disorders cause tongue pain without noticeable lesions on the tongue, including some autoimmune conditions or nutritional deficiencies. White coating, red blisters, or shallow ulcers on the tongue can all be associated with tongue pain. Some causes of tongue pain can be treated at home, but many of the infectious and systemic causes of tongue pain should be evaluated by a doctor.
Common accompanying symptoms of tongue pain
Symptoms that can be associated with tongue pain include:
What causes tongue pain?
There are a variety of infections, mostly viral or fungal, that can cause painful lesions to the tongue. Some of these infectious agents are sexually transmitted, but others are not. Canker sores are a common, noninfectious cause of painful tongue lesions. Trauma or burns to the mouth are other common causes of tongue pain. Additionally, some systemic medical issues like nutritional deficiency, autoimmune disorders, or genetic syndromes can cause tongue pain symptoms. The most dangerous cause of tongue pain is a drug hypersensitivity reaction that usually involves a rash with swelling to the lips and tongue.
Infectious causes may be to blame for your tongue pain.
- Viral infections: Many viruses including herpes, chicken pox, and HIV can cause painful lesions to the tongue and the inside of the mouth. These viruses are common, and some can be passed from person to person.
- Fungal infections: Fungal infection in the mouth is common, particularly in young children, elderly patients that wear dentures, and anyone with a compromised immune system. Typically, fungal infection is not passed from person to person.
- Sexually transmitted tnfections: Painful lesions in the mouth can be a sign of some sexually transmitted infections, including HIV and syphilis.
Non-infectious causes may also cause tongue pain.
- Burn: Eating or drinking something hot can cause a painful burn to the tongue or inside of the mouth.
- Trauma: Any trauma to the mouth or biting the tongue can cause pain. Patients with braces or dentures may experience pain due to friction from the device.
- Canker sore: Canker sores are round, shallow ulcers on the tongue and inside of the lips that can be very painful. These are not infectious and cannot be passed between people.
- Cancerous or precancerous lesions: Cancer to the tongue and mouth can cause painful lesions. Smoking or chewing tobacco and drinking alcohol greatly increase the risk of some types of oral cancer.
Other medical causes may result in tongue pain, such as the following.
- Nutritional deficiency: Some nutritional deficiencies can change the appearance and texture of the tongue, which may be accompanied by pain. Typically, nutritional deficiencies will have additional symptoms like fatigue, numbness or tingling in the limbs, or personality or mood changes.
- Autoimmune disease: Painful lesions on the tongue can be a symptom of several autoimmune conditions (conditions in which the immune system attacks the body).
- Genetic syndromes: Some inherited syndromes like Bechet's syndrome are characterized by recurrent painful oral lesions.
- Hypersensitivity or allergic reactions: Reactions to medications, food, or other allergens can cause swelling or painful rash that involve the lips, tongue, and inside of the mouth. Some of these reactions can be life-threatening.
This list does not constitute medical advice and may not accurately represent what you have.
Mucous cyst (mucocele)
A mucocele (mucous cyst) is NOT a serious tumor. It's typically caused by repeated biting leading to leakage of mucous from damaged mucous ducts, which accumulates and creates a cyst. It's most commonly found in kids, and usually inside the lower lip but also possibly under the tongue or in the inner cheek.
Top Symptoms: painful mouth sore, painless mouth sore, single mouth sore, sores on the inner cheek, sores on the inner lip
Urgency: Primary care doctor
Melanoma of the mouth
Mucosal melanoma of the head and neck (MMHN) is a rare cancer that is approximately 10% of melanomas arising in the head and neck and approximately 1% of all malignant melanomas. It is more common in an elderly population and has a poor prognosis.
Rarity: Ultra rare
Top Symptoms: gum pain, gum swelling, brown-colored skin changes, black-colored skin changes, mouth rash resembling an amalgam tattoo
Urgency: Primary care doctor
Burning mouth syndrome
Burning mouth syndrome (BMS) is a chronic pain syndrome defined as having a burning pain or sensation in your mouth without a cause that can be found. It happens way more often in women (7 times more likely), typically during times of hormonal changes (just before or during menopause). While no one has identified the cause, it could have to do with the makeup of saliva, damage from dentures, tics or teeth grinding, infections, and even autoimmune diseases.
Top Symptoms: dry mouth, changed sense of taste, tongue pain, burning sensation in the mouth, moderate mouth pain
Symptoms that always occur with burning mouth syndrome: burning sensation in the mouth, tongue pain
Urgency: Primary care doctor
Acute necrotizing ulcerative gingivitis (anug)
Acute necrotizing ulcerative gingivitis (ANUG) is a relatively rare infection of the gums. It's also known as "trench mouth", as it was discovered in a large number of soldiers in WWI that were stuck in trenches. The pain caused by ANUG is what makes it different from chronic periodontitis, and it requires treatment by professionals.
Top Symptoms: bleeding gums, gum pain, chronically bad breath, severe mouth pain, gum swelling
Urgency: In-person visit
A cold sore is a skin lesion on the lips caused by infection with the herpes simplex virus (HSV). Cold sores are extremely common. In fact, most adults are infected with HSV, usually transmitted in childhood by normal close contact with parents, siblings or friends.
