Sore or painful tongue

About a sore or painful tongue

If you have a sore or painful tongue, there may be an underlying problem that needs treating.

Your dentist can diagnose what the problem is and advise you about pain relief. Depending on the cause, your GP may also be able to help.

On this page, you can find information on some of the most common causes of tongue pain, as well as less common causes.

You shouldn't use the information on this page to diagnose yourself. You should always leave that to a healthcare professional.

Geographic tongue

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. They 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. For others, it may be more persistent.

See your dentist or GP if you have persistent, discoloured or painful patches on your tongue.

The cause of geographic tongue isn't clear. There's no specific treatment for it.

You may be able to manage the pain by taking over-the-counter painkillers. You should ask your pharmacist for advice.

You should also avoid anything that makes it worse, such as acidic, spicy or hot foods.

Oral thrush

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. This 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
• smoke
• have a weakened immune system as a result of having chemotherapy or radiotherapy treatment for cancer

See your GP if you think you have oral thrush. If it's left untreated, the symptoms will continue and your mouth will continue to be uncomfortable.

Oral thrush is treated with antifungal medicines. This is 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 seven to 14 days.

Aphthous mouth ulcers

Aphthous mouth ulcers are painful round or oval sores. They can occur anywhere in the mouth. They are common on the underside of the tongue.

Mouth ulcers are sometimes caused by damage to the mouth. This can be due to 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
• hormonal changes – some women develop mouth ulcers during their monthly period

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, or treatments (speak to your pharmacist). You should also avoid anything that makes it worse, such as eating spicy foods.

See your dentist or GP if you:

• have a mouth ulcer that doesn't improve within a few weeks
• 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 an ulcer, or swelling, for more than three weeks (particularly if it is bleeding) you must see your GP. The risk is higher if you are a heavy smoker or drinker

More useful links

• How to use your health services