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4 Swollen Tongue Causes

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Last updated April 17, 2024

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Swollen tongue causes can arise from inflammation from an infection, an allergic reaction, or trauma from biting, piercing, or dental irritation. Other causes of tongue swelling and red bumps on the tongue include medication side-effects. Read below for more information on other causes, related symptoms, and treatment options.

Symptoms of a swollen tongue

Did that presentation you just gave sound a little funny as you said it? Why does it seem harder to eat? One thing is for sure, something in your mouth just does not feel right. A swollen tongue can be uncomfortable and make it hard to do all the things our mouths do best.

The tongue plays a big role in our daily lives. The tongue lets us taste, assists the mouth with chewing and swallowing, and we do not say that words "roll off our tongue" for nothing. A lot is impacted by a swollen tongue.

The tongue is an organ made up of eight muscles and is covered with a mucous membrane. The upper surface of the tongue is covered in taste buds which detect sweet, bitter, salty, sour, spicy, and savory.

Common accompanying symptoms of a swollen tongue

If you're experiencing tongue swelling, it is also likely to experience:

  • Difficulty talking, eating, or swallowing
  • Extremely red tongue or pale tongue
  • Tongue lesions and/or bumps
  • Tongue pain and/or mouth soreness
  • Bleeding
  • Fever
  • Swelling
  • Smoothness

Symptoms of a swollen tongue may present themselves on their own or along with other issues in the body. Carefully considering all the symptoms surrounding a swollen tongue will help determine a cause and treatment.

What causes tongue swelling?

The causes of a swollen tongue are as varied as the symptoms. What we put in our mouths can often be the driving force behind a swollen tongue, but there are also other, and more serious, reasons for the swelling.

Environmental swollen tongue causes

A swollen tongue may occur due to lifestyle habit or certain exposures.

  • Trauma: Burning, biting, piercing, or otherwise injuring the tongue.
  • Irritation: Substances such as tobacco, alcohol, and spicy foods can irritate the tongue and cause swelling. Conditions like acid reflux can do the same.
  • Allergies: Reactions to food, medications, bee stings and other oral products can all cause swollen tongue symptoms.
  • Vitamin imbalance: The lack of proper nutrients in your body, particularly vitamin B complex, vitamin C, and folate, can lead to a swollen tongue.

Inflammatory swollen tongue causes

Bacterial infections of the tongue or other parts of the body can result in tongue swelling. Strep, syphilis, herpes, and yeast infections have all been known to cause a swollen tongue.

Systemic disease swollen tongue causes

Your tongue may swell due to the following systemic diseases.

  • Cancer: Tongue cancer causes swelling as it spreads. Typically, cancer starts on one part of the tongue and swelling may be minimal, but persistent tongue swelling is typical with tongue cancer.
  • Metabolic: Disruptions to metabolic functions can cause tongue swelling. Pituitary gland disorders are an example of metabolic disorders.
  • Hereditary: Inherited disorders, such as Down syndrome, can affect many aspects of the body, including the tongue.

This list does not constitute medical advice and may not accurately represent what you have.

Swelling caused by use of an ace inhibitor

ACE Inhibitors are drugs used to prevent, treat or improve symptoms in conditions such as high blood pressure, coronary artery disease, heart failure and diabetes. In rare cases, these drugs can cause an allergic reaction that can be life-threatening.

Rarity: Common

Top Symptoms: shortness of breath, swollen face, trouble swallowing, swollen lips, swollen tongue

Symptoms that never occur with swelling caused by use of an ace inhibitor: hives, red swollen bumps or patches with a pale center

Urgency: Hospital emergency room

Nephrotic syndrome

Nephrotic syndrome is a disorder of the kidneys that results in too much protein excreted into your urine. It is usually associated with damaged kidneys specifically damage to the kidneys' filters, called glomeruli.

Kidney damage and nephrotic syndrome primarily include albuminur...

