Although a sore tongue is not always a cause for concern, medical attention may be required in some cases.
The tongue is made up of different muscles that help us speak, swallow, chew, or taste food. So when we have a sore tongue, it can be quite hard to ignore.
Although a sore tongue is not always a cause for concern, emergency medical attention may be required in some cases, such as rapid tongue swelling due to an allergic reaction.
Sore Tongue Causes
The following are some of the most common causes of a sore tongue.
1. Food Allergy or Sensitivity
Certain types of food may hurt your tongue, especially when you have a type of food allergy called oral allergy syndrome or pollen-food syndrome.
This food allergy is usually triggered by the consumption of certain tree nuts, raw vegetables, and fruits. Aside from a sore tongue, the following symptoms might also be experienced:
- Swelling of the tongue, lips, or mouth
- Itchy mouth
- Scratchy throat
Older children up to young adults are more likely to experience this type of food allergy. Your doctor may recommend an epinephrine auto-injector if you have a history of severe allergic reactions.
2. Trauma or Injury
Any tongue injury can be painful. Tongue injuries can be simply caused by:
- Accidentally biting your tongue
- Burning your tongue on hot foods
- Clenching or grinding your teeth
Tongue pain from the trauma does not immediately go away and may still feel sore until the injury completely heals.
Tongue pain may also be due to swollen taste buds, which is characterized by enlarged papillae on the tongue. These bumps are called transient lingual papillitis or lie bumps, which often clear up after a few days.
If you see white patches on your tongue that look a lot like cottage cheese, you may have a type of yeast infection called oral thrush. Although oral thrush can develop in people of all ages, this infection is more commonly seen in infants and older adults who wear dentures and/or have weakened immune systems.
Other groups of people who are more susceptible to getting oral thrush, include:
- People who use steroid inhalers to help control their asthma
- People who have recently taken antibacterial drugs
The following infections can also cause an inflamed or sore tongue:
- Human papillomavirus (HPV)
- Hand, foot, and mouth disease (HFMD)
4. Canker Sores (Mouth Ulcers)
Canker sores may appear as white sores in the mouth or tongue, but may also appear as gray, yellow, or red sores. These sores often develop due to a variety of reasons, which include:
- Hormonal changes
- Tongue injuries (e.g., accidental biting of the tongue)
- Consuming hard, sharp foods or other types of food
- Quitting smoking
Over-the-counter pain relievers may be used to help ease the pain and discomfort. However, mouth ulcers tend to heal within 1-2 weeks without any treatment. To promote faster healing, avoid consuming spicy foods, which can further irritate your tongue.
Aside from quitting smoking, smoking itself can also cause tongue pain. People who smoke also have a higher risk of developing throat and mouth cancer. Smoking can also cause:
- Hairy tongue from yeast growth and bacteria
- White, pale, or thickened roof of the mouth
- Halitosis or bad breath
- Stained or discolored teeth
- Dental caries (tooth decay)
- Tooth loss
- Dark spots on gums
Less Common Causes of a Sore Tongue
1. Sjögren's Syndrome
Sjögren’s syndrome (SS) is a rare chronic autoimmune disorder that is characterized by salivary and lacrimal gland inflammation. The function of these moisture-producing glands is impaired resulting in chronic dry mouth and eyes.
People with chronic dry mouth are more prone to developing dry and fissured tongues, mouth ulcers, and other oral infections.
2. Certain Medications
A sore tongue can also be due to certain medications. These medications include beta-blockers and nonsteroidal anti-inflammatory drugs. Mouthwash and oral rinses may also cause tongue irritation and make your tongue feel sore.
3. Anemia and Other Vitamin Deficiencies
A deficiency in vitamin B12, folate, or iron may cause a smooth, sore tongue. Your tongue may also appear beefy red in color if your body lacks vitamin B12.
Burning tongue is also one of the symptoms of zinc deficiency. Other vitamin deficiencies may also cause any of the following symptoms:
- Muscle weakness
- Unexplained weight loss
- Arrhythmia (irregular heartbeat)
- Tingling or numbness in the hands and feet
4. Glossopharyngeal Neuralgia
Glossopharyngeal neuralgia is associated with glossopharyngeal nerve irritation, which can be triggered by coughing, chewing, swallowing, laughing, or speaking. This disorder causes episodes of severe pain in the tonsils, tongue, throat, and ear, which are all connected to the glossopharyngeal nerve (ninth cranial nerve).
These painful episodes may last up to a few minutes and may only occur on side of the face. Treatment involves the use of antidepressants and antiseizure medications to control pain. However, a surgical procedure to take the pressure off the glossopharyngeal nerve may be required in severe cases.
5. Pemphigus Vulgaris (PV)
This disorder is associated with painful sores in the mouth or genitals. Blisters in the mouth may rupture or ooze and may become infected, making it quite difficult to swallow or eat.
Treatment for PV often involves different types of medications, including some of the treatments used for severe burns.
6. Lichen Planus (LP)
Lichen planus is a chronic inflammatory skin condition that affects the hair, nails, skin, and mucous membranes. Its symptoms include tongue pain, white or red patches in the mouth, and a burning sensation while drinking or eating. However, mild cases of this skin condition may not cause discomfort or pain.
7. Moeller’s Glossitis
Also called atrophic glossitis, Moeller’s glossitis is a type of tongue inflammation that causes irritation and painful burning sensations. Due to atrophy, the tongue may become glossy, smooth, and without taste buds.
Nutritional and vitamin deficiencies such as anemia or vitamin B12 deficiency are often associated with this condition.
8. Oral Cancer
Oral cancer is another rare cause of tongue pain. Consult a doctor if you notice a painful sore or lump in your mouth that doesn’t go away for more than two weeks or longer. Other symptoms of oral cancer include:
- Bleeding sores or ulcers
- Sores that don’t heal
- Painful chewing and swallowing
- Lumps or thickening of skin, gums, or tissues
- Loose teeth
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