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Mouth ulcers, or canker sores, can sometimes appear on the tongue. Although a tongue ulcer will clear up on its own with time, some home remedies may help ease the symptoms.
People can also use over-the-counter (OTC) medications to alleviate pain.
In this article, we discuss tongue ulcers in more detail, including why they occur, their symptoms, and how to treat them.
We also look at how to identify them and when to see a doctor.
Tongue ulcers are whiteish sores on the tongue.
Also called canker sores, a 2019 article notes that these ulcers most often develop on the inside of the lips and cheeks. However, they can sometimes appear in other areas of the mouth, such as the gums, tongue, and roof of the mouth.
They can appear individually, or a person may experience between two and four at a time.
Minor canker sores are usually a few millimeters wide. However, if they measure 1–3 centimeters, healthcare professionals refer to them as major canker sores.
They are not contagious and cannot spread from person to person through contact or shared items.
The main symptom a person will notice is pain.
The pain may be worse if the ulcer comes into contact with an object, such as a toothbrush. Some foods can also aggravate the tongue ulcer, especially those that are spicy or acidic.
The ulcers themselves tend to be white and roundish. They are typically a few millimeters wide and appear slightly sunken.
Some ulcers may have an area of redness around their outer ring, especially if something irritates them.
There is no single cause of tongue ulcers. Instead, there are several potential triggers.
A person can develop tongue ulcers due to damage in the mouth that results from:
- biting the tongue
- injuries from dental work
- braces or retainers
- poorly fitting dentures
- burns from eating hot foods
- eating acidic or spicy foods
- brushing the teeth with a hard-bristled brush
The United Kingdom’s National Health Service (NHS) note that ulcers can also occur in the mouth due to:
- hormonal changes
- medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- food allergies or intolerances
- high stress levels
People may also develop tongue ulcers when they first stop smoking.
There may also be a genetic factor in developing tongue ulcers. Research in Advances in Dermatology and Allergology states that people with certain genes may be more likely to experience recurring canker sores.
People with certain conditions who experience tongue ulcers should talk to their doctor. These conditions include:
- inflammatory bowel disease
- celiac disease
- conditions that weaken the immune system
- Behcet’s disease
Some forms of ulcers on the tongue and in the mouth may be signs of oral cancer. Anyone with concerns about their symptoms should speak with a doctor to get a diagnosis.
Tongue ulcers tend to heal on their own. Researchers note that most lesions heal in 4–14 days without treatment.
Although tongue ulcers tend to clear up on their own, various home remedies may help ease the symptoms during the healing process.
People can soothe tongue ulcers at home by rinsing the mouth with:
- clean water, especially after eating
- warm salt water
- baking soda dissolved in water
They can also try applying very cold water to the ulcer or sucking on ice chips.
Medical treatment for tongue ulcers generally focuses on easing the symptoms while identifying and treating any underlying conditions responsible for the ulcers.
OTC medications can be a helpful remedy for symptoms of a tongue ulcer. People can try using pain relievers, such as acetaminophen, or numbing gels, such as benzocaine.
However, the numbing action may make it harder to feel the tongue. People using the gel should, therefore, take care to avoid further injury to the tongue, such as by biting it.
Calcium is an important nutrient that people need to consume for strong bones and teeth.
When a person does not consume enough calcium, phosphorus, and vitamin D, they can develop weaker, less-dense bones and teeth. This can lead to osteoporosis and other health complications, such as tooth decay and tooth loss.
According to the New York State Department of Health, females living with osteoporosis tend to have fewer teeth than those of a similar age not living with the condition. They also note that if the jawbone weakens or thins, it may no longer support the teeth properly, leading to tooth loss.
Calcium deficiency can cause bones throughout the body to become less dense and more fragile. When this occurs, it can make a person more susceptible to losing teeth.
According to an older study, researchers found a direct correlation between not getting enough calcium and losing teeth. The researchers found that people who did not take in enough calcium each day were much more likely to lose at least one tooth within a 2-year follow-up period.
According to the National Institutes of Health (NIH), the signs of calcium deficiency may not become apparent for several years because a person’s body will pull calcium from their bones when there is a deficiency.
Over the long term, calcium deficiency can cause:
- low bone mass, also called osteopenia
- an increased risk of osteoporosis
- higher risk of bone fractures
The NIH also state that severe cases of calcium deficiency can cause:
- numbness or tingling in the fingers
- abnormal heart rhythms
A person can take steps to strengthen their enamel and prevent calcium deficiency and its symptoms before they happen.
