Tongue Pain: Why Your Tongue Hurts and What Helps

Common causes of tongue pain

Injury

Biting your tongue, burns from hot food or drinks, and rubbing against a sharp or broken tooth, braces or dentures cause localized pain. A sore on the side of the tongue at the same spot as a sharp tooth is a classic clue. Burns usually heal within a week.

Canker sores

Canker sores (aphthous ulcers) are small, round, painful ulcers with a white or yellow center and a red rim. They often appear on the underside or sides of the tongue, last 7 to 14 days, and are triggered by minor injury, stress, hormonal changes, some toothpastes containing sodium lauryl sulfate, and certain foods. Frequent ulcers can be linked to vitamin deficiencies, celiac disease or inflammatory bowel disease.

Irritation

Spicy, acidic or very salty foods, alcohol, tobacco, strong mouthwashes and some toothpastes can irritate the tongue. Some people react to cinnamon flavoring or certain dental materials.

Lie bumps

Transient lingual papillitis ("lie bumps") are small, painful red or white bumps on the tip or top of the tongue. They appear suddenly and usually disappear within a few days.

Other causes of a sore tongue

Tongue pain on one side

Pain on one side usually comes from a sharp tooth, biting, a canker sore or an injury. Less often it is caused by nerve pain (glossopharyngeal or lingual nerve) or, rarely, a cancer on the side of the tongue. A one-sided sore, lump or patch that persists beyond 3 weeks needs examination.

How doctors find the cause

A dentist or doctor will ask how long it has hurt, about recent injuries, new products, medicines, smoking, alcohol and other symptoms, and examine the tongue, mouth, teeth and neck. Tests may include:

• Blood tests for anemia, vitamin B12, folate, iron (ferritin), blood sugar and celiac disease
• Swab for thrush or viral infection
• Biopsy of any persistent ulcer, lump or patch
• Allergy patch tests if a reaction to food flavors or dental materials is suspected

Treatment and relief

Home care

• Avoid triggers: spicy, acidic, salty or crunchy foods, alcohol, tobacco and very hot drinks until it heals.
• Rinse with warm salt water (half a teaspoon of salt in a cup of warm water) several times a day.
• Numbing gels or rinses containing benzocaine or lidocaine for short-term relief. Do not use benzocaine products in children under 2.
• Cold foods: ice chips, ice pops or cold water soothe burns and ulcers.
• Pain relief: acetaminophen (paracetamol) or ibuprofen at the label dose.
• Gentle oral care: a soft toothbrush and toothpaste without sodium lauryl sulfate.
• Stay hydrated and chew sugar-free gum if your mouth is dry.

Medical treatment

• Thrush: antifungal lozenges, gels or tablets.
• Vitamin and iron deficiency: supplements or injections, which usually heal the tongue within weeks.
• Recurrent canker sores: steroid mouth rinses or pastes, and investigation of underlying causes.
• Sharp teeth or appliances: smoothing or adjusting by a dentist.
• Burning mouth syndrome: addressing dry mouth and other causes, and medicines such as clonazepam rinses, and CBT.
• Oral cancer: surgery, radiotherapy or chemotherapy, with best results when found early.

Frequently asked questions

Why does my tongue hurt?

The most common reasons are biting or burning it, canker sores, and irritation from sharp teeth, braces or spicy and acidic foods. Thrush, vitamin or iron deficiency, geographic tongue, dry mouth and burning mouth syndrome are other causes. Pain lasting more than 2 to 3 weeks should be checked.

What causes painful bumps on the tongue?

Small, painful bumps on the tip or top of the tongue are often lie bumps (inflamed taste buds), which clear in a few days. Canker sores, injuries, viral infections and irritation from foods can also cause painful bumps. A lump that persists for more than 3 weeks should be examined.

Can vitamin deficiency cause a sore tongue?

Yes. Low vitamin B12, folate or iron can make the tongue smooth, red, swollen and sore, a condition called glossitis. It often comes with tiredness and pale skin, and B12 deficiency can cause tingling in the hands or feet. A blood test confirms it, and supplements usually help.

What does it mean when your tongue burns?

A burning tongue can be caused by a scald, acidic or spicy food, dry mouth, thrush, vitamin deficiency, or a reaction to toothpaste. When the tongue looks normal and burning lasts for months, it may be burning mouth syndrome, which a dentist or doctor can diagnose and help manage.

When should I worry about tongue pain?

See a dentist or doctor if a sore, lump, or red or white patch has not healed in 3 weeks, if pain is one-sided with numbness, or if you have tongue pain with tiredness and pale skin. Get emergency help for tongue swelling with breathing or swallowing difficulty.