A burn of the tongue is a common ailment. Typically, the condition occurs after you eat or drink something that is too hot. Standard first aid treatment for burns also applies to a burn of the tongue.
A mild burn of the tongue may be a nuisance, but will eventually heal. Serious burns, however, require the same immediate medical attention that you would give to a burn on any other part of your body.
In some cases, you may experience a burning sensation on your tongue without having burned it. This condition is called burning tongue syndrome.
Underestimating the temperature of steam, hot food, or liquids can cause a burn on your tongue, as well as on other areas of your mouth or lips.
Burning tongue syndrome, also called idiopathic glossopyrosis, is a condition that can make you feel the sensation of burning on the tongue for no apparent reason.
According to the Mayo Clinic, there are two types of burning tongue syndrome: primary and secondary. Primary burning mouth syndrome is the type for which there is no known cause. Secondary burning mouth syndrome is that which is likely caused by another medical condition.
Secondary burning mouth syndrome may be caused by:
- dry mouth (often a side effect of medications or a symptom of another medical condition)
- thrush (oral yeast infection)
- oral lichen planus (an often chronic inside-the-mouth inflammation that is caused by the immune system launching an attack on the mouth’s mucous membrane cells)
- geographic tongue (a condition in which the tongue’s surface is missing some of its typical small bumps, called papillae, and instead has areas of red, sometimes-raised patches that tend to disappear and then reappear in different areas of the tongue)
- vitamin deficiencies
- anxiety, depression, or extreme worry
- damage to the nerves
- allergic reaction to certain foods
- stomach acid that makes its way into the mouth (from conditions such as gastroesophageal reflux disease, or GERD)
- medications, such as those used for high blood pressure
- diabetes, hypothyroidism, and other endocrine disorders
- an imbalance of hormones, such as during menopause
- grinding the teeth, brushing the teeth too hard, using mouthwash too often, and other unhealthy oral habits (Mayo)
Frequently eating and drinking extremely hot food and beverages without testing the temperature first will put you at a higher risk for a burn of the tongue.
Postmenopausal women are at an increased risk for developing burning tongue syndrome. This may be related to a reduction in their estrogen levels. This hormonal change causes a decline in the sensitivity of taste buds.
A burn of the tongue will look and feel different, depending on the degree of the burn:
- A first-degree burn injures the outermost layer of the tongue. You will experience pain, and the tongue may become red and swollen.
- A second-degree burn is more painful because it injures both the outermost and under layer of the tongue. Blisters may form, and the tongue will appear red and swollen.
- A third-degree burn affects the deepest tissue of the tongue. The effect is white or blackened, burnt skin. You may also experience numbness or severe pain.
When the tongue becomes red or swollen, the bumps on the tongue—papillae—may disappear. This can give the tongue a smooth, rather than bumpy, appearance. Papillae are the small bumps that cover most of the upper part of the tongue. Between these bumps are the taste buds. A burn may also lessen your sense of taste as well. However, this is most often a temporary side effect unless the burn is severe.
In addition to feeling a burning sensation on the tongue, symptoms of burning tongue syndrome include:
- a tongue that feels normal in the morning, but worsens throughout the day
- a daily repetition of burning symptoms
- a metallic or bitter taste that accompanies the burning sensation
- a feeling of having a dry mouth, despite normal saliva production
If not identified and treated properly, a severe burn of the tongue can become infected. Second-degree and third-degree burns should always receive attention from a medical professional.
A burn of the tongue can also destroy taste buds, creating a lack of sensation where the burn occurred. However, this is typically a short-term complication, since your taste buds regenerate about every two weeks.
If you have burning tongue syndrome, the severe, untreatable pain can sometimes lead to feelings of depression and anxiety.
Redness, swelling, and blistering are signs of a burn of the tongue. Your doctor can likely diagnose the condition by simply examining your tongue.
Burning tongue syndrome is diagnosed by excluding diseases and conditions of which the sensation may be a symptom. Your doctor will first want to discuss your oral care habits, to see if any such habits (overusing mouthwash, brushing excessively hard) are causing your symptoms.
You may also receive any of the following tests to rule out other conditions:
- blood tests - to rule out nutritional deficiencies, hormone imbalances, and endocrine (diabetes, thyroid) disorders
- oral samples - to rule out oral conditions, such as thrush and oral lichen planus
- imaging tests - to rule out other conditions that your doctor may suspect
- allergy tests - to rule out food or additive allergy-caused burning of the tongue
- saliva testing - to rule out dry mouth
- psychological surveys - questionnaires to see whether depression, anxiety, or stress may be the cause
- gastric reflux tests - to see whether you have GERD
Initial treatment for a burn of the tongue should include basic first aid. Your physician should evaluate burns that exhibit the signs and symptoms of second-degree or third-degree burns.
To avoid infection and reduce pain in a first-degree burn on the tongue:
- Rinse the area well with cool water for a few minutes.
- Remove any dirt or particles that may be on the burn.
- Wet a clean cloth with cool water and hold it on top of the burn.
- Suck on ice chips or a popsicle to soothe the pain.
- Gargle with cool water or salt water.
- Avoid warm or hot liquids, which could irritate the burn.
- Take acetaminophen or ibuprofen for pain and inflammation.
- Sprinkle a few grains of sugar on the tongue to relieve pain.
Consult your physician or dentist if the burn does not improve or becomes infected. Signs of infection may include:
- increased redness
- drainage of pus
If you are suffering from burning tongue syndrome, you may find relief from the same types of remedies as those used to treat first-degree burns. However, there are no medically approved treatments specifically for burning tongue syndrome.
Sometimes, treating the conditions that may have caused secondary burning tongue syndrome can help. For example, if your current medication is causing dry mouth, your doctor may try you out on another prescription. If stomach acid is coming up into your mouth because of the condition GERD, your doctor may prescribe medications like omeprazole (Prilosec) to reduce your stomach’s production of acid.
Most burns of the tongue heal on their own within about two weeks. However, some burns can last for up to six weeks.
Burning tongue syndrome can persist for months or even years. According to the Cleveland Clinic, approximately 30 percent of individuals with burning tongue syndrome improve within three to five years without treatment (CC).
You can prevent a burn of the tongue by testing the temperature of any hot liquid or food before you put it into your mouth. Beverages or food heated in a microwave may not be heated evenly, so extra caution should be used with products prepared this way.
There is no known way to prevent burning tongue syndrome.