While the infection can be entirely unnoti...
Herpetic stomatitis is a viral infection of the mouth that causes fever and red and inflamed gums. This typically happens early in childhood.
Top Symptoms: fever, gum pain, painful mouth sore, gum swelling, gum redness
Symptoms that always occur with oral herpes: gum pain
Canker sores are small, grayish-white sores in the mouth, often on the inside of the cheeks, lips, and on the tongue. No one really knows why canker sores happen, but it seems to be inherited and susceptible to vitamin deficiencies and allergies.
Top Symptoms: painful mouth sore, numerous mouth sores, mouth sore surrounded by a red area, single mouth sore, oral ulcer
Symptoms that always occur with canker sore: painful mouth sore
Tongue pain treatments and relief
Some causes of tongue pain symptoms will resolve on their own and can be managed at home. However, many infectious and systemic causes of tongue pain should be evaluated by a doctor for further workup and appropriate treatment. Anyone with significant swelling to the lips or tongue should seek immediate medical attention, as serious hypersensitivity and allergic reactions can be life threatening.
When tongue pain is an emergency
Seek emergency tongue pain treatment if:
- You have significant swelling to the lips or tongue
- You have any difficulty breathing
At-home treatments for tongue pain
You can try the following remedies at home for your tongue pain symptoms.
- Watching and waiting: In the event of minor trauma, burning, or biting the tongue may just need time to heal. The cells of the tongue turn over very quickly, so this usually only takes a day or two.
- Pain relief: Over-the-counter gels that you place on the tongue can provide relief from pain.
- Salt water rinse: Salt water rinse can provide pain relief and aid in healing when canker sores are the cause of tongue pain.
Medical treatments for tongue pain
If your tongue pain persists despite home remedies, you should consult your physician. He or she may recommend the following.
- Topical gels: Some causes of tongue pain, particularly those associated with fungal or non-infectious lesions, can be treated with topical medications. Additionally, topical numbing agents can be used to relieve pain.
- Antiviral medication: Many viruses that cause painful tongue lesions are treated with antiviral medications.
- Steroids: Some inflammatory causes of tongue pain are treated with steroids.
- Blood testing: If a doctor suspects nutritional deficiency or autoimmune disorder as the cause of tongue pain, they may suggest blood tests to help determine the cause.
- Biopsy: If a doctor is worried the tongue pain might be from a cancerous or precancerous lesion, they may suggest a biopsy. A biopsy is when a small piece of the lesion is removed and examined to determine if it is cancerous.
FAQs about tongue pain
Can allergies cause tongue pain?
There are many different causes of tongue pain, including infections, canker sores, trauma or burns, and systemic medical illness. Some allergic and hypersensitivity reactions can cause swelling to the lips and tongue that may be accompanied by tongue pain. Any significant swelling to the tongue or lips requires emergency medical attention, as allergic and hypersensitivity reactions can be life threatening.
Is tongue pain a symptom of STDs?
Tongue pain with or without blisters or ulcers on the tongue can be due to a variety of infectious and non-infectious causes. Possible infectious causes of tongue pain include viruses like herpes or chickenpox, as well as fungal infections like candida. Some sexually transmitted infectious can cause painful lesions to the tongue and inside of the mouth, including HIV and syphilis.
Why does my tongue feel like it's burnt?
While burns or trauma to the tongue can cause tongue pain, there are many other possible causes of a painful or burning sensation on the tongue. There are multiple infectious and noninfectious causes of painful lesions to the tongue, including canker sores, viral infections, and fungal infections. Often, lesions caused by the herpes virus or chicken pox virus cause a sensation in the tongue that is similar to a burn. Additionally, some medical conditions like autoimmune diseases or nutritional deficiencies can lead to tongue pain.
What are these blisters on my tongue?
There are multiple non-infectious and infectious causes of tongue lesions. Some infectious causes including viruses like chicken pox or herpes, and other and sexually transmitted infections. All of these infections have the ability to cause blisters, lesions, or sores on the tongue. Some non-infectious causes of tongue lesions include canker sores or malignant or premalignant lesions.
Can a sore throat give you a sore tongue?
Some infections, particularly viral infections, can cause painful lesions in the throat and the rest of the oral cavity, including the tongue. However, there are multiple infectious and noninfectious causes of sore tongue that should be considered. Canker sores, fungal infections, or medical conditions like autoimmune diseases or nutritional deficiencies can lead to tongue pain.
Questions your doctor may ask about tongue pain
- Where specifically is your mouth pain?
- Do you have a rash?
- Have you ever been diagnosed with HIV or AIDS?
- Does your breath smell worse than usual?
Dr. Martin is an Emergency Medicine resident at the University of Washington in Seattle. She received her undergraduate degree from Stanford University where she majored in Human Biology, and received her MD from the University of Pennsylvania. She’s interested in Emergency Medical Services and Flight Medicine, and is currently a resident flight physician with Airlift Northwest. In her free time, she enjoys playing ultimate frisbee, cycling, rock climbing, and trail running!