Swollen tongue


A swollen tongue is an increase in size and volume of the tongue that affects either part or all of its surface. The reason for the increase in size is an increased accumulation of fluid in the tissue of the tongue, which in most cases is caused by inflammation. It is not uncommon for it to be accompanied by a changed texture of the surface. Redness, small pustules or a white coating are therefore not uncommon accompanying symptoms. The sensation of the swollen tongue can range from painful to numbness and often provides an indication of the cause.

Read more on the topic: Tongue inflammation


The causes of a swollen tongue can be of various kinds. The most banal is burning your tongue with food or objects that are too hot, such as cutlery. It causes localized swelling of the tongue where the foreign body touched the tongue. A sharply circumscribed swelling is typical here, which is associated with an injury to the mucous membrane. Depending on the degree of burn, it can be redness, a blistered change or even a bloody wound. In this case, the person affected can also directly identify and assign the cause.
Quite often, an allergy is also the trigger for the swelling of the tongue. If the mucous membrane of the mouth area and thus also the tongue come into contact with the allergen (e.g. nuts), it can swell massively within a few minutes if the person concerned is very sensitive. The swelling of the entire tongue is typical of allergic reactions. In addition, the mucous membrane of the cheeks and palate is irritated and becomes painful due to the inflammatory change. Depending on the sensitivity of the person concerned to the allergen, the swelling can be subtle or take a while. Recognizing the allergen as the cause can be difficult in some cases.
Medication is less likely to cause a swollen tongue. Blood pressure drugs in particular lead to swelling of the tongue mucous membrane. However, they usually also lead to fluid retention in the vocal cords, so that an annoying cough can occur at the same time. In the worst case, the swelling can also lead to shortness of breath. Pointing out the possible side effects when taking these drugs, however, minimizes this risk, which is also one of the rare side effects numerically.

Allergy as a cause of a swollen tongue

An allergy is a hypersensitivity reaction of one's own body to an actually harmless stimulus from the environment. In those affected, it manifests itself in an excessive activation of the immune system, which in turn manifests itself in inflammatory reactions in the form of swelling, redness and an increased temperature. A swollen tongue is mainly caused by food allergies. The decisive factor here is the contact between the food and the mucous membrane in the mouth area. The cells of the immune system contained there in large numbers mistakenly recognize the ingredient as foreign and initiate a defense reaction. Depending on the sensitivity of the person affected, the defense reaction can range from a furry and numb feeling to a severe swelling of the tongue with shortness of breath. The swelling causes defense cells to reach their destination to neutralize the allergen. It is characteristic of allergic reactions that the entire tongue swells evenly. In such cases, it is important to stop the supply of the allergen immediately and take medication. The danger is that the airways are obstructed by the swelling and then there is dangerous shortness of breath. Antihistamines are suitable as medication for mild reactions, and medically prescribed cortisone for severe reactions. Pollen or animal hair allergies tend not to manifest themselves with a swollen tongue. Here it is mainly an itchy palate or increased sneezing that affects those affected. However, in order to precisely identify the triggering allergen for the swollen tongue, a doctor's prick test is suitable.

Please also read our topic: Food allergy

Swollen tongue from a cold

A swollen tongue with a cold is relatively uncommon. A cold in itself is an upper respiratory infection. Exactly this means that the mucous membranes of the mouth, nose and throat area are mostly infected with viral pathogens. It is typical that the nasal mucous membranes and the throat are particularly affected. Of course, the tongue also comes into contact with the pathogens, but it is seldom seriously colonized by so-called "cold viruses". This is because most of the pathogens in the nose and throat ring are caught by lymphatic tissue. This lymphatic tissue contains a particularly large number of defense cells and is an important part of the own immune system. However, if the tongue swells as a result of a cold, it is most likely the base of the tongue. It is located at the roots of the tongue towards the throat and visually lies under the uvula. There is also increased lymphatic tissue here. In the event of a strong virus attack, this part of the tongue may swell with it. However, that the whole tongue increases in volume is rather unusual for a cold. Then perhaps an intolerance reaction to medication or an infected wound on the tongue should be considered.

Swollen tongue from antibiotics

If a swollen tongue occurs a short time to a few days after taking antibiotics, it is an intolerance reaction to the active substance. The drug should be discontinued immediately and, if necessary, replaced with a new one. However, it is very rare for a swollen tongue to be the only response to an antibiotic. Often in these cases the general well-being is impaired. Sufferers feel an additional change to their pre-existing illness that led to taking the antibiotic. This could be a rash or a renewed fever. In addition, swelling of the mucous membrane can often be observed throughout the mouth.