Swelling caused by use of an ace inhibitor

ACE Inhibitors are drugs used to prevent, treat or improve symptoms in conditions such as high blood pressure, coronary artery disease, heart failure and diabetes. In rare cases, these drugs can cause an allergic reaction that can be life-threatening.

You should go to the ER immediately. There, your doctor can consider the possibility of an allergic reaction, treat it, and make sure that you are able to breathe.

Severe infection of the mouth (ludwig's angina)

Ludwig angina is a bacterial infection of the floor of the mouth and occurs beneath the tongue.

You should visit an emergency room immediately. This requires immediate antibiotic treatment and, in some cases, surgery.

Salivary duct stone (sialolithiasis)

A salivary duct stone is the most common disorder of the salivary glands (where you make spit). They can range in size from tiny particles to stones that are several centimeters in length.

You can try treating this at home and going to the doctor if things don't work. You can stay well hydrated, apply warm compresses, and massage or "milk" the duct with the stone in it. Another tip would be to suck on lemon drops or other hard tart candy (called sialogogues, which promote salivary secretions) throughout the day. Pain is treated with NSAIDs like Ibuprofen. If things do not get better or you cannot find the stone, it's best to go to your doctor.

Rarity: Uncommon

Top Symptoms: swelling on one side of the face, swollen jaw, painful face swelling, spontaneous jaw pain, painful jaw swelling

Urgency: Phone call or in-person visit

Hypothyroidism

Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

Gingivitis

Gingivitis is the infection of the gums surrounding the teeth. It is caused by plaque and/or tartar that has built up on your teeth. Plaque is a sticky layer of gunk made by food particles, mucus, and bacteria. After a while, plaque hardens to become tartar (or calculus). Plaque and tartar at the bottom of the teeth causes the gums to become irritated and infected.

You should go to the nearest dentist in the next few weeks. There, the dentist or dental hygenist will clean your teeth, getting rid of that nasty plaque/tartar. Once cleaned, you should rinse your mouth twice-a-day with chlorhexidine 0.12% oral rinse (PerioGard) or half-strength hydrogen peroxide. Flossing and brushing your teeth are also essential.

Angioedema

Angioedema is a condition which can cause swelling and puffiness of the face, mouth, tongue, hand or genitals. It is often related to an allergic reaction to food, medicines or insect bites.

Allergic reactions can be dangerous and therefore you should be brought to the nearest Emergency Room for evaluation and treatment. Call for an ambulance if you are experiencing any of the following symptoms: fainting, vomiting, trouble swallowing, tightness in throat or trouble breathing.

Rarity: Rare

Top Symptoms: nausea or vomiting, abdominal cramps (stomach cramps), diarrhea, swollen face, hand swelling

Urgency: Hospital emergency room

Anaphylaxis

Anaphylaxis is the sudden onset of breathing or heart rate changes that are caused by a whole-body allergic reaction. This can be a deadly situation.

Call 911 immediately for an ambulance. If you have been prescribed an epinephrine pen, use it. Don't do this if you have never been prescribed one!

Allergic reaction (not life-threatening)

When the body encounters a harmful substance, it responds with inflammation and swelling that can be protective. In many individuals, the body responds this way to substances that are not normally harmful, like foods or pollen. This is the basis of allergic reaction, or Type 1 Hypersensitivity.

You should visit a physician right away to discuss the allergy and its severity, if you have not already been diagnosed. Your doctor may order an allergy screen to see what other substances produce the response. If you begin to feel tightness in the throat or difficulty breathing, get to an ER as soon as possible.

Rarity: Common

Top Symptoms: swollen face, swollen lips, lip numbness, hives, red swollen bumps or patches with a pale center, lip redness

Symptoms that never occur with allergic reaction (not life-threatening): shortness of breath, throat itching

Urgency: Primary care doctor

Acute salivary duct stone (sialolithiasis)

A salivary duct stone is the most common disorder of the salivary glands (where you make spit). They can range in size from tiny particles to stones that are several centimeters in length.