People can take steps to keep their teeth healthy by:
- taking care of the gums and teeth with regular brushing, flossing, and dentist visits
- replacing the toothbrush at regular intervals
- limiting alcoholic beverages
- avoiding smoking
- consuming 600–800 international units of vitamin D per day
- eating or consuming 1,000–1,200 milligrams of calcium each day through food or supplements
- maintaining a moderate weight
- eating a diet with plenty of vegetables, fruits, whole grains, lean proteins, and low fat dairy
- getting regular exercise
- visiting the dentist immediately if discomfort or other symptoms occur in the mouth
- using caution to avoid falls
What to eat
The American Dental Association (ADA) recommend that people add more calcium-rich foods to their diet.
There are various dietary sources of calcium, including nondairy and vegan options. They include:
- dairy products, including milk, cheese, and yogurt
- soy milk
- tofu with added calcium
- dark green, leafy vegetables
- orange juice with added calcium
- canned fish
The Academy of Nutrition and Dietetics recommend that a person eat foods rich in vitamin C and phosphorus in addition to calcium. Vitamin C helps promote gum health, while phosphorus, which is in foods such as beans, eggs, and meats, is important for strong teeth.
According to the ADA, lost teeth can lead to nutritional issues. They say that a person who has experienced tooth loss is more likely to eat a soft diet that may not include necessary nutrients. This can lead to other complications, such as obesity.
The ADA also recommend that a person talk to their dentist about replacing missing teeth. They say that having properly fitting dentures can make a difference in helping a person maintain a regular, healthful diet.
Calcium in food vs. supplements
In a 2015 study, researchers linked low calcium intake with an increased risk of both oral cancer and oral disease. They identified that people in the at-risk group ate more protein and drank more soft drinks than others.
Consuming enough calcium is an important part of preventing bone density loss. However, people should try to get their calcium and other nutrients from foods rather than supplements.
The researchers behind a 2013 study stated that doctors should avoid prescribing or recommending calcium supplements due to the minimal effect they have on preventing fractures. They also found that taking calcium supplements may increase the risk of heart attack, kidney stones, and acute gastrointestinal events.
Another study, this one from 2017, also advises people to get their calcium from the diet. The researchers recommend that doctors discourage people from using calcium supplements.
A range of treatments can help, and the best option will depend on the cause of the looseness.
- Scaling and root planing. This is a type of deep cleaning procedure that can treat and help to reverse gum disease.
- Medications or mouth rinses. These can help infected gums to heal and combat bacteria in the mouth.
- Surgery. The aim will be to remove inflamed gum tissue and bone that has been damaged by gum disease.
- Bone grafts. These can help to rebuild bone lost to gum disease.
- Soft tissue grafts. Also known as gum grafts, these can prevent further gum or tooth loss in people with gum disease.
- Dental appliances, such as bite splints. These can reduce damage from grinding and may help the mouth to heal after dental surgery.
- Treatment for diabetes. Appropriate treatment is important for dental health.
If a loose tooth falls out, a dentist can often restore a person’s smile with:
- A dental bridge. This type of crown fits over the teeth on either side of the missing tooth. The result is a bridge between two healthy teeth, connected by a prosthetic, or artificial, tooth in the place of the one that is missing.
- A dental implant. This involves an artificial tooth and root, which is connected to the jawbone.
While these options are effective, it is essential to treat the underlying cause of tooth loss and take any other steps needed to prevent further damage.
A dental bridge replaces one or more missing or broken teeth with fake teeth. Bridges use one or more real teeth on either side of the gap to hold the fake teeth in place.
Bridges may be either fixed, which means that they are permanent, or removable, which means that a person can take them out.
Dentists call each fake tooth in a bridge a "pontic," and some healthcare providers refer to a bridge as a "fixed partial denture."
In this article, learn more about dental bridges.
A dental bridge can replace a tooth or several teeth. The fake teeth in dental bridges look and function like real teeth.
For a bridge, a person may see a prosthodontist, a dentist who specializes in restoring and replacing missing teeth, or a regular dentist. Either way, there are many options for filling a gap in a smile.
One option is to have a crown — a fake bit of tooth attached to a small portion of real tooth that the dentist has ground down.
