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Whether it’s discomfort while chewing, a sore tongue, or a burning sensation, many of us have experienced some sort of pain in our mouths.

But what could be causing it? Mouth pain has many possible causes, including injuries, sores, and certain diseases.

Keep reading to learn the potential causes of mouth pain, as well as treatment options and when it’s important to seek medical care.

Pain in your mouth can occur in many locations, including the:

  • roof of your mouth
  • inside of your cheeks
  • back of your mouth
  • gums
  • tongue

Below, we explore some general causes of mouth pain that can affect different areas inside your mouth.

Later, we take a closer look at conditions that can impact your gums or tongue, and cause pain in those areas.

Injury

You may feel pain in your mouth due to an injury from an accident. For example, if you trip and fall, you may bite into your lip or the sides of your cheeks. This can cause pain and tenderness on the inside of your mouth.

You can also injure your mouth by biting into food that’s too hot. This can cause a burn to your hard palate, also known as the roof of your mouth.

Dry mouth

Your salivary glands produce saliva that keeps the inside of your mouth moist. When these glands don’t produce enough saliva it can cause dry mouth.

This can lead to a parched feeling in your mouth, as well as mouth sores, a rough tongue, and a burning sensation inside your mouth.

Often, dry mouth is caused by dehydration. However, certain medications or an underlying health condition like diabetes can also cause it.

Canker sores

A canker sore is a small type of ulcer that you may notice inside your cheeks, around your tongue, or on the back of the roof of your mouth (soft palate). They often appear as white lesions with a red border.

Canker sores can be triggered by many factors. Some of the most common include:

Some canker sores can be very painful, and you may also feel tingling or burning before they appear.

Herpes simplex virus

Herpes simplex virus (HSV) is the virus that causes cold sores.

Although cold sores are often associated with the lips, if you’re newly infected with the virus you may develop painful lesions on your tongue, gums, and throat.

With cold sores, you may feel a burning sensation before the lesions develop. Other symptoms can include:

  • a sore throat
  • swollen lymph nodes
  • a fever
  • muscle aches

Subsequent outbreaks tend to be less severe than the first one.

Other infections

In addition to HSV, a variety of other viral and bacterial infections may cause painful sores or lesions to appear inside your mouth. Some of the most common include:

Oral thrush

Oral thrush is a fungal infection. It’s caused by a type of fungus called Candida albicans.

Anyone can get oral thrush, but it’s more common if you have a weakened immune system or underlying health conditions.

Oral thrush can appear as cream-colored lesions in many places within your mouth, including inside your cheeks, on the roof of your mouth, and on your tongue. The affected area may feel sore and can sometimes bleed.

Oral lichen planus

Oral lichen planus is a condition that can develop on the insides of your cheeks, on your gums, or on your tongue. It can appear as raised white patches, red swollen areas, or even as sores.

It’s usually a painless condition, but in some cases irritation and ulcers may develop.

What causes oral lichen planus is unknown, but it seems to be tied to an immune response. The following factors may trigger this condition:

Squamous papilloma

A squamous papilloma is a benign (noncancerous) type of growth that can develop inside the mouth. These growths are caused by an infection with human papillomavirus (HPV).

Squamous papillomas most often appear on the roof of the mouth and the tongue. While they’re typically painless, they can become painful or irritated if the growth is disturbed while you’re chewing or biting.

Oral cancer

Cancer occurs when cells grow out of control in your body. Oral cancer can affect many areas of the mouth, including the:

  • roof of the mouth
  • insides of the cheeks
  • back of the mouth
  • tongue
  • salivary glands
  • gums

Some of the most common symptoms of oral cancer include:

  • painful oral lesions that won’t heal
  • unexplained lumps or growths in the mouth
  • white or red patches inside of the mouth
  • pain or difficulty swallowing
  • numbness in the lower lip, face, neck, or chin

One of the biggest risk factors for developing oral cancer is tobacco use. This includes cigarettes, as well as cigars, pipes, and chewing tobacco.

Other risk factors include:

  • HPV infection
  • heavy alcohol consumption
  • a weakened immune system
  • a family history of oral cancers or other types of cancer
  • being male

Some types of sores and diseases, like canker sores and oral lichen planus, can also affect your gums.

But there are other conditions that may specifically lead to pain in your gums:

Rough brushing and flossing

While maintaining good dental hygiene is important, sometimes brushing or flossing too aggressively can lead to irritation and pain in the gums.

To avoid injuring your gums, be sure to brush and floss gently. The American Dental Association recommends using a toothbrush with soft bristles.