You can try treating this at home and going to the doctor if things don't work. You can stay well hydrated, apply warm compresses, and massage or "milk" the duct with the stone in it. Another tip would be to suck on lemon drops or other hard tart candy (called sialogogues, which promote salivary secretions) throughout the day. Pain is treated with NSAIDs like Ibuprofen. If things do not get better or you cannot find the stone, it's best to go to your doctor.

When to seek treatment for a swollen tongue

We have all sipped before we should have and burned our tongue, maybe even caused it to swell. Unfortunately, we also all know that the treatment typically involves simply waiting for the pain to subside. When a swollen tongue is more persistent, however, or there are other swollen tongue symptoms present, advanced treatment may be required.

When to see a doctor for a swollen tongue

Contacting your doctor is recommended when you experience the following swollen tongue symptoms:

  • Persistent swelling for over 10 days
  • Extreme swelling
  • Problems breathing, swallowing, chewing, and speaking
  • Swelling associated with an allergic reaction
  • Swelling associated with an infection

Professional swollen tongue treatments

If the below at-home treatments are not enough, and your tongue swelling worsens or persists, you should consult your physician. He or she may recommend the following.

  • Prescription medications: Advanced cases of tongue swelling may require medications prescribed by a doctor.
  • Advanced medical procedures: Surgery, radiation therapy, and/or chemotherapy may be required to treat tongue cancer.

When tongue swelling is an emergency

It is recommended to contact emergency personnel if tongue swelling is preventing breathing or a blocked airway is imminent.

At-home swollen tongue treatments

You can try the following remedies at home to address your tongue swelling.

  • Lifestyle changes: Changes in diet can help reduce swelling caused by a variety of factors. Eliminating sour or spicy foods and tobacco can sometimes cure a swollen tongue. Minimizing chewing or instituting a liquid diet may also help.
  • Over-the-counter medications: NSAIDs, such as ibuprofen (Advil, Motrin), can help reduce inflammation.

A swollen tongue can make it difficult to chew and talk, but, oftentimes, is not a cause for serious concern. There is always the potential for a more significant cause, however, so it is important to monitor symptoms and ensure proper treatment for a swollen tongue.

FAQs about swollen tongue

Can allergies cause a swollen tongue?

Oral allergies can affect the mouth and tongue. People with allergies to foods like melons, pineapple, and apples can exhibit swollen tongues after consumption. Allergic reactions to certain medications, bee stings, or other oral products are also known to cause tongue swelling.

What does it mean when your tongue is swollen underneath?

Swelling beneath the tongue can be a sign of a salivary gland infection. The cause may be viral or from bacteria associated with smoking, chronic illness, or poor hydration. Treatment is often not required, but your doctor may prescribe antibiotics if a bacterial infection is present.

Can dehydration cause a swollen tongue?

Dehydration is known to cause a swollen tongue. Inadequate fluids can result in swelling or scalloping of the tongue or a salivary gland infection. Replenishing fluids can help relieve symptoms. Continued hydration and good oral care will help prevent tongue swelling from dehydration in the future.

Why is my tongue scalloped?

Several causes are associated with scalloped tongues. Thyroid problems are known to cause tongue swelling to the point of scalloping. Dehydration may be another cause. It is important to consult your doctor if you experience a scalloped tongue, particularly if a thyroid problem is possible.

What vitamin deficiency causes a swollen tongue?

Vitamin B deficiencies can cause several symptoms of the tongue, including swelling. Other symptoms include tingling, soreness, and loss of taste. It is important to consult your doctor and treat a vitamin B deficiency to avoid long-term effects.

Questions your doctor may ask about swollen tongue

  • What part of your mouth is swollen?
  • Do you have a rash?
  • Are your symptoms worse while eating?
  • Does your throat feel itchy or irritated?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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