Your tongue helps you taste, eat, digest, and speak. While you chew the tongue assists with moving the food and swallowing. The small bumps, or papillae, on the tongue, allow you to taste. The tongue is an agile and flexible muscle, giving it the ability to produce many words.
ANATOMY
The tongue consists of striated muscles and occupies the floor of the mouth. The dorsal mucosal surface consists of stratified squamous epithelium, with numerous papillae and taste buds. The tongue, a voluntary muscular structure, is attached by a fold, called the frenulum, to the floor of the mouth.
The tongue is a muscular organ that is anchored to the mouth by webs of tough tissue and mucosa. This is the moist, pink tissue that covers the tongue. To give the tongue its rough texture, tiny bumps called papillae [thousands of taste buds] cover the surface. Taste buds are collections of nerve-like cells that connect to nerves running into the brain. The tongue functions as a digestive organ by facilitating the movement of food during mastication and assisting swallowing. Other important functions include speech and taste.
Note: Guinness World Records, which will include Stoeberl in the 2015 edition of its famous book, says that the average tongue is 10cm long when measured from the oropharynx – the place in the back of the throat where the tongue begins – to the tip
MUCUS and CONDITIONS
Why is there yellow stuff on the back of my tongue?
What does oral thrush look like?
Swollen Tongue
A swollen tongue can be caused by several things, from allergic reactions to an injury in your mouth. Some causes of a swollen tongue can be harder to spot, like a side effect of a medication or an undiagnosed health condition.
Swelling (edema) of your tongue can be an annoying, but harmless, problem. However, it can also be a sign of a serious—even life-threatening—condition.
Depending on what’s causing the swelling, one or both sides of your tongue might get bigger. Your tongue may also itch or hurt. The swelling and other symptoms can make it hard to talk and eat.
If your taste buds are affected by the swelling, you might have an unusual taste in your mouth.
Some symptoms are serious, including:
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- Swelling that keeps getting worse: Swelling can block your airway. If you’re gasping for breath, seek medical attention right away.1
- Rapid, severe swelling: If you have swelling of your tongue and face that comes on fast, you might be having a severe allergic reaction (anaphylaxis). If this happens, you might have other symptoms like hives, trouble breathing, a bluish discoloration of your lips (cyanosis), nausea, and vomiting. If you think you may be having an anaphylactic reaction, seek emergency medical care right away.2
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Causes
The causes of a swollen tongue can include allergies, infections, trauma, GERD, drug reactions, autoimmune diseases, or rare disorders. While it’s less common, tongue cancer can also cause a swollen tongue. If you have a swollen tongue that isn’t very bad, make an appointment to see your provider.
There are many reasons that your tongue can swell, including health conditions and reactions to medications.
Allergic Reactions
Food allergies and allergic reactions to chemicals are the most common causes of a swollen tongue.
You might only have a mild allergic reaction that gets better on its own. However, swelling that’s caused by anaphylaxis is serious—you could even die from it.
Some people are born with allergies or get them in childhood. However, it’s also possible to develop an allergy later in life.
Symptoms of an allergic reaction usually start within minutes or hours of coming into contact with an allergen. Common food allergies include peanuts, tree nuts, milk, eggs, sesame seeds, soy, wheat, fish, and shellfish.
You may also have allergic reactions to non-food products.
For example, dentists often see patients who have had reactions to flavorings, dyes, and chemical additives in toothpaste, mouthwash, denture cleansers, and other oral care products.
Medication
Angioedema is the medical word for swelling under the skin. Usually, it refers to swelling caused by an allergy.
After food allergies, medication reactions are the most common cause of angioedema of the face, lips, or tongue.
The reaction happens when the body releases too much of an immune-system chemical called bradykinin that opens blood vessels.
Many prescription and over-the-counter (OTC) medications can cause non-allergic tongue swelling.4 Less often, a swollen tongue can be a side effect of a medication.
Here are a few examples:
- Angiotensin-converting enzyme (ACE) inhibitors:
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- ACE inhibitors are the most likely to cause angioedema of the tongue. These drugs help lower blood pressure. Between 20% and 40% of emergency room visits for drug-related angioedema are caused by ACE inhibitors.5
- Antidepressants6
- Pain relievers (e.g., nonsteroidal anti-inflammatory drugs)
- Drugs that are used to treat high cholesterol (statins)7
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Skin Conditions
Diseases of the skin can cause tongue irritation, which may lead to a little swelling.
For example, mouth sores and tooth erosion can cause the tissue around the tongue to swell.
