What is a tongue burn?

A tongue burn is a common ailment. Typically, the condition occurs after eating or drinking something that’s too hot. Standard first-aid treatment for burns can also work for a tongue burn.

A mild burn on your tongue can be a nuisance, but it will eventually heal. If you have a serious burn, seek immediate medical attention.

In some cases, you may feel a burning sensation on your tongue without an actual burn. This condition may be burning mouth syndrome, which is also known as idiopathic glossopyrosis.

Causes of a tongue burn

Tongue burn from food or liquid

Underestimating the temperature of steam, hot food, or liquids can cause a burn on your tongue, mouth, or lips. Frequently eating and drinking extremely hot food and beverages without testing the temperature puts you at a higher risk for tongue burn.

Burning mouth syndrome

Burning mouth syndrome (BMS) is a condition that can make you feel the sensation of a burn on your tongue for no apparent reason. The symptoms are ongoing and can last for years.

Along with pain, individuals often experience numbness and tingling of the tongue and mouth and changes in taste. It increases with age and is most common in women and men between the ages of 60 and 69 years old.

BMS has no known cause. It has been linked to abnormal function in the nerves of the mouth. Genetics and the environment are believed to play a role as well. In BMS, the saliva and anatomy of the mouth are otherwise normal.

Extreme stress, anxiety, and depression can affect how pain is managed by the body. These conditions can make the symptoms of BMS worse.

There are other conditions that can lead to similar symptoms. These must not be present in order for BMS to be diagnosed. They’re known as secondary causes of burning mouth pain.

Secondary causes may be due to:

  • dry mouth, which is often a side effect of medications or a symptom of another medical condition
  • thrush, which is an oral yeast infection
  • oral lichen planus, which is an often chronic inflammation inside the mouth that’s caused by the immune system launching an attack on the mouth’s mucous membrane cells
  • geographic tongue, which is a condition in which the tongue’s surface is missing some of its typical small bumps (papillae) and instead has areas of red and sometimes raised patches that tend to disappear and then reappear in different areas of the tongue
  • vitamin deficiencies
  • dentures
  • injury or mouth trauma
  • allergic reaction to certain foods
  • stomach acid that makes its way into the mouth from conditions such as gastroesophageal reflux disease (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

Symptoms of a tongue burn

Tongue burn

A burn of the tongue looks and feels different, depending on the degree of the burn:

  • A first-degree burn involves the outermost layer of the tongue. You experience pain, and your tongue may become red and swollen.
  • A second-degree burn is more painful because both the outermost layer and the under layer of the tongue are injured. Blisters may form, and the tongue appears 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, bumps on the tongue (papillae) may disappear. This can give the tongue a smooth, rather than bumpy, appearance. Between these bumps are the taste buds.

A burn may lessen your sense of taste as well. But this is most often a temporary side effect unless the burn is severe.

Burning mouth syndrome

In addition to feeling a burning sensation on the tongue, symptoms of BMS can include:

  • a feeling of little or no discomfort of the tongue in the morning that steadily increases throughout the day
  • a daily repetition of burning symptoms
  • numbness and tingling
  • a metallic or bitter taste that accompanies the burning sensation
  • a feeling of having a dry mouth despite normal saliva production

Complications from a tongue burn

Tongue burn

If it’s not identified and treated properly, a severe burn of the tongue can become infected. You should always go to a doctor for second-degree and third-degree burns.

A burn of the tongue can also destroy taste buds, creating a lack of sensation where the burn occurred. This is typically a short-term complication because your taste buds typically regenerate about every two weeks.

Burning mouth syndrome

If you have BMS, the severe, untreatable pain can sometimes lead to feelings of depression and anxiety.

Diagnosing a tongue burn

Tongue burn

Redness, swelling, and blistering are signs of a tongue burn. Your doctor can likely diagnose the degree of the condition by simply examining your tongue.

Burning mouth syndrome

BMS is diagnosed by excluding diseases and conditions with similar symptoms.

Your doctor will examine your mouth and ask you about your oral care habits to see if any habits, such as overusing mouthwash or brushing your teeth excessively hard, are causing your symptoms.

You may also receive any of the following tests to rule out other conditions:

  • Blood tests are used to rule out nutritional deficiencies, hormone imbalances, and endocrine disorders.
  • Oral samples are used to rule out oral conditions, such as thrush and oral lichen planus.
  • Allergy tests are used to rule out burning of the tongue caused by allergies to food or additives.
  • Saliva testing is used to rule out dry mouth.
  • Imaging tests are used to rule out any other conditions that your doctor may suspect.
  • Gastric reflux tests are used to see whether or not you have GERD.

Treating a tongue burn

Tongue burn

Initial treatment for a burn of the tongue should include basic first aid. Your doctor 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:

  • Drink and rinse the area well with cool water for a few minutes.
  • Suck on ice chips or a popsicle to soothe the pain.
  • Rinse with cool water or cool salt water (1/8 teaspoon of salt dissolved in 8 ounces of water).
  • Avoid warm or hot liquids, which could irritate the burn.
  • Take acetaminophen (Tylenol) or ibuprofen (Advil) for pain and inflammation.
  • Consider sprinkling a few grains of sugar or trying honey on the tongue to relieve pain.

Consult your physician or dentist if the burn doesn’t improve or shows signs of infection. Signs of infection may include:

  • increased redness
  • increased pain
  • poor healing
  • swelling
  • drainage of pus
  • fever

Burning mouth syndrome

If you’re suffering from BMS, you may find relief from the same types of remedies as those used to treat first-degree burns.

Although there are no medically approved treatments specifically for BMS, pain management specialists have found the following treatments to be effective in some cases:

  • topical prescription medications such as lidocaine, doxepin, and clonazepam
  • oral prescription medications such as gabapentin, SSRIs, and amitriptyline
  • complimentary treatments such as alpha lipoic acid, cognitive behavioral therapy, and meditation and relaxation techniques

Treating secondary causes are key to managing symptoms. For example, if your current medication is causing dry mouth, your doctor may suggest another prescription.

If stomach acid flows back up into your mouth because of acid reflux or GERD, your doctor may prescribe medications like omeprazole (Prilosec) to reduce your stomach’s production of acid.

Outlook for a tongue burn

Tongue burn

A primary tongue burn can heal in about two weeks or less without specific treatment. However, some burns can last up to six weeks depending on the cause and severity.

Burning mouth syndrome

BMS can persist for months or even years. It can be difficult to manage. Some studies suggest only 3 out of 10 people find improvement with treatment.

How to prevent a tongue burn

Tongue burn

You can prevent a primary tongue burn by testing the temperature of hot liquids and food before eating or drinking. Beverages or food heated in a microwave may not heat evenly, therefore you should use extra caution.

Burning mouth syndrome

There’s no known way to prevent BMS. You may be able to reduce the burning sensation by reducing stress and avoiding tobacco and certain types of foods and drinks. These include carbonated beverages, acidic foods, and spicy foods.