Tongue Ulcers: Causes, Symptoms & Treatments

Tongue ulcers, also known as mouth sores, are small but painful lesions that develop on the surface of the tongue. While they may seem harmless, these ulcers can interfere with eating, speaking, and oral hygiene. 

From minor irritations to symptoms of underlying health conditions, tongue ulcers have many causes—and understanding them is key to choosing the right treatment.

 In this article, we’ll explore the causes, symptoms, types, and proven treatments for tongue ulcers, along with tips on prevention and when to seek medical help.

What are Tongue Ulcers?

Tongue ulcers are sores that develop on the tongue’s surface, leading to discomfort and pain. These ulcers can appear individually or in clusters and may vary in size. They are typically white, round, and slightly sunken, often surrounded by a reddish area. 

Tongue ulcers can be aggravated by contact with objects like toothbrushes or by consuming spicy and acidic foods. Now, let’s explore the different types of tongue ulcers.

Types of Tongue Ulcers

Tongue ulcers can be classified into several categories, each with its own unique causes and characteristics. The most common types include:

1. Aphthous Ulcers (Canker Sores)

Aphthous ulcers, or canker sores, are the most prevalent type of tongue ulcer. These small, round sores can appear individually or in groups. 

Minor canker sores are a few millimetres in diameter, while major ones can span 1–3 centimetres. Although these ulcers often heal on their own within a couple of weeks, they can be painful and may require over-the-counter pain relief.

2. Traumatic Ulcers

Traumatic ulcers are caused by physical trauma to the tongue, such as accidentally biting it, injuries from dental procedures, or using hard-bristled toothbrushes. A specific type called traumatic ulcerative granuloma (TUG) can occur due to trauma and may resemble oral cancer, necessitating medical attention for accurate diagnosis and treatment.

3. Infectious Ulcers

Infectious ulcers can be caused by viral or fungal infections. For instance, hand, foot, and mouth disease (HFMD) can result in tongue ulcers, particularly in children but also in adults. Another example is oral thrush, a fungal infection that can cause ulcers on the tongue, characterised by white patches and a red, smooth patch on the tongue’s upper surface.

Signs and Symptoms of Tongue Ulcers

If you have a tongue ulcer, you may experience:

• Pain or discomfort on the tongue
• Visible sores or ulcers on the surface of the tongue
• Redness and inflammation surrounding the ulcers
• Difficulty eating or speaking due to the pain
• Increased sensitivity to spicy, acidic, or sharp foods
• In some cases, you may also have a fever or swollen lymph nodes

Causes of Tongue Ulcers

Tongue ulcers can be caused by a variety of factors, including stress, autoimmune diseases, physical trauma, infections, and certain medical conditions. 

Let’s explore some of these causes in more detail.

1. Stress

• Emotional stress: High levels of stress can lead to physical symptoms, including tongue ulcers.
• Impact on the immune system: Stress can weaken the immune system, making it harder for the body to fight off infections that could cause ulcers.

2. Celiac Disease

• Autoimmune reaction: Celiac disease triggers an autoimmune response to gluten, which can lead to oral manifestations, including tongue ulcers.
• Malabsorption: Nutrient deficiencies due to malabsorption can contribute to the development of ulcers.

3. Crohn’s Disease

• Inflammatory response: Crohn’s disease, a inflammatory bowel disease, can cause oral lesions and ulcers.
• Systemic inflammation: The systemic inflammation associated with Crohn’s disease can affect various parts of the body, including the mouth.

4. Tongue Biting

• Accidental injury: Biting the tongue accidentally can cause ulcers.
• Trauma: Physical trauma to the tongue can lead to the formation of ulcers.

5. Aphthous Ulcer

• Common cause: Aphthous ulcers, also known as canker sores, are one of the most common causes of tongue ulcers.
• Unknown origin: The exact cause of aphthous ulcers is often unknown but may include stress, minor oral injury, or certain foods.

6. Herpes

• Viral infection: Herpes simplex virus can cause ulcers on the tongue and other parts of the mouth.
• Recurring episodes: Herpes infections can recur, leading to repeated episodes of ulcers.

