If you find what appears to be a hole in your tongue, the first thing that comes to mind might be tongue cancer. You can breathe a sigh of relief, though, as the chances of it being cancer are slim.
According to the National Cancer Institute, tongue cancer is very rare and makes up only 1 percent of new cancers in the U.S.
Chances are, what you’re seeing isn’t actually a hole. Only a body modification procedure, such as a tongue piercing, or a traumatic injury can cause a hole in your tongue.
Seek immediate medical treatment if the hole in your tongue is the result of a traumatic injury.
There are other things that can make it look like you have a hole in your tongue. Read on to learn what can cause the appearance of a hole in your tongue and when it’s time to see a doctor.
Fissured tongue is a harmless condition that affects the top portion of your tongue. Rather than having a flat surface, a fissured tongue has a single groove down the center or multiple smaller furrows called fissures.
According to the American Academy of Oral Medicine, fissured tongue occurs in approximately 5 percent of the U.S. population.
Fissures can vary in depth and length. Sometimes, a fissured tongue has such a deep groove in the center that it can appear as though the tongue is split in half. Smaller fissures can also form on other areas of your tongue.
Fissures can be present at birth, but they seem to become more noticeable with age. Some people with fissured tongue have another harmless tongue condition called geographic tongue, which causes smooth patches with raised borders.
The exact cause of fissured tongue is unknown. It doesn’t require treatment and isn’t considered a cause for concern.
Canker sores are shallow, painful ulcers that develop in the soft tissues of your mouth or at the base of your gums. There are different types of canker sores, but minor canker sores are most common.
Minor canker sore
Minor canker sores usually have a red border and appear:
- round or oval-shaped
- white or yellow in the center
They typically heal in a week or two on their own, but they can be painful, especially when eating or drinking.
Major canker sore
Major canker sores are larger and deeper than minor canker sores. They can have irregular borders and be very painful.
It can take as long as six weeks for them to heal, and they can cause severe scarring.
Canker sores aren’t contagious. Their cause is unknown, but they’re linked to the following:
- minor injury to your mouth, such as biting your cheek or aggressive brushing
- food sensitivities
- emotional stress
- toothpastes and mouthwashes that contain sodium lauryl sulfate
- not getting enough iron, folate, or vitamin B-12 in your diet
Having a medical condition that weakens your immune system can also increase your risk of canker sores.
Syphilis is a sexually transmitted infection that can cause sores on your tongue. These sores are called chancres. They appear during the first stage of infection at the original site of infection.
Chancres can also appear on your lips, gums, and back of your mouth. They start off as small red patches and eventually grow into larger sores that can appear red, yellow, or gray.
Oral syphilis can be transmitted by having oral sex with a person carrying syphilis-causing bacteria, even if they don’t have any signs or symptoms.
Chancres are highly contagious and can be very painful. They can last anywhere from three to six weeks and heal on their own with or without treatment.
Even if the sores disappear, you still have the bacteria in your body and can spread it to others, so it’s important to follow up with antibiotic treatment. Left untreated, syphilis can cause heart and brain damage, organ failure, and other serious complications.
There’s a very small chance that the hole you’re seeing is a symptom of tongue cancer.
Tongue cancer can form on two parts of the tongue: the oral tongue or the base of the tongue. Cancer on the oral tongue, which is the front portion of your tongue, is called oral tongue cancer. Cancer at the base of your tongue, where your tongue attaches to your mouth, is called oropharyngeal cancer.
Tongue cancer can cause an ulcer, which may resemble a hole in your tongue. Other possible symptoms of tongue cancer include:
- a red or white patch on the tongue that doesn’t go away
- an ulcer or lump that doesn’t go away or continues to grow
- pain when swallowing
- chronic sore throat
- unexplained bleeding from the tongue
- numbness in the mouth
- persistent ear pain
Still, many other conditions can cause similar symptoms. If you’re concerned that you may have tongue cancer, see your healthcare provider. They can rule out the other potential causes of your symptoms and conduct follow-up testing if needed.
A canker sore or indentation from a dental appliance or your teeth can make it appear as if you have a hole in your tongue.
You should be evaluated by a doctor if you notice any changes to your tongue’s appearance that last more than two weeks or experience any of the following:
- unusually large sores or ulcers
- recurring or frequent sores
- severe pain that doesn’t seem to improve
- a sore or ulcer accompanied by fever
- extreme difficulty eating or drinking
You should also see a doctor if there’s a chance you’ve been exposed to syphilis or have symptoms of tongue cancer.
What appears to be a hole in your tongue is likely a harmless fissure or sore that doesn’t require any treatment. The chance of it being something serious is rare.
See your doctor if it lasts more than two weeks or is accompanied by other worrying symptoms, such as a fever or extreme pain that interferes with your ability to eat or drink.