Sharp pain under the tongue when swallowing can be an unsettling sensation. This discomfort, located in an area crucial for oral function, is often linked to common, non-life-threatening conditions.
Understanding the Common Causes
Minor Injuries
Pain under the tongue during swallowing often stems from minor injuries. Accidental biting of the tongue or soft tissues, cuts from sharp foods like chips or crusty bread, or burns from hot beverages can irritate the delicate lining, leading to temporary pain.
Oral Sores
Oral sores are another frequent source of localized pain. Canker sores, also known as aphthous ulcers, are small, shallow lesions that can develop on the tongue or inner cheeks and lips. They typically appear with a white or yellowish center and a red border, often triggered by stress, minor trauma, or certain dietary elements. Though not contagious, they can make eating and talking uncomfortable for one to two weeks.
Salivary Gland Issues
Issues with the salivary glands beneath the tongue can also cause sharp pain. Sialolithiasis, a condition where small stones form within the salivary ducts, is a common culprit. These stones can obstruct saliva flow, leading to pain and swelling, particularly noticeable during meals. The submandibular and sublingual glands, whose ducts open under the tongue, are often affected. If left unaddressed, these blockages can lead to sialadenitis, an infection or inflammation of the salivary gland.
Infections
Infections within the mouth can also cause pain under the tongue. Oral thrush, a fungal infection caused by an overgrowth of Candida albicans, can present as creamy white patches on the tongue and inner cheeks. This infection can cause redness, soreness, and difficulty swallowing. Other bacterial or viral infections in the oral cavity may also contribute to localized pain.
Dental Problems
Dental problems can sometimes refer pain to the area beneath the tongue. A severe tooth infection, such as an abscessed tooth, can lead to widespread bacterial infections in the mouth and jaw. In rare but serious cases, this can result in Ludwig’s angina, a rapidly spreading bacterial infection in the floor of the mouth that causes significant swelling under the tongue and jaw. An impacted wisdom tooth, especially in the lower jaw, might also cause pain that radiates to this region.
When to Consult a Doctor
Persistent or Worsening Pain
While many instances of sharp pain under the tongue resolve without specific medical intervention, certain signs indicate the need for professional evaluation. If the pain persists for more than two weeks without improvement, or if it rapidly worsens, a medical consultation is advisable. Severe pain that significantly interferes with daily activities like eating or speaking also warrants attention.
Accompanying Symptoms
Accompanying symptoms can signal a more serious underlying issue. The presence of fever, chills, or a general feeling of malaise alongside the pain suggests a potential infection that may require medical treatment. Any significant or rapidly developing swelling under the tongue or in the neck area should prompt immediate medical assessment, as this could indicate a serious infection or other concerning condition.
Urgent Symptoms
Difficulty breathing or severe difficulty swallowing are particularly concerning symptoms that require urgent medical attention. These could indicate an airway obstruction, especially in the case of conditions like Ludwig’s angina, where swelling can rapidly compromise breathing. Numbness or tingling in the tongue or mouth, or unexplained weight loss and fatigue, are also red flag symptoms that necessitate a thorough medical investigation to rule out less common but more serious causes.
Managing Discomfort and Prevention
Home Remedies
Immediate relief from discomfort can often be achieved through simple home remedies. Rinsing the mouth with warm salt water several times a day can help reduce inflammation and keep the area clean, potentially preventing infection. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help manage the pain and reduce swelling. Applying ice chips or sucking on ice pops can provide a temporary numbing effect. For localized sores, oral numbing gels or pastes made from baking soda and water might offer temporary comfort.
Dietary Adjustments
Dietary adjustments play a role in managing symptoms and promoting healing. It is advisable to avoid foods that can irritate the sensitive tissues under the tongue, such such as highly acidic (e.g., citrus fruits, tomatoes), spicy, or very hot items. Crunchy or sharp foods that could further injure the area should also be avoided. Opting for soft, bland foods that are easy to chew and swallow, served at lukewarm or room temperature, can minimize irritation during meals.
Oral Hygiene
Maintaining good oral hygiene is fundamental for both managing current discomfort and preventing future issues. Gentle but thorough brushing of teeth and flossing helps reduce bacteria in the mouth, which can prevent infections from worsening or developing. Using a soft-bristled toothbrush and a mild toothpaste can prevent further irritation. Tongue scraping can also help remove bacteria and debris from the tongue’s surface.
Adequate Hydration
Adequate hydration is important for overall oral health and salivary gland function. Drinking plenty of water throughout the day helps maintain a healthy flow of saliva, which naturally cleanses the mouth and aids in digestion. Saliva contains components that protect against oral infections and tooth decay. Avoiding dehydration can help prevent the thickening of saliva, which can contribute to the formation of salivary stones.
Preventive Measures
Preventive measures include being mindful during eating to avoid accidental trauma to the tongue and soft tissues. Regular dental check-ups are important for identifying and addressing dental issues early before they contribute to pain under the tongue. Avoiding tobacco products and excessive alcohol consumption also supports oral health, as these can irritate mouth tissues and contribute to various oral problems.