Here are a few examples of skin diseases that might make your tongue swell:
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- Pemphigus: This is a group of potentially fatal autoimmune diseases. In people with pemphigus, the immune system attacks the skin and mucus membranes, causing skin blisters and mouth sores.8
- Oral lichen planus: This little-understood disease causes rashes on the skin or in the mouth.9
- Oral psoriasis: This autoimmune condition can cause geographic tongue (the hair-like projections on the surface of the tongue get stripped away) and fissured tongue (deep grooves develop on the surface of the tongue)10
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Trauma
Burning your tongue on hot foods or drinks, biting your tongue, or piercing the tongue can cause temporary swelling. It should get better within about five days. If it doesn’t, see your healthcare provider.
Serious injuries and oral piercings can also lead to a bacterial infection called Ludwig’s angina, which causes swelling of the area under the tongue.11
If the infection is not treated immediately, the swelling can cause your airway to become completely blocked.
If you have symptoms of Ludwig’s angina, you need treatment right away. Call 911 or go to the emergency room immediately.
Infection
The mouth can get many types of infections, including sexually transmitted infections (STIs) that are passed through oral sex.
Syphilis, gonorrhea, and human papillomavirus (HPV) can cause inflammation, sores, warts, or swelling of the tongue and the tissue around it.12
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a digestive disorder that causes acid from the stomach to back up into the esophagus. It can cause chronic irritation at the back of the throat.
In some people with GERD, the base of the tongue is also affected and may swell.13
Sjögren’s Syndrome
Sjögren’s syndrome is an autoimmune disease that causes dryness of the eyes and mouth. The condition can also cause swelling in the salivary glands (which make spit) and the lacrimal glands (which make tears).
Some people with Sjögren’s have a tongue that looks or feels swollen.14
Melkersson-Rosenthal Syndrome
Melkersson-Rosenthal syndrome is a rare disorder of the central nervous system. It mostly affects the muscles of the face.
The most common symptom is facial paralysis. Some people with the condition also have permanent swelling of their face, which can include the lips and tongue.15
Cancer
Tongue cancer is a rare cause of a tongue that looks or feels swollen. Usually, this discomfort is related to a cancerous growth (tumor) on the tongue.16
Depending on where the tumor is located, you might also feel like you have a lump in your mouth or throat. Your mouth, tongue, and throat may hurt.
In some cases, the discomfort is bad enough that a person has trouble talking, chewing, and swallowing.
Tongue swelling that’s related to cancer does not go away on its own and may get worse over time.
Diagnosis
If your tongue swelling is getting worse or you have other serious symptoms (like trouble breathing), seek emergency care rather than wait to be seen by your healthcare provider.
If your tongue is only a little swollen and you don’t have other symptoms, you can call your provider and make an appointment.
To figure out what’s causing the swelling, your provider will look at your tongue and the tissue around it. They’ll also make sure that your airway is not getting blocked.
Here are some key points that your provider will be thinking about during the exam:
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- Is there an immediate risk to your breathing?
- Do you have an underlying condition such as an autoimmune disease?
- Do you have other symptoms such as hives?
- What is your medical history, current medications, diet, and lifestyle?
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If your provider thinks you have an allergy, are having a drug reaction, or have an underlying medical problem that hasn’t been diagnosed, they might need to do more tests.
For example, they might scrape a bit of tissue off your tongue and send it to a lab to be looked at under a microscope. If they think you might have an autoimmune disease, they may order blood tests.
In some cases, your provider might choose to start you on treatment before they figure out the exact cause of your swollen tongue. For example, they might be able to give you medicine to make sure the swelling does not get worse.
Treatment
If your airway is blocked, the most important goal of treatment will be making sure that you can breathe. The next steps are to get the swelling down and ease any discomfort you have.
Once your immediate needs are met and you’re safe, your provider will help you take steps to prevent a swollen tongue in the future.
Medications
Up to 15% of people with angioedema will have a blocked airway.1 They need to have an injection of epinephrine right away.
In less severe allergic reactions, an oral antihistamine can be given instead.
If tongue swelling is not related to an allergy, your provider may use one of these treatments:
- For a reaction caused by too much bradykinin: You might be given an antihistamine, epinephrine, oral corticosteroids, or a preventive drug such as Berinert (C1-esterase inhibitor concentrate) that stops your body from making the chemical.1
- For oral sores and inflammation:You might be given topical corticosteroids or retinoic acid to help the lesions heal.17
If you have a swollen tongue because you have an infection or a medical condition, your tongue won’t get better until you treat the root cause.
