A sore tongue may result from an injury or a mouth ulcer, which can typically heal on its own. Sometimes, a sore tongue can be a symptom of a more serious issue, including a vitamin deficiency, infection, or chronic condition.

If your tongue is sore, it can be pretty hard to ignore. It may bother you when you speak or eat, and you may worry that something is seriously wrong. The good news is that most causes of a sore tongue aren’t a reason for concern.

Here are some of the most common causes, as well as when you should head to the doctor.

Biting down hard on your tongue can be extremely painful. Eating something very hot can burn your tongue and even blister it. Grinding your teeth or clenching them may cause pain on the outer edges of your tongue.

Just like when you bang your arm or leg, the pain from trauma doesn’t necessarily go away immediately. Whatever the case may be, injury to your tongue may make may it feel sore and uncomfortable until the damage fully heals.

You may develop what are called enlarged papillae on your tongue. These white or red bumps are sometimes referred to as lie bumps or transient lingual papillitis. This means you have swollen taste buds, and they can be painful. They usually clear up in a few days on their own.

Oral thrush is a type of yeast infection that may cause tongue pain. You may see white patches that look like cottage cheese on your tongue. This infection is more common in babies and older adults, especially those who wear dentures or have weakened immune systems. You may develop oral thrush if you’ve recently taken antibiotics. It can also occur in people who use steroid inhalers to manage their asthma.

Other infections may also give you a sore tongue, such as:

Your tongue pain may be focused around a specific spot. If you open your mouth to look, you may see a round or oval ulcer or canker sore. It may be whitish in appearance or sometimes red, yellow, or gray.

These spots can develop for a number of reasons, like:

  • biting your tongue or other damage
  • eating something hard or sharp
  • experiencing stress or anxiety
  • eating particular foods
  • stopping smoking
  • undergoing hormonal changes

Ulcers generally heal after a week or two with no other treatment. You may take over-the-counter pain medications to help ease the discomfort. You may also want to avoid eating things like spicy foods that may irritate your tongue further.

That’s right — certain foods may make your tongue hurt. You may have what’s called oral allergy syndrome. This condition is also known as pollen-food syndrome, and it’s most often caused by raw fruits, vegetables, and certain tree nuts.

Along with a sore tongue, you might experience:

  • an itchy mouth
  • a scratchy throat
  • swelling of your lips, mouth, or tongue

Oral allergy syndrome is more likely to start in older children, teens, and younger adults. If your reaction is severe, your doctor may suggest you carry an epinephrine auto-injector.

Smoking — and even stopping smoking — can cause tongue pain. When you smoke, you also put yourself at a higher risk of developing cancer in your mouth and throat.

Other issues smoking can cause in your mouth include:

  • stained teeth
  • bad breath
  • tooth decay and loss
  • hairy tongue from bacteria and yeast growth
  • brown spots on your gums
  • thickened and pale or white palate, or roof of your mouth

Stopping smoking today can halve your risk of developing oral cancer within five years, according to a 2010 report from the U.S. surgeon general for the Centers of Disease Control and Prevention.

Still don’t know what’s going on? There are other, less common causes of pain that you may want to discuss with your doctor. With many of these health issues, you may experience more than just a sore tongue.

You may have a smooth, sore tongue if your body is deficient in either vitamin B-12, iron, or folate. If you’re deficient in vitamin B-12, your tongue may also be beefy red in color. Low levels of zinc can cause a burning tongue.

Other symptoms of vitamin deficiencies include:

  • fatigue
  • dizziness
  • irregular heartbeats
  • unexplained weight loss
  • muscle weakness
  • numbness or tingling in your hands and feet

Vitamin deficiencies generally develop over a long period of time — anywhere from several months to years. Treatment involves eating a well-balanced diet, taking supplements, and sometimes receiving vitamin injections.

Does your pain feel more like burning? Burning mouth syndrome, or burning tongue syndrome, can cause this sensation on your tongue or in other areas of your mouth, like the inside of your cheeks, gums, lips, or palate. You may even feel at times like you’ve eaten extremely hot foods and have scalded your tongue. The feeling can happen suddenly or develop over time. Other symptoms include increased thirst or dry mouth and taste changes or a loss of taste.

Neuralgia results from nerve irritation or damage. It may be a reason people experience recurring tongue pain if there’s no other obvious cause, like trauma or infection.

The type of pain associated with this condition is intense, like an electric shock. You may feel it on your tongue or in your throat, tonsils, or ears. It may be triggered by swallowing and can occur in people who have throat or neck cancer. Otherwise, the cause isn’t always known.

If you end up having this condition, you may need to take medications to help with nerve pain or discuss surgery with your doctor.

Lichen planus is a chronic skin issue that causes anything from an itchy rash on your skin to white lacy patches and pain on your tongue. More mild cases of this disorder may not cause any discomfort at all. Other symptoms include red or white patches in your mouth or burning while eating or drinking. You may even develop painful red gums with this condition. Treatment may be ongoing.

Behcet’s disease causes blood vessel inflammation throughout your body. It’s a rare reason for tongue pain, but it may cause mouth sores that look like canker sores. These sores begin as round, raised areas of irritation. They may last anywhere from one to three weeks and may return with time.

Other symptoms of this condition include:

  • acne-like sores and lumps on your skin
  • inflammation in your eyes
  • joint pain
  • digestive issues
  • genital ulcers

Moeller’s glossitis is also called atrophic glossitis or even “bald” or “smooth” tongue. This condition is a type of inflammation of the tongue. It can cause pain, irritation, or a burning sensation. Your tongue may become smooth and even glossy in appearance because your taste buds have atrophied. This condition is usually related to nutritional deficiencies, like vitamin B-12 deficiency or anemia, or even celiac disease.

Do you take nonsteroidal anti-inflammatory drugs, like naproxen (Aleve), or beta-blockers? Some studies have suggested that these medications may make your tongue sore by causing ulcers. Mouthwashes may also irritate your tongue and make it sore.

Though rare, pemphigus vulgaris is a disorder that can cause painful sores in your mouth or on your genitals. These sores may show up as blisters in your mouth. They may rupture and ooze and become infected. You may even find it difficult to eat or swallow. Treatment usually involves different medications or therapies like those that are used to treat severe burns.

Another rare cause of tongue pain is oral cancer. Again, there are many reasons you may have a sore tongue — cancer is only a remote possibility. If you notice pain with a lump or sore that doesn’t go away, you may want to head to the doctor for a checkup.

Other symptoms include:

  • painful chewing
  • painful swallowing
  • loose teeth
  • sores that won’t heal
  • sores that bleed
  • thickening of the skin that lines your mouth

Oral cancer may not cause pain in the early stages, so it’s a good idea to head to your doctor if you feel a lump even without pain for two weeks or longer.

Sjögren syndrome is an autoimmune disorder that leads to inflammation in the salivary and lacrimal glands, which results in chronic dry eyes and dry mouth. It’s also typically associated with skin changes, joint pain, and other issues. It’s unclear why some people develop Sjögren syndrome. In people with chronic dry mouth, the tongue can become dry and fissured, and can easily develop ulcers and infections.

Call your doctor or dentist if you notice any changes in your tongue that concern you. These changes may include anything from a change in color, lumps, and sores to pain that continues for two weeks or longer.

In many cases, pain isn’t a reason to worry, but your doctor can help you rule out more rare causes of tongue discomfort, like pemphigus vulgaris or oral cancer. Your doctor can also prescribe medications to get oral thrush, infections, or other issues under control so you’re feeling better soon.