Consuming excessively hot food or liquid exposes the body’s tissues to a thermal challenge that can cause rapid injury, known as a scald burn. The delicate lining of the mouth and throat is highly sensitive to heat. Temperatures above 110 degrees Fahrenheit can cause a superficial burn, while 160 degrees Fahrenheit or higher can cause a burn almost instantly upon contact. The severity of the resulting damage depends on the substance’s temperature, the volume ingested, and the duration of contact with the tissue.
Immediate Impact on the Oral Cavity
The initial site of injury is the oral cavity, where the hot substance makes contact with the tongue, lips, inner cheeks, and the soft palate. These areas typically sustain first-degree, or superficial, burns because contact time is usually brief before the immediate pain sensation causes the person to spit out or quickly swallow the item. A common example is the localized burn on the roof of the mouth often called “pizza palate” from hot cheese or sauce.
Symptoms of these superficial injuries include immediate redness, localized swelling, and tenderness. Blistering may occur, which signals a deeper, second-degree burn, though this is less common with quick contact. A temporary side effect is a dulled or lost sense of taste in the burned region of the tongue, which usually returns as the tissue heals. Most minor oral burns are self-limiting and tend to heal completely within a week to ten days without scarring.
Thermal Injury Progression Down the Esophagus
If the hot substance is swallowed, the thermal injury can progress past the mouth into the pharynx (throat) and down the esophagus, the muscular tube leading to the stomach. The lining of the esophagus is susceptible to heat damage, and a hot liquid or solid can leave a path of injury as it travels down. Symptoms suggesting damage in this area include pain or difficulty when swallowing (odynophagia or dysphagia), and a sensation of a foreign body being stuck in the chest.
A danger following internal thermal injury is swelling (edema) in the throat and upper esophagus. This swelling can potentially narrow the passage, making breathing or swallowing saliva difficult. In severe cases, particularly with hot liquids, the injury may manifest endoscopically as linear erythema and white pseudomembranes, sometimes described as a “candy-cane” appearance. While the stomach lining is relatively resilient, deeper burns in the esophagus can lead to ulceration, perforation, or long-term stricture.
Immediate First Aid and Home Care
For superficial oral burns, the immediate goal is to stop the burning process and soothe the irritated tissues. This involves cooling the area by rinsing the mouth with cool water for several minutes or sucking on ice chips or a popsicle. Drinking cold milk is also helpful because it can coat the scorched tissue and provide relief.
Pain can be managed with over-the-counter pain relievers such as ibuprofen, which also helps reduce swelling. Avoid irritating the healing tissue by temporarily eliminating certain foods and beverages. This includes acidic items, spicy foods, alcohol-based mouthwashes, and crunchy or sharp-edged foods like potato chips. Saltwater rinses can also be performed to keep the area clean and promote healing.
When to Seek Emergency Medical Attention
While most burns from hot food are mild and resolve with home care, certain symptoms indicate a severe internal injury requiring immediate professional assessment. Seek emergency medical attention if you experience difficulty breathing, signaled by shortness of breath or hoarseness, as this could suggest swelling has compromised the airway. An inability to swallow liquids, including saliva, or having food feel stuck in your throat is also a significant warning sign.
Other serious symptoms include persistent, forceful vomiting, especially if the vomit contains blood or material resembling coffee grounds, or if you pass bloody stool. Severe chest or abdominal pain lasting more than a few minutes should prompt immediate medical evaluation. Any signs of shock, such as cool, clammy skin, a weak pulse, or shallow breathing, also necessitate emergency care.