Tongue Swelling: Causes of Swollen Tongue

The medical term for swollen tongue is glossitis. Glossitis may be:

• Acute: sudden onset, usually severe, such as during an allergic reaction or from angioedema
• Chronic: may indicate an underlying condition
• Atrophic (also called Hunter glossitis), occurs when many of the small, bumpy structures on the tongue (papillae) are lost, giving the tongue a smooth, red, glossy appearance

In addition to a tongue swelling and inflammation, symptoms of glossitis include: 

• Pain, soreness, or tenderness of the tongue
• Changes in tongue color (pale or bright red)
• Difficulty chewing or swallowing
• Trouble speaking
• Smooth appearance to the surface of the tongue
• Blocked airway/difficulty breathing (severe)

There are numerous causes for tongue inflammation. 

• Allergic reactions 
  • Called angioedema, it results in swelling deep under the skin
  • May be caused by foods, certain medications, insect bites
  • Can lead to anaphylaxis, which can be life-threatening if the tongue and throat swell and block the airways
• Acquired angioedema
  • May occur in people who have cancer or an autoimmune disease
  • Caused by medications, especially ACE inhibitors
• Injury
  • Biting the tongue
  • Tongue piercings
  • Braces 
  • Mouth trauma
• Infection
  • Oral thrush (oral candidiasis) 
  • Sexually transmitted infections (STIs) such as gonorrhea, syphilis, and oral HPV
  • Soft tissue infections of the floor of the mouth or the neck
• Environmental irritants
  • Tobacco
  • Spicy foods
  • Alcohol
  • Cinnamon
  • Some toothpastes and mouthwashes
• Vitamin deficiencies 
  • Magnesium
  • Iron
  • B vitamins
• Certain medical conditions
  • Cancer
  • Sjogren’s syndrome (an autoimmune disease)
  • Amyloidosis 

A swollen tongue is diagnosed with a physical exam in which the doctor will examine the mouth for other abnormalities of the mouth and tongue. 

Blood tests and samples of saliva may be taken to check for the cause of the swollen tongue. 

Treatment for swollen tongue depends on the cause. 

• Allergic reactions 
  • Epinephrine (Epi-Pen)
  • Corticosteroids
  • Antihistamines 
• Injury
  • Ice packs to reduce swelling
  • Sucking on ice cubes or ice pops
  • Stitches for open wounds
  • Rinsing with warm salt water
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) for pain and inflammation
  • Avoid spicy foods and alcohol
  • Don’t smoke
• Infection
  • Antibiotics 
  • Antifungals
  • Corticosteroids
• Environmental irritants
  • Avoid known irritants
• Vitamin deficiencies 
  • Vitamin or mineral supplements