Tongue swollen from stress

Stress does not usually lead to a significantly swollen tongue. Rather, it is the subjective feeling of those affected. It is due to the reduced salivation during stress. The tongue becomes reactively dry and this can lead to small tears in the tongue mucous membrane. These, in turn, can become inflamed and cause the tongue to swell. However, the swelling is usually minimal and can be avoided with a balanced intake of fluids. However, since the sensitive innervation of the tongue is so pronounced, the minimal swelling is perceived as oversized. However, this can be refuted by the fact that sufferers can usually move their tongue normally and articulation is not affected by the swelling.

Swollen tongue after a tongue piercing

A swollen tongue is normal after a tongue piercing. The swelling is due to the injury to the tongue. The wound leads to the onset of wound healing and, as a result, to an increased accumulation of fluid. The fluid is supposed to help get the cells needed for the repair to their destination. However, the swelling should be limited around the piercing and decrease as it heals. Increasing redness, increasing pain or even purulent deposits should not occur after piercing.

More about this topic can be found: Tongue piercing

Swollen tongue due to thyroid gland

A dysfunctional thyroid gland can also lead to a swollen tongue. In most cases it is an underactive thyroid. At an advanced stage, the tongue then becomes dry and increases in size. But other symptoms are in the foreground. Especially at the beginning it is an increasing tiredness and sensitivity to cold that those affected notice. Weight gain is also typical.

Liver as the cause of a swollen tongue

Chronic liver disease can lead to changes in the tongue. However, the emphasis here is on the fact that it can lead to change, but does not have to. In addition, changes in the tongue are not specific to liver disease. It is therefore important to consider the synopsis with other symptoms. Experts often speak of so-called "liver skin signs". They are characteristic of chronic liver diseases and can only be determined visually. This also includes the "lacquer tongue". The name suggests that it is a flat, shiny, deep red tongue. It is also often painful. Swelling is variable. However, it is never isolated, but can be accompanied by other symptoms such as red palms and soles, a lack of hair on the stomach (“bald head”) and liver asterisks. The latter appear as star-shaped skin hemorrhages that can be found all over the body. If you press on its center with a normal pen, the skin discoloration disappears. In addition, those affected also suffer from general disorders such as increasing tiredness, digestive problems or pain in the right upper abdomen. General symptoms are more useful for diagnosis than the changes in the tongue.

Swollen tongue from lack of vitamins

A swollen tongue can also indicate a vitamin deficiency. An undersupply of vitamin B3 and vitamin B12 in particular can manifest itself in an inflamed, red tongue that burns painfully. In order to determine the deficiency with certainty, a blood sample is always required. Should a vitamin deficiency prove to be true, more vitamins can be supplied in the form of capsules or a conscious diet. Almost only animal foods such as fish, meat, eggs and dairy products contain a high vitamin B content. They should therefore be prepared preferentially.

Treatment / therapy

Treatment for a swollen tongue depends on the triggering factor.
If an injury to the tongue is the cause of the swelling, the choice of medication depends on the size of the wound. In the case of small wounds, it is often sufficient to wait and see and take local measures such as drinking pleasantly cool drinks or eating soft food. However, if the wound is larger, antibiotics must often be prescribed. This is because there are a lot of bacteria in the mouth and they can infect the wound. An antibiotic is therefore often preventive and optimizes the healing process. If the wound is also painful, pain relievers such as ibuprofen can also be given. Brushing the tongue with a local anesthetic is only partially effective, as it is quickly washed off the saliva and only lasts for about one to two hours. However, this can be a good support before eating.
If an allergy is the reason for the swollen tongue, antihistamines or stronger drugs such as cortisone are suitable, depending on the severity. In any case, a doctor should be consulted in the event of an allergic reaction in the oral cavity. The therapy here depends on the severity of the swelling. Slight swellings can thus be relieved with tablets, while severe cases require inpatient monitoring in the hospital. In the worst case, even short-term ventilation may be necessary if the swollen mucous membranes threaten to obstruct the airways. Therefore, in the case of an allergy, it is always important to assess the general condition of the person affected and, if necessary, to initiate a medical clarification quickly.
In the case of drug intolerance, it is important to stop using the triggering agent and switch to another preparation.

Home remedies

The simplest home remedy for a swollen tongue is to drink pleasantly cool water. Care should be taken to ensure that it is not too cold to prevent cold damage to the tongue. The water has two effects. On the one hand, it wets the mucous membrane of the tongue and washes away possible pathogens on the surface. On the other hand, it cools the warm, swollen tongue. This will reduce the symptoms of inflammation and the pain will automatically subside. If regular drinking of water is not enough as a supportive measure, you can also drink teas. However, one should bear in mind that acidic teas such as fruit tea would only irritate the mucous membrane of the tongue. Chamomile or sage tea are therefore a good alternative. Sucking ice cream is only conditionally recommended if you have a swollen tongue. Here, the person affected should decide for themselves whether the ice will provide relief. However, milk and fruit ice cream harbor the risk of creating a perfect nutrient medium for the pathogens on the tongue. Rinsing with water after consumption is therefore advisable. If those affected notice that the consumption of special foods generally leads to swelling of the tongue, it is advisable to avoid this. However, if this is only noticed afterwards, it is advisable to clean the tongue with a tongue cleaner. If necessary, the toothbrush can also be used for this and then washed out well. Food residues are thus removed from the tongue and can no longer irritate the mucous membrane.

