Pain under the tongue

Definition

Pain under the tongue is the term used to describe all subjective sensations of pain in the lower part of the oral cavity. The extent and quality of pain in this area can vary. Depending on the cause, burning pain, pressure pain or tension pain may dominate. Pain under the tongue is based on the fact that the oral cavity is in contact with many environmental substances. If certain substances or irritants are classified as “dangerous” by the body’s own defense system, they can cause inflammation and pain under the tongue.

Causes

The causes of pain under the tongue can be roughly divided into 3 categories. As triggers, we distinguish incompatibilities/allergies from bacterial/viral inflammation and other diseases. Frequently, intolerance reactions or allergies occur with mouthwashes, toothpaste, food (see: food allergy) or medication (see: medication intolerance).

These incompatibilities are often harmless and the complaints are spontaneously reduced if the irritant causing them is avoided. Rarely, however, is an allergic reaction so severe that swellings occur in the entire throat area, leading to shortness of breath and requiring emergency medical treatment. Viral and bacterial inflammation can cause pain under the tongue.

An example of a viral cause is the so-called herpes simplex infection. In the course of the infection a mouth rot, a so-called gingivostomatitis herpetica, can develop. Various bacteria can also cause pain under the tongue.

Among other things, they can also cause inflammation of the salivary glands with accompanying pain under the tongue. For differential diagnosis, so-called oral floor and tongue base abscesses (see: abscess), which cause pain under the tongue, must be distinguished. As a rule, the abscesses form due to inflammation that has developed after injuries to the oral mucosa, for example after dental surgery or other interventions in the oral cavity.

If they are highly susceptible to inflammation, an underlying metabolic disease, such as diabetes mellitus, should be excluded. In addition, mucous membrane ulcers, so-called aphtae, can cause pain under the tongue. These are often caused by vitamin and mineral deficiencies, stress or hormonal changes.

These often develop, for example, during puberty, menstruation, pregnancy, menopause or in immunocompromised people. A cyst, a so-called frog tumour (ranula), can also form under the tongue. In addition, salivary stones can cause tension pain under the tongue.

The mucous membrane of the mouth can also be injured and hurt by burns caused by excessively hot food or drinks. A cyst, a so-called frog tumor (ranula), can also form under the tongue. In addition, salivary stones can cause tension pain under the tongue.

The mucous membrane of the mouth can also be injured by burns caused by excessively hot food or drinks and can be painful. After a tongue piercing, the tongue and the floor of the mouth can be painfully swollen by the procedure. These complaints should usually subside after a few days and be completely healed after about 2-3 weeks.

In rare cases an inflammation can occur due to unclean materials or material incompatibilities. The mucous membrane of the mouth can also be injured, the area can become inflamed and cause pain under the tongue. In these cases it is advisable to consult a doctor.

Tumours, inflammations, stones and tumours of the salivary glands can cause pain under the tongue. A frog tumor is a congenital or trauma-acquired adhesion of the sublingual salivary gland. If the gland is closed, the tumor can cause pain under the tongue when it is heavily filled and even push the tongue aside.

The tumor usually appears as a reddish-bluish, fluid-filled cyst. Inflammation of the salivary glands usually affects the parotid gland (see: Inflammation of the parotid gland) and causes pain under the tongue only when the pain is strong. Salivary stones can cause tension pain under the tongue.

Due to the tortuous duct, the parotid gland of the lower jaw is often affected. The salivary stones develop by changing the composition of the saliva.It is suspected that this can happen during an infection. Even after a permanent secretion congestion, with a narrowed salivary gland duct, salivary stones can follow.

The formation of salivary stones can manifest itself with or without signs of inflammation and with more or less pain. Less frequently, tumors of the salivary glands are responsible for pain under the tongue. In 80% of cases, the parotid gland is affected. A tumor in the sublingual salivary gland is a rarity.