When a person has lost a tooth or the dentist has had to remove it, however, a crown alone is not an option, and a dental bridge may be the best choice.
The term "bridge" refers to a structure that contains one or more fake teeth. The structure is often anchored in place with one or more crowns on either side of the gap in the mouth. For example, if a person loses several front teeth, due to injury or decay, a doctor may use a bridge to fill in the gap.
A person may not wish to have a gap in their teeth, after having a tooth removed, for example, because they need a tooth in the area for chewing or because of cosmetic concerns.
For some people, a permanent dental implant is an alternative to a bridge. Dental implants are fake teeth that dentists surgically insert into bone in the mouth.
For others, dentists recommend implants to help secure a bridge, particularly if many teeth are missing.
A dental bridge can help a person feel more comfortable with their smile. It can also enable them to chew normally.
When a person loses one or more teeth, it can affect their bite, causing pain or difficulty eating. Replacing those teeth prevents these complications.
A person may need a bridge if:
- a tooth is so decayed that it falls out or a dentist removes it
- an accident or injury damages a tooth beyond repair
- decay or infection is so deep within a tooth that neither a filling nor a root canal are sufficient
Dentists use several types of bridges:
- A traditional bridge involves two crowns — sometimes called abutments — anchoring the fake tooth or teeth. This is the most popular type of bridge, and it can be fixed or removable.
- A cantilever bridge requires only one crown for support. This involves a less intensive procedure and may be a good option for people who do not want to damage healthy teeth. However, the single crown can act as a lever, increasing the risk of tooth and jaw damage.
- Maryland bridges are more conservative and less invasive than traditional or cantilever bridges. The bridge is anchored by metal or porcelain frameworks attached to the backs of teeth on either side of the gap. These bridges can preserve healthy teeth, but they are less secure.
- Implant-supported bridges use dental implants as anchors. This type of bridge is more expensive and invasive but more secure.
The specific procedure depends on the type of bridge.
When a person gets a traditional bridge, the process begins by preparing the teeth on either side of the gap. The dentist will grind down these teeth, removing any decay. Next, they will take an impression of the mouth that will help with fitting the bridge.
The dentist will put a temporary bridge on the damaged teeth to protect them. Temporary bridges include structures that look like real teeth, but they are not permanent, so it is crucial to return to the dentist within a few weeks.
Once the real bridge is ready, the dentist removes the temporary structures and affixes the bridge using strong adhesives.
The process is similar for cantilever bridges, though only one tooth will need a crown. A Maryland bridge requires less preparation, since no crowns are involved. Both of these bridges also require at least two appointments.
When a person has implants to support a bridge, the process typically begins with implant surgery. Afterward, the dentist will take an impression of the mouth to create a bridge that fits over the implants seamlessly.
A person's mouth may feel tender and sore after a dentist grinds down the teeth. It may also feel sore after the placement of the bridge. The gums may be tender and bleed.
For most people, this soreness goes away after a few days. However, the gums may need a few weeks to completely heal from the procedure.
A person can return to work or school as soon as they feel well enough, and this is usually the day after the appointment.
People who choose to be sedated during the bridge placement should not drive after the procedure.
Anyone who has implants may feel unwell after waking from anesthesia. They, too, should not drive and may need assistance for a day or two after the procedure.
To care for a bridge, it is important to:
- Practice regular oral hygiene to prevent further decay.
- See a dentist twice a year so that they can check the bridge and clean the teeth.
- Ask the dentist if it is important to avoid certain foods.
Some complications of a dental bridge can include:
- Bridge failure. The bridge may break or slip out of place. A person may then need another bridge, implants, or other dental procedures.
- Pain or chewing problems. Some people struggle to adjust to chewing with a bridge, especially in the weeks after the procedure. If the bite does not feel right, return to the dentist for an adjustment.
- Infection. Some people develop infections after treatment, especially if they have widespread tooth decay or gum disease.
- Tooth decay. It is possible for a tooth to continue to decay under the crown that anchors the bridge. This is more common in people with serious gum disease or very severe cavities in the teeth that need crowns.
To prevent tooth decay around a bridge, it is crucial to practice excellent home care, including brushing and flossing. Some floss products are designed for use with bridges.
Working with a knowledgeable dentist and carefully following their aftercare instructions can reduce the risk of serious complications.