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What Is The Cause Of Tongue Ulcer?

Last Updated on May 21, 2023 by Nurse Vicky

What Is The Cause Of Tongue Ulcer?


Tongue ulcers, or aphthous ulcers, are painful sores that develop on the surface of the tongue or the soft tissues inside the mouth. These ulcers often have a round or oval shape and are characterized by a whitish or yellowish center surrounded by a red halo.

Tongue ulcers can vary in size and may occur as a single sore or in clusters. They can cause discomfort, pain, and sensitivity, making it challenging to eat, drink, and even speak normally.

 Possible Causes of Tongue Ulcers


The exact cause of tongue ulcers remains unknown. However, various factors have been identified as potential triggers for their development. Understanding these factors can provide insights into effective management and preventive measures. Here are ten possible causes of tongue ulcers:

 Trauma and Injury


Accidental biting, burns from hot food or beverages, and physical trauma to the tongue can lead to the formation of ulcers. Injury to the tongue’s delicate tissues can disrupt the mucous membranes and pave the way for the development of ulcers.

Nutritional Deficiencies


Inadequate intake of essential nutrients, such as vitamin B12, iron, folic acid, and zinc, can contribute to the occurrence of tongue ulcers. These nutrients play a crucial role in maintaining healthy oral tissues and a strong immune system. Deficiencies weaken the body’s defense mechanisms, making it more susceptible to oral conditions like ulcers.

 Hormonal Factors


Hormonal changes, particularly in women, have been associated with the development of tongue ulcers. Fluctuations in hormone levels during menstrual cycles, pregnancy, or menopause can potentially trigger the formation of these oral sores.

Stress and Emotional Factors


Stress and emotional factors have been linked to a range of oral health problems, including tongue ulcers. High levels of stress can weaken the immune system, making the body more susceptible to various conditions, including oral ulcers.

Immune System Dysfunction


Certain autoimmune disorders, such as Behçet’s disease and systemic lupus erythematosus (SLE), can cause tongue ulcers. These conditions involve the immune system mistakenly attacking healthy tissues, leading to inflammation and ulceration in the mouth, including the tongue.

 Inflammatory Bowel Diseases


Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, are chronic inflammatory conditions that primarily affect the digestive tract. However, these diseases can also manifest with oral symptoms, including tongue ulcers.

 Certain Medications


Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), beta-blockers, and angiotensin-converting enzyme inhibitors (ACE inhibitors) have been associated with the development of tongue ulcers. These medications can disrupt the normal healing processes in the oral cavity, leading to the formation of ulcers.

Food Sensitivities


Certain individuals may experience tongue ulcers as a result of food sensitivities or allergies. Consuming trigger foods, such as citrus fruits, spicy foods, chocolate, or nuts, can irritate the tongue’s delicate tissues and contribute to the development of ulcers.

 Genetic Predisposition


Some individuals may have a genetic predisposition to developing tongue ulcers. Research suggests that certain genetic factors can increase the likelihood of developing oral ulcers, including those on the tongue.

 Viral and Bacterial Infections


Viral and bacterial infections can play a role in the development of tongue ulcers. Conditions such as oral herpes (caused by the herpes simplex virus), hand, foot, and mouth disease (caused by the Coxsackievirus), and bacterial infections (such as those caused by Streptococcus or Staphylococcus bacteria) can lead to the formation of ulcers on the tongue.

It is important to note that these factors can contribute to the development of tongue ulcers individually or in combination. Identifying the underlying cause for an individual’s tongue ulcers may require medical evaluation and professional diagnosis.

Diagnosing Tongue Ulcers


Diagnosing tongue ulcers typically involves a thorough examination of the oral cavity by a healthcare professional. During the examination, the healthcare provider will assess the size, appearance, and location of the ulcers, as well as inquire about the individual’s medical history and symptoms.

In some cases, further, diagnostic tests or laboratory investigations may be necessary to rule out underlying conditions or determine the specific cause of the ulcers.

 Treatment Options for Tongue Ulcers


The treatment of tongue ulcers aims to alleviate symptoms, promote healing, and prevent further complications. The specific treatment approach may vary depending on the underlying cause, severity of the ulcers, and individual factors. Here are several treatment options commonly utilized for tongue ulcers:

 Topical Medications


Topical medications, such as corticosteroid creams or ointments, can be applied directly to the ulcers to reduce inflammation, relieve pain, and promote healing. These medications are usually prescribed by a healthcare professional and should be used as directed.

 Oral Rinses


Oral rinses or mouthwashes containing antimicrobial agents, such as chlorhexidine, can help reduce the risk of infection and maintain oral hygiene. Rinsing the mouth with a prescribed mouthwash can also provide relief from the discomfort associated with tongue ulcers.

Pain Relief Measures


Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or topical numbing gels, can help alleviate pain and discomfort associated with tongue ulcers. It is important to follow the recommended dosage instructions and consult a healthcare professional if the pain persists or worsens.

 Dietary Modifications


Making dietary modifications can aid in the healing process of tongue ulcers. It is recommended to avoid spicy, acidic, or rough-textured foods that can further irritate the ulcers. Consuming soft, bland foods and maintaining adequate hydration can provide relief and support the healing of tongue ulcers.