For example, your provider might prescribe you antibiotics if you have an STI caused by bacteria or immunosuppressants if you have an autoimmune disease.
To help with symptoms, your provider might also recommend products that relieve dry mouth.
For example, prescription medications like Salagen (pilocarpine) and Evoxac (cevimeline) increase saliva production. There are also OTC rinses and sprays that work as “artificial saliva” to add moisture to your mouth.
At-Home Remedies
If your tongue swelling isn’t very bad and is not getting any worse, there are some things you can do at home to help with your symptoms until you can see your provider:
- Eat and drink something cool. Suck on ice chips to soothe your mouth and ease the swelling.
- Practice good oral hygiene such as brushing and flossing. Avoid irritating mouthwashes, such as those that have alcohol in them.
- Rinse your mouth with a warm saltwater solution.
- Avoid very acidic or extremely salty foods.
- If a dry mouth is causing tongue discomfort, keep it moist by drinking plenty of fluids and using lozenges or gum. Just make sure that any gum or hard candy you choose is sugar-free. These versions have ingredients (like xylitol) that make your mouth produce more saliva, which helps relieve dry mouth.
Summary
The causes of a swollen tongue can include allergies, infections, trauma, GERD, drug reactions, autoimmune diseases, or rare disorders. While it’s less common, tongue cancer can also cause a swollen tongue.
If you have a swollen tongue that isn’t very bad, make an appointment to see your provider. If the swelling is getting worse and you have other symptoms (like not being able to breathe) you need to seek emergency medical care.
The treatment for a swollen tongue depends on what’s causing it. Good oral hygiene, antibiotics, antihistamines, corticosteroids, and products that help keep your mouth moist may help.
What’s Causing My Sore Tongue?
If your tongue is sore, it can be pretty hard to ignore. It may bother you when you speak or eat, and you may worry that something is seriously wrong. The good news is that most causes of a sore tongue aren’t a reason for concern.
Biting down hard on your tongue can be extremely painful. Eating something very hot can burn your tongue and even blister it. Grinding your teeth or clenching them may cause pain on the outer edges of your tongue.
Just like when you bang your arm or leg, the pain from trauma doesn’t necessarily go away immediately. Whatever the case may be, injury to your tongue may make may it feel sore and uncomfortable until the damage fully heals.
You may develop what is called enlarged papillae on your tongue. These white or red bumps are sometimes referred to as lie bumps or transient lingual papillitis. This means you have swollen taste buds, and they can be painful. They usually clear up in a few days on their own.
Oral thrush is a type of yeast infection that may cause tongue pain. You may see white patches that look like cottage cheese on your tongue. This infection is more common in babies and older adults, especially those who wear dentures or have weakened immune systems. You may develop oral thrush if you’ve recently taken antibiotics. It can also occur in people who use steroid inhalers to manage their asthma.
Other infections may also give you a sore tongue, such as:
Your tongue pain may be focused around a specific spot. If you open your mouth to look, you may see a round or oval ulcer or canker sore. It may be whitish in appearance or sometimes red, yellow, or gray.
These spots can develop for a number of reasons, like:
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- biting your tongue or other damage
- eating something hard or sharp
- experiencing stress or anxiety
- eating particular foods
- stopping smoking
- undergoing hormonal changes
Ulcers generally heal after a week or two with no other treatment. You may take over-the-counter pain medications to help ease the discomfort. You may also want to avoid eating things like spicy foods that may irritate your tongue further.
That’s right — certain foods may make your tongue hurt. You may have what’s called oral allergy syndrome. This condition is also known as a pollen-food syndrome, and it’s most often caused by raw fruits, vegetables, and certain tree nuts.
Along with a sore tongue, you might experience:
- an itchy mouth
- a scratchy throat
- swelling of your lips, mouth, or tongue
Oral allergy syndrome is more likely to start in older children, teens, and younger adults. If your reaction is severe, your doctor may suggest you carry an epinephrine auto-injector.
Smoking — and even stopping smoking — can cause tongue pain. When you smoke, you also put yourself at a higher risk of developing cancer in your mouth and throat.
Other issues smoking can cause in your mouth include:
- stained teeth
- bad breath
- tooth decay and loss
- hairy tongue from bacteria and yeast growth
- brown spots on your gums
- thickened and pale or white palate, or roof of your mouth
Stopping smoking today can halve your risk of developing oral cancer within five years, according to a 2010 reportTrusted Source from the U.S. surgeon general for the Centers for Disease Control and Prevention.
