Swelling under the tongue can be a noticeable and sometimes alarming symptom. This area of the mouth is intricate, containing various structures that can become inflamed or obstructed, leading to swelling. Understanding the potential causes helps individuals recognize when to seek professional medical advice, as some may require prompt attention.
Anatomy of the Oral Cavity Floor
The floor of the oral cavity, beneath the tongue, houses several important structures. This includes the sublingual and submandibular salivary glands. The sublingual glands lie directly under the tongue, producing mostly mucous saliva. Their secretions drain into the mouth through several small ducts that open along folds of tissue under the tongue.
The submandibular glands, situated beneath the jaw, also have ducts that open into the floor of the mouth, near the lingual frenulum. The floor of the mouth also contains blood vessels, nerves, and small lymph nodes, all of which can be involved in swelling.
Causes of Swelling
Swelling under the tongue can stem from various underlying conditions, ranging from common blockages to more complex infections or growths. A frequent cause involves issues with the salivary glands, particularly the sublingual and submandibular glands.
Salivary Gland Issues
Salivary stones, known as sialolithiasis, are mineral deposits that can form in the ducts of these glands. These stones can block saliva flow, causing the gland and surrounding area to swell, especially during or after meals when saliva production increases. A complete obstruction can cause intense pain.
Sialadenitis is an inflammation or infection of a salivary gland. This can occur due to bacterial or viral infections, or as a result of a salivary stone causing a blockage. While commonly affecting other glands, it can also involve the sublingual glands.
Infections
Infections beyond the salivary glands can also lead to swelling. Bacterial infections can cause abscesses (localized collections of pus) or spread as cellulitis. Ludwig’s angina, a rapidly progressing cellulitis often from a dental infection, can cause significant swelling and elevate the tongue. Viral infections like mumps can also affect the submandibular and sublingual glands.
Trauma
Physical trauma or injury to the mouth can result in localized swelling. This includes biting the tongue, cuts from sharp food, or irritation from dental procedures or ill-fitting dentures. Such injuries can cause bleeding and fluid accumulation, potentially leading to a sublingual hematoma.
Allergic Reactions
Allergic reactions can manifest as sudden swelling under the tongue, called angioedema. This occurs when the body releases chemicals in response to an allergen, causing fluid to leak into tissues. Common triggers include certain foods, medications (like ACE inhibitors), or insect stings.
Cysts and Growths
Various types of cysts and growths can appear under the tongue. A ranula is a common mucous cyst that forms when a salivary gland is damaged or blocked, causing saliva to leak into the surrounding tissues. These cysts often appear as clear or bluish lumps. Benign or malignant growths in the salivary glands or other tissues can also present as swelling.
Associated Symptoms
Swelling under the tongue often accompanies other symptoms. Pain is a common companion, ranging from a dull ache to sharp, intense discomfort, and may worsen with eating if a salivary gland is involved. The affected area might also feel tender to the touch, appear red, and feel warm.
The swelling can interfere with normal oral functions, causing difficulty swallowing or trouble speaking clearly. A fever and chills can indicate an infection, and a foul taste or pus might be present if the cause is bacterial. Increased drooling or a feeling of dryness in the mouth can also occur.
When to Seek Medical Attention
While some swelling under the tongue may resolve on its own, certain signs indicate the need for prompt medical evaluation. Seek immediate medical attention if the swelling develops rapidly or is accompanied by difficulty breathing or swallowing. Severe, increasing pain, or a high fever and chills also warrant urgent care.
Medical consultation is advisable if the swelling spreads quickly, if redness or warmth extends beyond the initial area, or if pus drains from the site. Any swelling that persists without improvement for more than a few days, or if it interferes with daily activities like eating or speaking, should also be evaluated by a healthcare professional.