Natural Remedies


Some individuals find relief from tongue ulcers by using natural remedies. Examples include applying aloe vera gel, chamomile tea bags, or honey directly to the ulcers. However, it is important to note that

A simple research of various causes has revealed the following:

Bacterial infections, Herpes Simplex Virus, and genetic factors. To determine the most likely cause, read on. Symptoms and treatments vary between people. Although there is no single cause, you can take over-the-counter pain medications for immediate relief. You should avoid eating spicy foods, as these tend to irritate the tongue.

Herpes Simplex Virus


Symptoms of Herpes Simplex Virus Infections are often painful. These sores can form on any part of the mouth. Sometimes you may experience as many as 10 or more. Fever and difficulty swallowing are other symptoms of Herpes Simplex Virus Infections.

Most people are infected with this condition before the age of three, and they are contracted through contact with an adult who has an outbreak of the virus. Herpes is highly contagious and has three stages. Symptoms of Herpes on the tongue typically come in the form of red, swollen blisters.

These sores may start off as mild irritation and then gradually become increasingly painful. In some cases, herpes will manifest itself as a yellowish ulcer. The symptoms of Herpes Simplex Virus Infection vary from person to person and can be very painful.

The treatment of this condition depends on the severity and location of the sore. Treatment for Herpes Simplex Virus Infections can range from topical to oral medications.  treatments are the most commonly prescribed method. Antiviral medications help reduce the length of the outbreak.

Over-the-counter drugs should never contain aspirin. You should also avoid close contact with people who have the disease. Avoid sharing utensils, glasses, or bath towels. These medications may also cause some side effects.

Bacterial infections


There are several possible causes of tongue ulcers. One of these is an auto-immune condition called aphthous stomatitis. This is the cause of a common oral condition known as a canker sore. While the condition itself can be caused by several causes, there are some common ones.

For instance, anemia or another blood disorder may lead to an ulcer. Additionally, certain gastrointestinal diseases and certain skin conditions can lead to ulcers in the mouth. Fungal infections are less common than bacterial infections. They often occur on the roof of the mouth under a partial denture.

People with a weakened immune system may also develop thrush on the tongue. This type of infection often has whitish patches that appear in the mouth and may last for 10-14 days.

A fungal infection is caused by a fungus called candida. The fungus grows out of control and can cause candidiasis or thrush. Thrush can be uncomfortable and requires medical attention. In the worst-case scenario, a bacterial infection can lead to an abscess, or pocket of pus in the mouth.

It can form in the mouth as a result of a cavity, gum disease, or a foreign object lodged in the gums. When this happens, the pain can radiate. A bacterial infection can also cause severe gastrointestinal symptoms, such as fever and sluggishness.

Genetic factors


New research suggests that some genetic variations in the mouth can lead to the development of ulcers, including a common gene linked to the immune system.

The researchers studied the genetic data of over 350,000 people from 23andMe and the UK Biobank. They discovered 97 common variations that predispose individuals to mouth ulcers.

Further studies using the data from the Bristol Children of the Nineties (ALSPAC) study confirmed the findings. They found that the genetic variations that are associated with mouth ulcers were enriched for genes involved in the immune system.

The researchers concluded that the prevalence of RAS is greater among younger people, which suggests a shift in etiology with age. However, they did not identify specific genetic loci involved in RAS.

A genome-wide association study of 461,106 people evaluated genetic variants and estimated the heritability of the disease at 6.4% to 9 percent. Other independent studies replicated the findings, and an additional independent cohort confirmed the results of the GWAS.

Among the variants identified by the current study, one gene encoding the IL10 protein was associated with the most severe cases of mouth ulcers.

A variant in PPP5C, rs3764613, conferred a significant effect on the incidence of mouth ulcers. A further gene linked to the development of this condition is rs3182633, which confers a significant effect on its risk for development.





Tongue ulcers, or aphthous ulcers, can be a painful and uncomfortable condition that affects many individuals. While the exact cause of tongue ulcers remains elusive, several factors have been identified as potential triggers.

These include trauma and injury, nutritional deficiencies, hormonal factors, stress, immune system dysfunction, inflammatory bowel diseases, certain medications, food sensitivities, genetic predisposition, and viral or bacterial infections.

Diagnosing tongue ulcers involves a thorough examination by a healthcare professional, and treatment options may vary depending on the underlying cause and severity of the ulcers.

Topical medications, oral rinses, pain relief measures, dietary modifications, and natural remedies are often utilized to alleviate symptoms, promote healing, and prevent complications.

To prevent tongue ulcers, maintaining good oral hygiene, consuming a balanced diet, managing stress levels, avoiding trigger foods, protecting against infections, and scheduling regular dental check-ups are recommended.

However, it is essential to consult with a healthcare professional for a proper diagnosis and individualized treatment plan. Remember, each individual’s experience with tongue ulcers may differ, and what works for one person may not work for another.

If you are experiencing persistent or severe symptoms, it is crucial to seek medical attention for appropriate evaluation and guidance.

By understanding the causes, symptoms, treatment options, and preventive measures related to tongue ulcers, individuals can take proactive steps to manage this condition effectively and improve their overall oral health and well-being.

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