You may have a smooth, sore tongue if your body is deficient in either vitamin B-12, iron, or folate. If you’re deficient in vitamin B-12, your tongue may also be beefy red in color. Low levels of zinc can cause a burning tongue.
Other symptoms of vitamin deficiencies include:
- fatigue
- dizziness
- irregular heartbeats
- unexplained weight loss
- muscle weakness
- numbness or tingling in your hands and feet
Vitamin deficiencies generally develop over a long period of time — anywhere from several months to years. Treatment involves eating a well-balanced diet, taking supplements, and sometimes receiving vitamin injections.
Does your pain feel more like burning? Burning mouth syndrome, or burning tongue syndrome, can cause this sensation on your tongue or in other areas of your mouth, like the inside of your cheeks, gums, lips, or palate. You may even feel at times like you’ve eaten extremely hot foods and have scalded your tongue. The feeling can happen suddenly or develop over time. Other symptoms include increased thirst or dry mouth and taste changes or a loss of taste.
Neuralgia results from nerve irritation or damage. It may be a reason people experience recurring tongue pain if there’s no other obvious cause, like trauma or infection.
The type of pain associated with this condition is intense, like an electric shock. You may feel it on your tongue or in your throat, tonsils, or ears. It may be triggered by swallowing and can occur in people who have throat or neck cancer. Otherwise, the cause isn’t always known.
If you end up having this condition, you may need to take medications to help with nerve pain or discuss surgery with your doctor.
Lichen planus is a chronic skin issue that causes anything from an itchy rash on your skin to white lacy patches and pain on your tongue. More mild cases of this disorder may not cause any discomfort at all. Other symptoms include red or white patches in your mouth or burning while eating or drinking. You may even develop painful red gums with this condition. Treatment may be ongoing.
Behcet’s disease causes blood vessel inflammation throughout your body. It’s a rare reason for tongue pain, but it may cause mouth sores that look like canker sores. These sores begin as round, raised areas of irritation. They may last anywhere from one to three weeks and may return with time.
Other symptoms of this condition include:
- acne-like sores and lumps on your skin
- inflammation in your eyes
- joint pain
- digestive issues
- genital ulcers
Moeller’s glossitis is also called atrophic glossitis or even “bald” or “smooth” tongue. This condition is a type of inflammation of the tongue. It can cause pain, irritation, or a burning sensation. Your tongue may become smooth and even glossy in appearance because your taste buds have atrophied. This condition is usually related to nutritional deficiencies, like vitamin B-12 deficiency, anemia, or even celiac disease.
Geographic tongue is a benign oral inflammatory condition characterized by loss of epithelium [outer layer tissue], particularly of the filiform papillae on the dorsum of the tongue.
Geographic tongue is also called benign migratory glossitis because the signs move around.
Geographic tongue affects approximately 1–3% of the adult population worldwide. It is less common in children. The incidence is twice as high in women than in men. Patients may have a family history of geographic tongue or fissured tongue.
The cause of geographic tongue is unknown but geographic tongue occurs more often in patients who have psoriasis, especially pustular psoriasis.
It is also seen in patients with a food allergy, allergic contact dermatitis, asthma, atopic dermatitis, reactive arthritis, anemia, hormonal disturbance, emotional stress, and in patients with early-stage of type 1 diabetes.
Geographic tongue is characterised by irregularly-shaped, red, map-like, smooth and swollen patches surrounded by white lines. Geographic tongue can occur suddenly and persist for months or longer, and may often recur.
Most often there are no symptoms but burning or irritation of the tongue are common, particularly when eating hot, spicy and acidic food
Do you take nonsteroidal anti-inflammatory drugs, like naproxen (Aleve), or beta-blockers? Some studies have suggested that these medications may make your tongue sore by causing ulcers. Mouthwashes may also irritate your tongue and make it sore.
Though rare, pemphigus vulgaris is a disorder that can cause painful sores in your mouth or on your genitals. These sores may show up as blisters in your mouth. They may rupture and ooze and become infected. You may even find it difficult to eat or swallow. Treatment usually involves different medications or therapies like those that are used to treat severe burns.
Another rare cause of tongue pain is oral cancer. Again, there are many reasons you may have a sore tongue — cancer is only a remote possibility. If you notice pain with a lump or sore that doesn’t go away, you may want to head to the doctor for a checkup.
Other symptoms include:
- painful chewing
- painful swallowing
- loose teeth
- sores that won’t heal
- sores that bleed
- thickening of the skin that lines your mouth
Oral cancer may not cause pain in the early stages, so it’s a good idea to head to your doctor if you feel a lump even without pain for two weeks or longer.
