What causes a swollen tongue?

A swollen tongue can be minor or a sign of a real emergency, and it's not always easy to tell which it is at first. If it came on suddenly and you're having trouble breathing or swallowing, call 911 or get to an emergency room right now. Otherwise, the cause is usually an allergic reaction, an infection, an injury or a health condition that's worth having checked. 

What you will learn in this article: 

• Allergic reactions, infections and injuries can cause sudden tongue swelling. 

• An oral piercing may cause swelling, infection or other problems. 

• Some health conditions can make the tongue slowly grow larger. 

• Trouble breathing or swallowing means you need emergency care. 

If your tongue has been swollen or sore and you're not sure why, schedule an appointment with an Aspen Dental provider. Your care team can look at your mouth and help you figure out the next step. 

What causes a sudden swollen tongue? 

A tongue that swells quickly may be caused by an allergic reaction, an infection or an injury. When the swelling began and what other symptoms you have can help a dental provider or doctor find the cause. This is different from swollen gums, which usually points to gum disease or irritation rather than the causes covered here. 

Can an allergic reaction cause it? 

Yes. Food, medicine, an insect sting or latex can trigger a serious allergic reaction called anaphylaxis. MedlinePlus notes that anaphylaxis can begin quickly. The lips or tongue may swell, and you may have throat tightness, trouble swallowing, wheezing or shortness of breath. Call 911 if you have signs of a serious allergic reaction.¹ 

Can an infection cause a swollen tongue? 

Yes. An infection in or near the tongue can cause swelling and pain. The American Dental Association lists swelling, infection and unusual discharge among the possible complications of an oral piercing.² 

If you also have tooth pain, swollen lymph nodes or swelling near your jaw, a dental provider can check for a dental infection. 

Can an oral piercing cause your tongue to swell? 

Yes. The American Dental Association says pain and swelling may occur during the first five days after an oral piercing. Rare but serious complications include infection, bleeding and swelling severe enough to block the airway.² 

Get prompt care if the swelling keeps growing or the piercing site becomes more painful, tender or produces an unusual discharge. Call 911 if you have trouble breathing or swallowing. 

Can an injury or irritation swell your tongue? 

Yes. Biting your tongue, burning it on hot food or rubbing it against a rough tooth or dental appliance can cause swelling. Contact your dental provider or doctor if the swelling gets worse or does not begin to improve. 

Can a swollen tongue be a sign of an ongoing health condition? 

Sometimes the tongue slowly becomes larger over months or years. Long-term tongue enlargement is called macroglossia, and it can have several possible causes. 

A peer-reviewed case report describes a 65-year-old woman whose tongue grew larger over several years because of localized amyloidosis. Amyloidosis is a condition in which abnormal proteins collect in body tissue. The article also lists Down syndrome and acromegaly among other rare conditions doctors may consider. Because this was a report about one patient, it does not show how common amyloidosis is among people with an enlarged tongue.³ 

A tongue that presses against the teeth for a long time may develop a wavy, scalloped edge. If your tongue has slowly grown larger, talk with a doctor. Your dental provider can also check how the swelling is affecting your teeth and mouth. 

When is a swollen tongue a medical emergency? 

Call 911 if your tongue swells suddenly and you have: 

• Trouble breathing 

• Throat tightness 

• Trouble swallowing 

• Wheezing or shortness of breath 

• Dizziness, fainting or a weak pulse 

MedlinePlus notes that anaphylaxis can start quickly and may become life-threatening. A serious allergic reaction needs immediate emergency care.¹ 

Fever, spreading redness, worsening pain or unusual discharge may point to an infection that needs prompt care. If you are breathing normally, contact your dental provider or doctor to have these symptoms checked. 

Do not wait to have ongoing tongue swelling examined. Contact your local dental provider to check for a dental or oral cause and find the right next step. 

What causes a swollen tongue? FAQs 

Still have questions about a swollen tongue? These answers cover a few common concerns. 

Can stress cause a swollen tongue? 

Stress itself is not a proven cause of tongue swelling. However, some people bite their tongue or press it against their teeth when they feel tense. This may cause soreness or mild swelling. A dental provider can check for signs of repeated injury. 

Can medicine cause a swollen tongue? 

Yes. Some medicines can cause an allergic reaction that makes the tongue or lips swell. This may happen with a new medicine or one you have taken before. Contact your doctor if this happens. Call 911 if you also have trouble breathing or swallowing. 

Should I see a dental provider or go to the ER first? 

Call 911 if you are struggling to breathe or swallow. If the swelling is mild and you can breathe normally, a dental provider can check for a tooth, piercing or other oral cause. Your dental provider may refer you to a doctor if the swelling appears to come from a medical condition. 

What can I do at home for mild tongue swelling? 

If the swelling began after a minor bite or burn, gently rinse your mouth with cool water. Avoid hot, spicy, salty or acidic foods that irritate the area. Contact your dental provider or doctor if the swelling gets worse or does not improve. Call 911 if breathing or swallowing becomes difficult. 

Sources 

¹ National Library of Medicine, MedlinePlus: “Anaphylaxis.” https://medlineplus.gov/anaphylaxis.html 

² American Dental Association, Oral Health Topics: “Oral Piercing/Jewelry.” https://www.ada.org/resources/ada-library/oral-health-topics/oral-piercing-jewelry 

³ International Scientific Information, American Journal of Case Reports: “A 65-Year-Old Woman with an Enlarged Tongue Due to Amyloidosis.” https://amjcaserep.com/abstract/full/idArt/936192