Sore or painful tongue 

  • Overview

Introduction 

Oral thrush can cause sore white plaques on the tongue 

If your child is affected...

If your child has a painful tongue and a slightly raised temperature, the cause is likely to be hand, foot and mouth disease or a herpes simplex virus (cold sore) infection. The infection should get better in time without the need for treatment.

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.

If the pain is persistent and you haven't accidentally bitten or burnt your tongue, see your GP or dentist. There may be an underlying infection or deficiency that needs treating, and your GP or dentist may be able to advise on pain relief while you wait for it to get better. 

If you have a mouth ulcer that fails to heal within a few weeks, or if you have a red patch on your tongue with a white border that changes shape within weeks, see your GP or dentist. You may need to be referred to a specialist.

This page outlines the most likely causes of tongue pain, but you shouldn't use it to diagnose yourself with a condition – always leave that to a healthcare professional. 

Information on a coated or white tongue can be found elsewhere.

Common causes

Common causes of tongue pain are outlined below.

Geographical tongue

Also known as benign migratory glossitis or oral erythema migrans, geographical tongue is a common condition.

Nodules on the surface of the tongue become inflamed as you fight off the infection, and you develop irregular red patches surrounded by white lines that give the tongue a map-like appearance.

This can sometimes cause a burning sensation in the mouth and over-sensitivity. Eating acidic, spicy or hot foods can be particularly painful. 

The exact cause is unknown. Geographical tongue will eventually get better on its own after a few weeks or months. In the meantime, you may be able to manage the pain by taking over-the-counter painkillers (speak to your pharmacist for advice) and avoiding anything that makes it worse, such as certain foods or mouthwash.

Oral thrush

Oral thrush is a yeast infection in the mouth caused by a fungus. It can cause a burning sensation on the tongue, as well as sore white plaques that can be scraped off.

You are more likely to develop oral thrush if you:

You should see your GP if you think you have oral thrush. If it is left untreated, the symptoms will persist and your mouth will continue to be uncomfortable.

Oral thrush is treated with antifungal medicines. Read more about treating oral thrush.

If you wear dentures, your chances of getting oral thrush are lowered if you clean your dentures as often as you would clean your regular teeth (at least every morning and night). To improve your oral hygiene:

  • brush dentures with paste before soaking to remove food particles
  • soak the dentures in a fizzy solution of denture-cleaning tablets to remove stains and bacteria – follow the manufacturer's instructions and do not soak them overnight
  • brush the dentures a second time, as you would your normal teeth (but don't scrub too hard)

Anaemia

Anaemia is a condition where the amount of haemoglobin in the blood is below the normal level, or there are fewer red blood cells than normal. It can sometimes cause a sore tongue, as well as an altered sense of taste.

There are several different types of anaemia and each one has a different cause, although iron deficiency anaemia is the most common type.

Treatment for iron deficiency anaemia involves taking iron supplements to boost low levels of iron in the body, which in turn cures the tongue pain.

See your GP if you think you have anaemia.

Aphthous mouth ulcers

Aphthous mouth ulcers are painful sores that can occur anywhere within the mouth and tend to keep coming back.

You may be able to manage the pain by taking over-the-counter painkillers (speak to your pharmacist for advice) and by avoiding anything that worsens it, such as spicy foods or mouthwash.

The ulcers tend to recur less often as you get older, and usually eventually go away for good.

There is a misconception that aphthous mouth ulcers are caused by a vitamin deficiency, but the cause is unknown.

Less common causes

Less commonly, tongue pain may be caused by:

  • a viral infection – such as hand, foot and mouth disease or cold sores
  • median rhomboid glossitis – where a smooth red inflamed patch develops on the middle or back of the tongue, thought to result from a yeast infection
  • glossodynia or "burning mouth syndrome" – a burning pain on the tip of the tongue that is often seen in people with depression
  • glossopharyngeal neuralgia – where repeated episodes of severe tongue pain are believed to be caused by nerve irritation
  • lichen planus – a long-term skin condition that causes an itchy rash that 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 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
  • drugs – such as reserpine or aspirin sucked for toothache, and certain mouthwashes
  • Moeller's glossitis – a form of inflammation of the tongue 
  • cancer of the tongue – although this is rare

You can click on the above links for more information about these conditions.

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.

Page last reviewed: 08/08/2012

Next review due: 08/08/2014

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Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

LancsCarol said on 10 February 2014

Had a creamy-fur-coated tongue in the morning, or after sleeping, all my adult life, contributing to halitosis. Was advised in my mid 30s to scrub it with a toothbrush to remove the thick fur deposit.
After I was given insulin, when diagnosed with diabetes type 1 at 64yrs old, the next morning, and each day since, after insulin the night before, the fur coat on the tongue has not been there, or barely there.
No doctor, diabetes consultant or diabetes nurse, many of whom I have told about this, recognises any connection between high blood glucose and a furry tongue.
Has anyone noticed this connection?
It could have been an early predictor of diabetic problems, for me and maybe for others.

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