7. Oral Cancer

• Serious condition: Oral cancer can manifest as persistent ulcers on the tongue that do not heal.
• Risk factors: Smoking, alcohol consumption, and HPV infection are risk factors for oral cancer.

8. Behçet’s Disease

• Rare condition: Behçet’s disease is a rare disorder that can cause recurrent tongue and mucous membrane ulcers.
• Systemic inflammation: The disease involves inflammation of blood vessels throughout the body, which can lead to tongue ulcers.

9. Certain Food Allergies

• Allergic reactions: Some people may develop tongue ulcers as a result of allergic reactions to certain foods.
• Common allergens: Foods that commonly cause allergic reactions include nuts, seafood, and dairy products.

How are Tongue Ulcers Treated? 

If you are suffering from tongue ulcers, consider the following treatments to alleviate discomfort and promote healing:

• Apply an antiseptic gel to the ulcersand rinse your mouth with an alcohol-free medicated mouthwash containing chlorhexidine gluconate twice daily.
• Use a topical alcohol-free steroid mouthwash or ointment prescribed by a dentist or oral medicine specialist.
• Apply an anaesthetic gel or cream containing lidocaine to help with pain and inflammation.
• Rinse your mouth with warm, slightly salted water for up to 4 minutes, repeating four times daily.
• Avoid spicy, salty, sour, and acidic foods until the ulcers heal.

How to Prevent Tongue Ulcers: Simple & Effective Tips

To minimise the risk of developing tongue ulcers, consider the following prevention tips:

• Maintain good oral hygiene by brushing your teeth gently with a soft toothbrush, flossing daily, and avoiding hard-bristled toothbrushes and mouthwashes containing sodium lauryl sulfate (SLS) or alcohol.
• Eat a well-balanced and nutritious diet rich in vitamins and iron to prevent deficiencies that can lead to ulcers.
• Avoid foods that irritate your mouth, such as acidic fruits, nuts, chips, and spicy foods.
• Reduce stress through activities like yoga or meditation, as stress can contribute to the formation of mouth ulcers.
• Ensure any orthodontic appliances have smooth edges to avoid irritation.

When to Contact a Doctor?

Tongue ulcers usually heal within 1-2 weeks. Seek medical advice if they persist, recur, or are accompanied by severe symptoms like fever, weight loss, or red/white patches, as these may indicate underlying issues.

Additionally, ulcers caused by medication or infection, such as oral thrush, require tailored treatment. Early detection of red flags like hard lumps or sores is crucial for addressing underlying issues, including potential oral cancer.

Takeaway

Tongue ulcers can be uncomfortable, but with the right care and awareness, they are often manageable at home. Identifying the cause is the first step to managing them. Using gentle oral hygiene practices, avoiding irritants, and maintaining a balanced diet can speed up healing and prevent recurrence.

If a tongue ulcer doesn’t heal within two weeks, is unusually large, or comes with other symptoms like fever or swollen glands, it’s time to see a doctor.

For more insights and access to affordable medications, download the Truemeds app today and get expert-backed support delivered to your doorstep.

Expert Quote:

“Most tongue ulcers heal on their own but persistent or painful sores could be a sign of an underlying health issue and you must visit your dentist for the same. Early diagnosis and proper oral care can prevent complications.”

– Dr Lakshmi Vaswani

Frequently Asked Questions (FAQs)

References:

• Website, N. (2024, March 13). Mouth ulcers. nhs.uk. https://www.nhs.uk/conditions/mouth-ulcers/
• Verma, S., Srikrishna, K., Srishti, Shalini, K., Sinha, G., & Srivastava, P. (2023). Recurrent oral ulcers and its association with stress among dental students in the Northeast Indian population: a Cross-Sectional Questionnaire-Based survey. Cureus. https://doi.org/10.7759/cureus.34947
• Pecci-Lloret, M. P., Ramirez-Santisteban, E., Hergueta-Castillo, A., Guerrero-Gironés, J., & Oñate-Sánchez, R. E. (2023). Oral Manifestations of Crohn’s Disease: A Systematic review. Journal of Clinical Medicine, 12(20), 6450. https://doi.org/10.3390/jcm12206450