Sore tongue: causes, what helps and when to see a dentist or GP

The NHS lists biting or burning the tongue with hot food or drink as the first cause of a sore tongue and says the pain and swelling should last only a few days. Mouth ulcers, which the NHS describes as round, painful and swollen sores that can look like blisters and appear on the tongue, the inside of the cheeks or the lips, are another common cause. nidirect adds that aphthous ulcers are common on the underside of the tongue and that most heal within a week or two without treatment.

Irritants are a further cause. The NHS advises not using toothpaste containing sodium lauryl sulphate, not eating spicy, acidic or hot food and drink that may irritate the tongue, and not smoking or drinking alcohol. nidirect says some mouthwashes can also cause tongue pain in some people.

Oral thrush causes white patches and can make the mouth painful, with an unpleasant taste or loss of taste, according to nidirect. It says median rhomboid glossitis, a red, smooth patch or lump in the middle of the top of the tongue, can occur with oral thrush. The NHS lists a sore tongue among thrush symptoms in adults and says a mouth gel from a pharmacy can treat it.

Geographic tongue produces irregular smooth red patches with a white or light border that give a map-like appearance. nidirect says the patches may move from one area to another over days, weeks or months, that some people find them sore with certain foods and drinks, and that there is no specific treatment, although avoiding acidic, spicy or hot foods and using over-the-counter painkillers may help. The NHS says lichen planus can cause white patches on the tongue and inside the cheek.

The NHS lists a sore tongue among the less common symptoms of iron deficiency anaemia, alongside food tasting strange, itching, hair loss, painful open sores at the corners of the mouth and spoon-shaped nails. The more common symptoms are tiredness, shortness of breath, palpitations, pale skin and headaches. A GP will usually arrange a full blood count.

For vitamin B12 or folate deficiency, the NHS lists a sore and red tongue, mouth ulcers, extreme tiredness, pins and needles, muscle weakness, vision problems and psychological symptoms. It stresses seeing a GP if you think you may be deficient, because although many symptoms improve with treatment, some problems can be irreversible. nidirect likewise says a sore tongue may sometimes be a symptom of iron deficiency anaemia or B12 or folate deficiency.

nidirect names several other causes that a clinician would consider if the soreness is persistent: viral infections such as hand, foot and mouth disease or cold sores, burning mouth syndrome, a burning pain on the tip of the tongue, glossopharyngeal neuralgia, lichen planus, Behcet's disease, pemphigus vulgaris, and medicines such as NSAIDs and beta-blockers, which can cause painful mouth ulcers.

It also lists cancer of the tongue. It says this is rare, but that an ulcer or swelling lasting more than three weeks, particularly if bleeding, should be seen by a GP, with the risk higher in heavy smokers and drinkers.

For a sore tongue the NHS suggests using a soft toothbrush, brushing the tongue or using a scraper to help a white tongue, drinking cool drinks through a straw and taking paracetamol or ibuprofen. It adds that a pharmacist can help and may advise whether to see a dentist or GP.

See a dentist or GP if the soreness has not settled within a few days after an obvious injury, if it keeps returning, if there are white patches, if an ulcer is lasting longer than 3 weeks or bleeding, or if you feel generally tired or unwell, which could point to anaemia or a vitamin deficiency.

• No obvious cause and sore for more than a few days: see a dentist or GP.

• White patches on the tongue that do not wipe off: see a dentist or GP.

• Ulcer, lump or swelling lasting more than 3 weeks, or bleeding: be seen promptly.

• Sore red tongue with tiredness, pins and needles or breathlessness: ask a GP about a blood test.