Sjögren syndrome is an autoimmune disorder that leads to inflammation in the salivary and lacrimal glands, which results in chronic dry eyes and dry mouth. It’s also typically associated with skin changes, joint pain, and other issues. It’s unclear why some people develop Sjögren syndrome. In people with chronic dry mouth, the tongue can become dry and fissured and easily develop ulcers and infections.
The term fissured tongue describes the finding of multiple small furrows or grooves on the dorsal (top) surface of the tongue. These fissures can be shallow or deep, single or multiple. Often there is a prominent fissure in the center of the tongue. Some people with the condition report discomfort and sensitivities.
Fissured tongue occurs in approximately 5 percent of Americans. It may be evident at birth or develop during childhood. The exact cause of fissured tongue isn’t known.
Fissured tongue generally doesn’t require treatment. However, it’s important to maintain proper oral and dental care, such as brushing the top surface of the tongue to remove food debris and clean the tongue.
Your tongue can tell a lot about your health.
White Patches signify oral candidiasis, which is an overgrowth of yeast or thrush. Try brushing your tongue regularly for a week to see if this is a matter of oral hygiene. If the patches persist, their cause is likely an overgrowth of candida. This condition can be treated with anti-fungal drugs.
Black and Hairy-Looking tongue occurs due to several reasons such as yeast infections, diabetes, cancer therapies, and poor oral hygiene. A buildup of dead skin cells on your tongue’s papillae results in a hairy look. No medical care is needed for this condition; simply practice excellent oral hygiene by regularly brushing your tongue (with the aid of tongue scrapers, as needed), and the problem should not persist.
Red and White Spots on Your Tongue. Nothing’s wrong here! Red and white spots on your tongue simply indicate the areas where your taste buds have worn down. This is common and requires no treatment. Buds do regenerate.
Tongue Has Abnormal Redness. A red tongue can indicate a deficiency in folic acid, B12, or iron, or it may imply fever or strep throat. Rather than functioning as an ailment itself, a red tongue hints at your overall health. All of these symptoms are easy fixes that require a supplement or medication.
The Tongue Has a Webbed or Stripped Look. This condition is caused by your immune system attacking the cells and often hints at an inflammatory condition known as oral lichen planus. Lichen planus is not contagious but puts you at risk for mouth cancer, so it is important to monitor the condition.
There Are Ridges on Your Tongue. Ridges occur when your teeth press into your tongue. This usually happens while you sleep. Fortunately, the ridges require no treatment and go away with time.
You See Bumps on Your Tongue. Bumps on your tongue are most likely canker sores or cold sores. These are caused by many things, including biting, smoking, and stress ulcers. These bumps don’t necessarily call for a doctor’s appointment; instead, try some at-home remedies like gargling warm salt water, chewing on mint leaves, and eating food that is soft and cold (like yogurt). Avoid foods that might trigger a negative reaction (greasy foods like fries) and take care of your teeth. If need be, schedule an appointment with your dentist to discuss the condition.
HEALTH Conditions
- Oral cancer: A growth or ulcer appears on the tongue and grows steadily. Oral cancer is more common in people who smoke and/or drink alcohol heavily.
- Macroglossia (big tongue): This can be broken down into various categories based on the cause. These include congenital, inflammatory, traumatic, cancerous, and metabolic causes. Thyroid disease, lymphangiomas, and congenital abnormalities are among some of the reasons for an enlarged tongue.
- Geographic tongue: Ridges and colored spots migrate over the surface of the tongue, periodically changing its appearance. Geographic tongue is a harmless condition.
- Burning mouth/burning tongue syndrome: a relatively common problem. The tongue feels burned or scalded, or strange tastes or sensations develop. Apparently harmless, burning mouth syndrome may be caused by a mild nerve problem.
- Atrophic glossitis (bald tongue): The tongue loses its bumpy texture, becoming smooth. Sometimes this is due to anemia or a B vitamin deficiency.
- Canker sores (aphthous ulcers): Small, painful ulcers appear periodically on the tongue or mouth. A relatively common condition, the cause of canker sores is unknown; they are unrelated to the cold sores caused by herpes viruses. Canker sores are not contagious.
- Oral leukoplakia: White patches appear on the tongue that can’t be scraped off. Leukoplakia may be benign, or it can progress to oral cancer.
- Herpes stomatitis: The herpes virus can uncommonly cause cold sores on the tongue. Herpes virus cold sores are usually on the lip.
Mewing While Sleeping
TONGUE EXERCISES
