Canker Sore on Tongue: Feeling, Causes, Get Rid of It (2024)

A canker sore is an ulcer (an open sore) that develops on the underside of the tongue, in addition to other locations within the mouth. These small, red sores are often painful, but they are not contagious.

Canker sores have multiple potential triggers, including diet, allergies, viruses, and hormonal changes. Fortunately, a variety of over-the-counter (OTC) and natural remedies exist to help ease the discomfort and speed up the healing process.

This article provides an overview of the potential causes of a canker sore on the tongue—and how to get rid of it.

Quick Treatment for a Tongue Canker Sore

In many cases, canker sores will go away on their own without treatment within a week or two. But for painful or bothersome canker sores on the tongue, experts recommend a few treatment tactics.

Some quick options are:

• Try an OTC topical medication to help numb the pain temporarily or mouth rinse to help fight against the sore.
• Rinse your mouth with salt water to promote healing.
• Use a cotton swab to apply a mixture of hydrogen peroxide and water to the sore a couple of times a day to treat the area.
• Combine 1 part of the allergy medication liquid Benadryl (diphenhydramine) and 1 part of milk of magnesia (magnesium hydroxide) and rinse your mouth with it.
  

Making Sure It's a Canker Sore on Tongue

Here's how to tell whether your tongue sore is a canker sore or something else.

Typically, a tongue canker sore starts as a red, painful bump on the tongue with a white or yellow center. These sores are usually less than 1 centimeter (cm)—equal to about one-third inch—across and may start to turn white or gray as they heal. Canker sore pain usually decreases within a week or so, though it may take up to three weeks for a canker sore to heal completely.

In rare cases, a tongue canker sore may also accompany a fever, malaise (a general feeling of being unwell), and swollen lymph nodes.

Why Do Canker Sores Appear?

Some canker sores develop without an apparent reason, while others may be linked to an underlying cause. While experts aren't sure exactly what causes canker sores to develop, there are a few factors that seem to trigger them.

Stomatitis

Stomatitis (mouth tissue inflammation) can be caused by a viral or bacterial infection (among other causes) and can lead to canker sores. If these canker sores recur on a regular basis, you may have aphthous stomatitis, which is a common condition.

Medications

Certain medications may also cause frequent canker sores.

Some drugs that have been known to trigger mouth sores in general include:

• Aspirin
• Beta-blockers, a type of medication used to treat heart rhythm, high blood pressure, and other conditions
• Chemotherapy medications
• Cupramine, Depen (penicillamine), a drug that treats conditions such as Wilson's disease (an inherited disorder leading to copper buildup in the body) and rheumatoid arthritis (a type of autoimmune inflammatory disease)
• Dilantin (phenytoin), a type of anticonvulsant, a drug to treat epileptic seizures
• Sulfa drugs, used to treat and prevent certain bacterial infections

Allergies

In some cases, canker sores result from an allergic reaction. Common culprits include certain foods and ingredients in toothpaste or mouthwash.

If you're unsure whether allergies are behind your tongue canker sores, try noting when the sores develop and what you've consumed during that time. Experts often consider the following food ingredients and additives as triggers:

• Benzoic acid (preservative found in foods and soft drinks)
• Cinnamon
• Fruits
• Gluten (a protein found in wheat, barley, and rye)
• Nuts
• Tomatoes

Mouth Injury

Experiencing a mouth injury may also prompt a canker sore. Here's what experts see most often in these cases:

• Cutting the inside of the mouth with braces or a sharp or broken tooth
• Having dental work
• Biting the inside of the mouth
• Burning the mouth with a hot drink or food
• Brushing your teeth too vigorously
• Wearing ill-fitting dentures
  

Stress

Research shows that stress and canker sores are connected.

This may be linked to changes to saliva that occur during a stressful event, like an increase in the stress hormone cortisol. Or, these canker sores could be prompted by stress-linked, habitual actions like biting the inside of the mouth.

Diet

Nutritional deficiencies are another potential trigger for canker sore development. Low levels of nutrients involved in the production of hemoglobin (the oxygen-carrying molecule in red blood cells) have been associated with aphthous stomatitis, including:

• Folate
• Iron
• Vitamin B12
  

Other potential nutrients that may contribute to canker sores include thiamine, zinc, and vitamin D.

Hormones

It's possible to experience more frequent canker sores during times when hormone levels are fluctuating. This seems to occur particularly when levels of the hormone progesterone are increased, which has been shown to lead to oral health changes—like bleeding gums, canker sores, and inflamed salivary glands.

Risk Factors

Anyone can get a canker sore, but some people may be more likely to develop canker sores than others. For example, researchers have found that you may have an increased risk for experiencing canker sores if you:

• Have a family history of frequent canker sores
• Are in your teens or late 20s
• Are assigned female at birth
• Have an underlying health condition, such as human immunodeficiency virus (HIV), a gastrointestinal disorder, an autoimmune disease, a weakened immune system, or certain types of cancer

When to Consult a Healthcare Provider

An occasional canker sore is common and typically not a cause for concern. But it's a good idea to check with a healthcare provider if you notice a canker sore that:

• Develops after starting a new medication
• Lasts longer than two weeks
• Is larger than 1 cm across
• Makes it extremely painful to eat or drink
• Comes along with other symptoms, such as a fever, rash, drooling, or difficulty swallowing

You should also consult with your healthcare provider if you have a weakened immune system from health conditions or medications and if you experience multiple canker sore outbreaks per month.

After asking about your medical history and symptoms and also examining your mouth and tongue, a healthcare provider may order a blood test to determine a nutritional deficiency, perform an allergy test, or perform a culture test. From there, they can make a diagnosis and offer a treatment plan.

How to Treat Tongue Canker Sores That Do Not Heal

Canker sores have no cure, but some treatments are available to help ease the pain, shorten their duration, and reduce recurrence.

In mild cases, basic home care may be enough, including:

• Taking OTC pain relievers, like Tylenol (acetaminophen)
• Using an OTC topical medication to help numb the pain
• Using an OTC mouth rinse to help heal the sore
• Applying a thin paste of baking soda and water to the area
• Mixing 1 part hydrogen peroxide with 1 part water and applying it to the sore with a cotton swab

In severe or long-lasting cases, a healthcare provider may prescribe stronger treatments. For example, for stubborn tongue canker sores, a healthcare provider may recommend:

• A prescription-strength antiseptic mouth rinse to help cut down on bacteria
• Stronger oral care products to numb the area
• Corticosteroids like prednisone in pill or topical form to clear recurring or severe canker sores
• In some cases, medications to reduce gastric acid to lessen the pain
• Supplementing with folate and vitamin B12 to prevent canker sores from developing if a nutritional deficiency is the underlying issue

Eating and Oral Hygiene With a Tongue Canker Sore

Experts often recommend some lifestyle modifications when it comes to your diet and oral hygiene to help soothe a tongue canker sore.

For example, consider:

• Staying away from hot foods or drinks
• Limiting spicy, salty, and citrus foods
• Gargling with salt water
• Trying fruit-flavored Popsicles
• Brushing your teeth twice a day and flossing your teeth daily
  

Summary

A canker sore is a small, red, painful sore that may develop on the tongue or in other parts of the mouth. While the exact underlying cause of canker sores isn't known, several factors may trigger their appearance, including nutritional deficiencies, mouth injuries, stress, hormone fluctuations, and more.

If using at-home remedies like mouth rinses or over-the-counter numbing products isn't helping after several days, see a healthcare provider for prescription-strength treatment.