The underside of the tongue contains several natural structures that might appear as bumps or irregularities. Understanding these normal anatomical features can help distinguish typical variations from potential concerns.
Normal Structures Under Your Tongue
A prominent structure beneath the tongue is the lingual frenulum, a thin band of tissue that connects the tongue to the floor of the mouth. This fold of mucous membrane helps to anchor the tongue and stabilize its movements. It typically runs along the midline, visible when the tongue is lifted.
Adjacent to the lingual frenulum are the plica fimbriata, delicate, fringed folds of mucous membrane. These folds run parallel to the frenulum and can appear as small, bumpy lines or horn-like projections. These are natural remnants from the tongue’s development and are generally considered harmless.
The sublingual glands, the smallest of the major salivary glands, are located beneath the tongue and produce saliva that is primarily mucous in nature. Saliva from these glands drains into the mouth through numerous tiny ducts, known as the ducts of Rivinus, which open along elevated ridges called sublingual folds. The submandibular gland’s main duct, Wharton’s duct, also opens at the sublingual caruncle, a small papilla found on each side of the lingual frenulum, and these openings can sometimes be visible as small bumps.
Visible blue or purplish lines on the underside of the tongue are usually the lingual veins. These veins are a normal part of the anatomy, and their visibility is due to the thin mucous membrane covering them. With increasing age, these veins can become more prominent, appearing enlarged or twisted, a condition sometimes referred to as “caviar tongue” or sublingual varicosities, which is generally benign. While the underside of the tongue contains many normal features, certain noticeable bumps can arise from various non-cancerous conditions. These are often benign, meaning they are not serious, and may resolve without intervention or be easily managed.
Fluid-filled sacs, known as mucoceles or ranulas, can appear if a salivary gland duct becomes blocked or damaged. Mucoceles are typically smaller, while ranulas are larger cysts that specifically develop on the floor of the mouth, often appearing as a translucent, bluish swelling. These are usually painless, but a large ranula might interfere with speech or swallowing.
Sublingual tori are benign bony growths that can form on the inner side of the lower jaw, beneath the tongue. These are typically harmless and painless, varying in size and shape among individuals. They usually require no treatment unless they become large enough to interfere with chewing, speaking, or the fitting of dental appliances.
Minor trauma or irritation is a frequent cause of temporary bumps or swellings. This can result from biting the tongue, consuming sharp or hot foods, or other localized irritation. Such bumps are generally short-lived, resolving on their own as the irritated tissue heals.
Fibromas are common, benign growths of connective tissue that develop in response to chronic irritation or repeated trauma. These smooth, pink or white bumps are typically painless and can occur on the tongue or other oral surfaces. They may be removed if bothersome or if irritation persists.
Oral papillomas are benign, wart-like growths on the tongue or other oral tissues, caused by certain types of human papillomavirus (HPV). They appear as painless, pink or white bumps with a cauliflower-like texture. While generally harmless, medical evaluation may be warranted to confirm their nature.
When to Consult a Professional
While many bumps under the tongue are harmless, certain signs warrant evaluation by a healthcare professional. It is important to monitor any new or changing oral features to ensure timely diagnosis and appropriate management.
Consult a doctor or dentist if a bump under your tongue persists for more than two weeks, or if it causes increasing pain, tenderness, or discomfort. Noticeable changes in the bump’s size or shape, especially rapid growth, also warrant professional advice. Any unexplained bleeding from the bump or surrounding area should be promptly investigated.
Changes in the color of the bump or surrounding tissues, such as new red, white, or dark patches that do not go away, indicate a need for professional assessment. Difficulty with basic functions like swallowing, speaking, or moving the tongue or jaw should prompt a visit. Be aware of associated symptoms such as fever, swollen lymph nodes in the neck, numbness in the mouth, a persistent sore throat, or unexplained weight loss.