Hormonal changes

Sometimes, a change in hormones can affect and irritate your gums. This tends to be more common with women, especially during:

Sinus infection

A sinus infection happens when your sinuses become swollen and infected. Sometimes, a sinus infection can cause pain in the teeth and gums. This most often occurs around the upper teeth.

Gum disease

Gum disease happens when a buildup of plaque causes your gums to become swollen and tender. Early gum disease is called gingivitis while the more advanced form is called periodontitis.

Symptoms of gum disease can include:

In addition to poor dental hygiene, lifestyle choices such as smoking can also contribute to gum disease.

Dental abscess

A dental abscess happens when a pocket of pus develops around a tooth. This is due to a bacterial infection.

If you have a dental abscess, you’ll feel pain around the affected tooth, which may get worse when you chew or experience hot or cold temperatures. You may also have facial swelling and possibly a fever.

Many of the conditions we’ve already discussed can also affect your tongue or the area underneath it, including:

  • canker sores
  • infections such as HSV and hand, foot, and mouth disease
  • oral thrush
  • oral lichen planus
  • squamous papilloma
  • oral cancer

But what conditions may more specifically lead to pain in the tongue or the area below it? Below are some possibilities.

Nutritional deficiencies

Sometimes, a deficiency in specific nutrients can cause your tongue to become swollen or sore. This can include deficiencies in:

Geographic tongue

Geographic tongue happens when red patches appear on your tongue. These patches can be a variety of shapes and sizes and can change location over time. In some cases, they may be painful.

It’s unknown what exactly causes geographic tongue. In some individuals, certain types of foods, such as those that are acidic or spicy, may irritate it.

Burning mouth syndrome

People with burning mouth syndrome experience a burning or tingling sensation in their mouth. This condition typically affects the tongue, although other areas of the mouth such as the roof can also be impacted.

Pain due to burning mouth syndrome can vary from person to person. In some people, the pain may come and go. In others, it may be constant.

Some people find that eating or drinking alleviates discomfort.

Salivary gland stones

Stones can form in your salivary glands and block the flow of saliva into your mouth. These stones can develop in the salivary glands under your tongue, or in the salivary glands on the sides of your mouth.

People with salivary gland stones may experience pain or swelling in the mouth that comes and goes. It’s unclear what exactly causes the stones to form, although a few factors may put you at a higher risk:

  • being dehydrated
  • some medications, such as blood pressure drugs and antihistamines
  • not eating enough, which can cause you to produce less saliva

Neuralgia

A specific type of neuralgia called glossopharyngeal neuralgia can cause bouts of severe pain that can impact the tongue. Other areas, such as the throat and tonsils, may also be affected.

Pain due to this condition is often triggered by swallowing, coughing, or speaking.

The pain may last for only a few seconds or for several minutes. Glossopharyngeal neuralgia is thought to be caused by irritation of the glossopharyngeal nerve, one of the 12 cranial nerves.

While you should always get severe pain checked out by a dentist, there are several at-home options that may help to ease the pain and discomfort in your mouth.

Home remedies for mouth pain

  • Take an over-the-counter (OTC) medication like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). These OTC pain medications can help ease both pain and inflammation.
  • Use OTC products that contain benzocaine or hydrogen peroxide to help relieve pain associated with sores or lesions. You shouldn’t use benzocaine on children under 2.
  • Make a salt water rinse by dissolving 1 teaspoon of salt in 1/2 cup of warm water, then swirling it around your mouth for 30 seconds before spitting it out. This is especially helpful for canker sores.
  • Apply ice to the affected area to help with pain relief and swelling.
  • Avoid spicy, acidic, or salty foods that could irritate your mouth, gums, or tongue.
  • Increase the amount of fluids you drink, particularly if you find that you have a dry mouth.
  • Avoid smoking or using tobacco products.
  • Brush and floss your teeth gently and continue to practice good oral hygiene.

Be sure to visit your doctor or dentist if you have:

  • pain that’s severe and can’t be managed with at-home care
  • pain that causes difficulty with eating, drinking, or swallowing
  • persistent tooth or gum pain
  • mouth sores that are large, won’t go away, or keep coming back
  • an unexplained growth that doesn’t go away
  • white lesions inside your mouth
  • a mouth injury that causes severe bleeding or appears infected
  • signs of infection like swelling and fever

Mouth pain can have many causes, and you may feel the pain not only on the inside, top, or back of your mouth, but also around your tongue or gums.

You can take steps to ease mild mouth pain by taking OTC medications and using saltwater rinses. However, if you experience mouth pain that’s severe, persistent, or that keeps coming back, be sure to follow up with your doctor or dentist.