There are many reasons you may have a swollen tongue. Some you might recognize right away—for example, an injury to your mouth or allergies. Other causes can be harder to spot, like a side effect of a medication or an undiagnosed health condition.
Swelling (edema) of your tongue can be an annoying, but harmless, problem. However, it can also be a sign of a serious—even life-threatening—condition.
This article will go over the possible causes of a swollen tongue. You’ll also learn how a provider can diagnose and treat a swollen tongue.
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Depending on what’s causing the swelling, one or both sides of your tongue might get bigger.
Your tongue may also itch or hurt. The swelling and other symptoms can make it hard to talk and eat.
In medicine, the word edema means “swelling.”
There are also some serious symptoms related to a swollen tongue, including:
- Swelling that keeps getting worse: Swelling can block your airway. If you’re gasping for breath, seek medical attention right away.
- Rapid, severe swelling: If you have swelling of your tongue and face that comes on fast, you might be having a severe allergic reaction (anaphylaxis). If this happens, you might have other symptoms like hives, trouble breathing, a bluish discoloration of your lips (cyanosis) nausea, and vomiting. If you’re having an anaphylactic reaction, seek emergency medical care right away.
When to Seek Care
There are many reasons that your tongue can swell, including health conditions and reactions to medications.
Food allergies and allergic reactions to chemicals are the most common causes of a swollen tongue.
You might only have a mild allergic reaction that gets better on its own. However, swelling that’s caused by anaphylaxis is serious—you could even die from it.
You may also have allergic reactions to non-food products.
Angioedema is the medical word for swelling under the skin. Usually, it refers to swelling caused by an allergy.
After food allergies, medication reactions are the most common cause of angioedema of the face, lips, or tongue.
The reaction happens when the body releases too many immune-system chemicals that are needed to open blood vessels (bradykinin).
Many prescription and over-the-counter (OTC) medications can cause non-allergic tongue swelling. Less often, a swollen tongue can be a side effect of a medication.
Here are a few examples:
Diseases of the skin can cause tongue irritation which may lead to a little swelling.
Here are a few examples of skin diseases that might make your tongue swell:
- Pemphigus: This is a group of potentially fatal autoimmune diseases. In people with pemphigus, the immune system attacks the skin and mucus membranes, causing skin blisters and mouth sores.
- Oral lichen planus: This little-understood disease causes rashes on the skin or in the mouth.
- Oral psoriasis: This autoimmune condition can cause geographic tongue (the hair-like projections on the surface of the tongue get stripped away) and fissured tongue (deep grooves develop on the surface of the tongue)
Burning your tongue on hot foods or drinks, biting your tongue, or piercing the tongue can cause temporary swelling. It should get better in about five days. If it doesn’t, see your healthcare provider.
Serious injuries and oral piercings can also lead to a bacterial infection called Ludwig’s angina, which causes swelling of the area under the tongue.
If the infection is not treated immediately, the swelling can cause your airway to become completely blocked.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a digestive disorder that causes acid from the stomach to back up into the esophagus. It can cause chronic irritation at the back of the throat.
In some people with GERD, the base of the tongue is also affected and may swell.
Sjögren’s syndrome is an autoimmune disease that causes dryness of the eyes and mouth. The condition can also cause swelling in the salivary glands (which make spit) and the lacrimal glands (which make tears).
Some people with Sjögren’s have a tongue that looks or feels swollen.
The most common symptom is facial paralysis. Some people with the condition also have permanent swelling of their face, which can include the lips and tongue.
Tongue cancer is a rare cause of a tongue that looks or feels swollen. Usually, this discomfort is related to a cancerous growth (tumor) on the tongue.
Depending on where the tumor is located, you might also feel like you have a lump in your mouth or throat. Your mouth, tongue, and throat may hurt.
In some cases, the discomfort is bad enough that a person has trouble talking, chewing, and swallowing.
Tongue swelling that’s related to cancer does not go away on its own and may get worse over time.
If your tongue swelling is getting worse or you have other serious symptoms (like trouble breathing), seek emergency care rather than wait to be seen by your healthcare provider.
If your tongue is only a little swollen and you don’t have other symptoms, you can call your provider and make an appointment.
To figure out what’s causing the swelling, your provider will look at your tongue and the tissue around it. They’ll also make sure that your airway is not getting blocked.
Here are some key points that your provider will be thinking about during the exam:
- Is there an immediate risk to your breathing?
- Do you have an underlying condition such as an autoimmune disease?
- Do you have other symptoms such as hives?
- What is your medical history, current medications, diet, and lifestyle?
If your provider thinks you have an allergy, are having a drug reaction, or have an underlying medical problem that hasn’t been diagnosed, they might need to do more tests.
For example, they might scrape a bit of tissue off your tongue and send it to a lab to be looked at under a microscope. If they think you might have an autoimmune disease, they may order blood tests.
In some cases, your provider might choose to start you on treatment before they figure out the exact cause of your swollen tongue. For example, they might be able to give you medicine to make sure the swelling does not get worse.
If your airway is blocked, the most important goal of treatment will be making sure that you can breathe. The next steps are to get the swelling down and ease any discomfort you have.
Once your immediate needs are met and you’re safe, your provider will help you take steps to prevent a swollen tongue in the future.
Up to 15% of people with angioedema will have a blocked airway. To prevent them from dying from not being able to breathe, they need to have an injection of epinephrine right away.
In less severe allergic reactions, an oral antihistamine can be given instead.
If tongue swelling is not related to an allergy, your provider may use one of these treatments:
- For a reaction caused by too much bradykinin: You might be given an antihistamine, epinephrine, oral corticosteroids, or a preventive drug such as Berinert (C1-esterase inhibitor concentrate) that stops your body from making the chemical.
- For oral sores and inflammation: You might be given topical corticosteroids or retinoic acid to help the lesions heal.
If you have a swollen tongue because you have an infection or a medical condition, your tongue won’t get better until you treat the root cause.
To help with symptoms, your provider might also recommend products that relieve dry mouth.
For example, prescription medications like Salagen (pilocarpine) and Evoxac (cevimeline) increase saliva production. There are also OTC rinses and sprays that work as “artificial saliva” to add moisture to your mouth.
If your tongue swelling isn’t very bad and is not getting any worse, there are some things you can do at home to help with your symptoms until you can see your provider:
- Eat and drink something cool. Suck on ice chips to soothe your mouth and ease the swelling.
- Practice good oral hygiene such as brushing and flossing. Avoid irritating mouthwashes, such as those that have alcohol in them.
- Rinse your mouth with a warm saltwater solution.
- Avoid very acidic or extremely salty foods.
- If a dry mouth is causing tongue discomfort, keep it moist by drinking plenty of fluids and using lozenges or gum. Just make sure that any gum or hard candy you choose is sugar-free. These versions have ingredients (like xylitol) that make your mouth produce more saliva, which helps relieve dry mouth.
The causes of a swollen tongue can include allergies, infections, trauma, GERD, drug reactions, autoimmune diseases, or rare disorders. While it’s less common, tongue cancer can also cause a swollen tongue.
If you have a swollen tongue that isn’t very bad, make an appointment to see your provider. If the swelling is getting worse and you have other symptoms (like not being able to breathe) you need to seek emergency medical care.
The treatment for a swollen tongue depends on what’s causing it. Good oral hygiene, antibiotics, antihistamines, corticosteroids, and products that help keep your mouth moist may help.