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.
See your doctor or dentist if you have persistent pain and you haven't accidentally bitten or burnt your tongue.
There may be an underlying problem that needs treating, and your doctor or dentist may be able to advise you about pain relief.
This page outlines some of the most common causes of tongue pain, as well as a number of less common causes.
You shouldn't use the information on this page to diagnose yourself with a condition – always leave that to a healthcare professional.
Causes of tongue pain
Geographic tongue is a condition where irregular smooth, red patches that have a white or light-coloured border occur on the tongue. It's called geographic tongue because the patches have a map-like appearance.
The patches can vary in size, and may occur on one area of the tongue before moving to another area after a few days, weeks or months.
In some people, the patches can feel sore or sensitive when consuming certain foods and drinks.
Some people with geographic tongue find it improves over time, while for others it may be more persistent.
See your doctor or dentist if you have persistent, discoloured or painful patches on your tongue.
The cause of geographic tongue isn't clear and there's no specific treatment for it.
However, you may be able to manage the pain by taking over-the-counter painkillers – speak to your pharmacist for advice.
You should also avoid anything that makes it worse, such as acidic, spicy or hot foods.
Oral thrush (oral candiasis) is an infection caused by a type of fungus called Candida.
It causes white patches (plaques) to develop in the mouth. You may experience a loss of taste or an unpleasant taste in your mouth. It can also be painful, making eating and drinking difficult.
Median rhomboid glossitis is a condition that can affect your tongue if you have oral thrush. It causes a red, smooth patch or lump to develop in the middle of the top part of your tongue, which can be sore.
You're more likely to develop oral thrush if you:
- have recently taken antibiotics
- take inhaled corticosteroid medication for asthma
- wear dentures , particularly if they don't fit properly
- have poor oral hygiene
- have a medical condition, such as diabetes
- have a dry mouth , either because of a medical condition or a medication you're taking
- have a weakened immune system as a result of having chemotherapy or radiotherapy treatment for cancer
See your doctor if you think you have oral thrush. If it's left untreated, the symptoms will persist and your mouth will continue to be uncomfortable.
Oral thrush is treated with antifungal medicines , often in the form of a gel or liquid that you apply directly to the inside of your mouth.
You'll usually need to use it several times a day for around 7 to 14 days.
Aphthous mouth ulcers
Aphthous mouth ulcers are painful round or oval sores that can occur anywhere in the mouth and are common on the underside of the tongue.
Mouth ulcers are sometimes caused by damage to the mouth, such as accidentally biting your tongue or eating something hard and sharp.
Ulcers that keep recurring may be caused by stress, anxiety, eating certain foods, stopping smoking, or hormonal changes – some women develop mouth ulcers during their monthly period .
Read more about the causes of mouth ulcers.
Most mouth ulcers heal within a week or two without treatment. In the meantime, you may be able to manage the pain by taking over-the-counter painkillers and avoiding anything that makes it worse, such as eating spicy foods.
See your doctor or dentist if you have a mouth ulcer that doesn't improve within a few weeks or you develop ulcers regularly.
Less common causes
Less commonly, tongue pain may be caused by:
- a viral infection – such as an infection that causes hand, foot and mouth disease or cold sores
- vitamin deficiencies and anaemia – a sore tongue can sometimes be a symptom of iron deficiency anaemia and vitamin B12 or folate deficiency anaemia
- glossodynia or "burning mouth syndrome" – a burning pain on the tip of the tongue that often affects people with depression
- glossopharyngeal neuralgia – repeated episodes of severe tongue pain thought to be caused by nerve irritation
- lichen planus – a long-term skin condition that causes an itchy rash and 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 painful 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
- medications – painful mouth ulcers can be a side effect of non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers; certain mouthwashes can also cause tongue pain in some people
- Moeller's glossitis – a type of inflammation of the tongue
- cancer of the tongue – although this is rare
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.