Possible Causes of a Swollen Tongue and When to Contact a Doctor

A swollen tongue can result from an allergic reaction, an infection, trauma, or another incident or condition. Many cases of tongue swelling are not serious, but in some instances, a swollen tongue could indicate a serious or life threatening condition. In many cases, treatment can be as simple as maintaining good oral hygiene and changing your diet. Other cases may require professional treatment, such as prescription medications.

If your tongue swells up rapidly, this could be a symptom of an allergy or a life threatening condition called anaphylaxis. Symptoms of anaphylaxis include a swollen tongue — and swelling in general — as well as hives, itchiness, shortness of breath, and rapid breathing.

Anaphylaxis is sudden and severe, and it can include respiratory distress. If any of these symptoms occur, administer emergency epinephrine (in the form of an EpiPen), if available, and seek immediate medical care (call 911).

This article looks at possible reasons for a swollen tongue, how to care for the symptoms at home, and when to contact a doctor.

A swollen tongue is a symptom of a variety of diseases, disorders, and conditions. Some causes of a swollen tongue are serious, such as anaphylaxis. Other causes may be relatively mild, such as a small cut due to biting your tongue.

Bacterial, yeast, and viral infections can lead to glossitis, which is a condition characterized by tongue swelling. In some cases, the tongue may also become smooth or change color. Glossitis can also result from vitamin deficiencies, a dry mouth, skin conditions, and certain autoimmune conditions.

Other causes of a swollen tongue include a variety of irritants and exposure to very hot foods or beverages, spicy foods, tobacco, and alcohol. A swollen tongue can also be due to having no teeth or taking certain medications.

Potential infectious causes of a swollen tongue include:

• herpes simplex virus
• a strep infection, such as scarlet fever, caused by a strain of bacteria called group A Streptococcus
• syphilis
• a yeast infection

A swollen tongue can be due to mild and serious allergies and allergic reactions, including:

• an insect-related allergy, such as a bee sting
• a drug allergy, such as penicillin or codeine
• a food allergy
• an anaphylactic allergic reaction

A swollen tongue can also arise from irritants and sources of trauma, including:

• biting the tongue
• burning the tongue, such as with hot liquids, hot foods, or spicy foods
• using dental appliances
• using tobacco

A swollen tongue can be due to a variety of other diseases, disorders, and conditions, including:

• acromegaly, which is a hormonal disorder
• Beckwith-Wiedemann syndrome, which is a congenital disorder
• Down syndrome
• hereditary angioedema, which is a serious genetic disorder that causes periodic swelling of the throat and other areas
• hypothyroidism, or an underactive thyroid
• lymphangioma, which is a type of congenital anomaly
• oral neurofibroma, which is a benign tumor possibly due to an inherited disorder called neurofibromatosis type 1
• pellagra, which are skin lesions and other problems caused by a deficiency in vitamin B3, or niacin
• pernicious anemia, which is a decrease in red blood cells due to inadequate vitamin B12 absorption
• pituitary gland disorder
• sarcoma, which is a type of soft tissue cancerous tumor
• tongue cancer

If your tongue is swollen, you may also be experiencing other symptoms, depending on the underlying disease, disorder, or condition. Other common symptoms include tongue pain, tongue lesions, difficulty chewing, and difficulty swallowing.

A swollen tongue may occur with other symptoms of an allergic reaction, including:

• abdominal pain or cramps
• a mild cough
• mild diarrhea
• mild vomiting
• sneezing and a runny nose

A swollen tongue may also occur with other symptoms, including:

• a burning feeling affecting the tongue
• a change in tongue texture, such as the surface becoming smooth or grooved
• a change in tongue color, including white or dark patches
• fever
• general edema, or swelling
• a goiter
• a headache
• spitting blood due to trauma
• symptoms of hypothyroidism, including:
  • fatigue
  • weight gain
  • dry skin
  • hair loss
  • puffy eyes
  • depression
  • menstrual anomalies
• tongue or mouth pain and soreness

In some cases, a swollen tongue can indicate a serious or life threatening condition called anaphylaxis. This can rapidly develop into anaphylactic shock and death. If available, administer emergency epinephrine (in the form of an EpiPen) and seek immediate medical care (call 911) for a swollen tongue that occurs with any of these symptoms:

• bluish coloration of the lips or fingernails
• a change in the level of consciousness or alertness, such as passing out or becoming unresponsive
• coughing up blood
• difficulty swallowing
• feeling like your throat is tight
• general edema, or swelling, around the eyes and lips
• hives or a rash
• intense distress
• itchiness in the throat or mouth
• low blood pressure, or hypotension
• nausea or vomiting
• respiratory or breathing problems, such as:
  • shortness of breath
  • difficulty breathing
  • labored breathing
  • wheezing
  • not breathing
  • choking

Learn more about what to do for anaphylaxis here.

For many cases of tongue swelling, treatment may consist of maintaining good oral hygiene by regularly brushing and flossing the teeth. Over-the-counter pain relievers can help ease pain and discomfort.

If your swollen tongue does not respond to home treatments or you experience symptoms such as a headache, fever, and burning feeling, contact your healthcare practitioner.

If you experience serious symptoms — such as coughing up blood, difficulty swallowing or breathing, or nausea or vomiting — seek immediate medical care (call 911).

In nonemergency situations, your licensed healthcare practitioner will perform a physical examination to help diagnose the underlying cause of a swollen tongue. They may also ask you several questions related to your symptoms. Questions they may ask during your examination include:

• Is the whole tongue or just a portion of the tongue swollen?
• When did the tongue swelling start?
• How long has the tongue swelling lasted? Does it come and go?
• Before the swelling started, did you eat any foods or have any contact with any unusual substances, such as seafood, shellfish, or latex?
• Have you had any recent infections or injuries in the mouth?
• Do you have any pain or other symptoms?

If your swollen tongue does not improve on its own, your doctor may prescribe a mouthwash with corticosteroids and lidocaine to help with swelling and pain.

If the swollen tongue has resulted from another condition, an infection, or an allergic reaction, treatment may include:

• antibiotics to treat an infection
• vitamin B12 to address a deficiency
• epinephrine in the case of allergic reactions
• discontinuing any medication that is causing tongue swelling as a side effect

A swollen tongue is a symptom of numerous infections, conditions, and allergic reactions. It is not usually serious, but it can be a symptom of a life threatening allergic reaction called anaphylaxis.

If a swollen tongue occurs with symptoms such as difficulty breathing, chest or throat tightness, hives, and other swelling in the lips, mouth, or face, administer emergency epinephrine (in the form of an EpiPen), if available, and call 911.

In nonemergency cases, treatment for a swollen tongue can include maintaining good oral hygiene. If an underlying condition or infection causes a swollen tongue, treatment will focus on resolving the root cause.

If a swollen tongue does not go away with home treatment or your symptoms get worse, contact your doctor or dentist.