Which doctor is responsible for a swollen tongue?

There is no specific recommendation to whom a person with a swollen tongue should turn. In general, however, every family doctor should have the competence to treat a swollen tongue and, if necessary, refer it to a specialist. The presence of other symptoms is decisive here. Inflammation in the oral cavity can therefore be a case for the dentist, while additional symptoms such as fever may be a case for the internist. It is important to decide on a case-by-case basis. However, if there is an additional shortage of air, it is always important to call the ambulance and get first aid.


The duration of a swollen tongue should not exceed hours to a few days. It depends very much on the degree of swelling to what extent it can be tolerated. Any pronounced swelling should be eliminated within a very short time with medication and supportive measures. Slight swellings can be observed waiting for a few days. In the case of injuries, the swelling usually goes down significantly within 3-4 days. This can be explained by the rapid regeneration time of the oral mucosa. Allergic reactions should improve within minutes with successful therapy and subside after a few hours. If drugs are the trigger, the duration depends on the time the drug is active. Even in this case, the swelling should not last longer than 48 hours.


The symptoms of a swollen tongue vary widely depending on the cause. In all cases, however, those affected indicate that they have the subjective feeling of a significant increase in the volume of the tongue. Thus, sensations such as the tongue hitting the teeth or the palate or almost completely filling the oral cavity are not uncommon. In addition, those affected often have the feeling that their tongue feels different. The tactile sensation of the tongue thus either decreases with a feeling of numbness or it increases extremely with an increased sensitivity. What both have in common is that mobility is also affected. Because where the swelling predominates, the tongue cannot be moved or shaped as usual. In some cases it even affects the language.

Also read: Pain in the tongue

Swollen tongue with no pain

A swollen tongue can also be present without pain. This is because perception via the nerve fibers of the tongue can be restricted. Mostly it is due to a very strong swelling of the tongue, which leads to an undersupply of the nerve fibers. The effect is initially a tingling sensation that then turns into numbness. The numbness indicates that the tongue is no longer adequately supplied by the nerves in this area.

Any numbness should be seen as a warning signal that can indicate an undersupply of the tissue. Find out more about this topic at: Numbness of the tongue

Swollen tongue with pain

The tongue is extremely well supplied with sensitive nerve fibers so that it can serve as a tactile organ for humans. In addition, most of the receptors are very superficial in order to be able to perceive any contact. If both the nerve fibers and the receptors are stimulated, this sometimes leads to the perception of pain. In the case of a swollen tongue, it is the stored fluid in the tissue that compresses the nerves and thus causes pain.An accompanying inflammation of the affected area also sensitizes the fibers.

Swollen tongue and throat

A swollen tongue in combination with a swollen throat usually indicates an infection of the upper respiratory tract, which includes the mouth and throat area. The swollen neck is explained by the activation of the immune system by the lymph nodes in the neck area. They recognize the pathogens from the mouth area as foreign and initiate a defense reaction. The more immune cells they attract, the larger they become. Those affected perceive this process as a painful swelling in the throat. The swollen tongue itself can have a number of causes. The most common cause is a small sore on the tongue that is infected by bacteria from the mouth. The result is inflammation of the affected area and an increased susceptibility to further infection by pathogens. If the inflammation cannot be limited by the body's own mechanisms, it will spread further. The tongue is supplied with blood via the neck vessels. It is therefore logical that the infection should not only spread locally in the mouth, but also towards the throat. The stronger the infection, the more symptoms accompanying the swollen throat such as fever or difficulty swallowing the person affected. The appearance of the tongue often provides information about the status of the infection. The larger the tissue defect, the sooner there is a need for action. If no wound is visible, a metabolic disorder must also be considered. This must then be found out through a systematic examination of the organs.

Also read: Lymph node swelling in the neck

Swollen tongue and white coating

A white coating on the tongue is often the result of a fungal infection. Especially in people with a weakened immune system or after long antibiotic therapy, the body's own oral flora is disturbed. It is not uncommon for pathogens penetrating from the outside, such as fungi, to use the chance to colonize the mucous membrane of the tongue and throat. If the infection is manifest, it manifests itself as a white, flat coating on the tongue. It is characteristic that it cannot be wiped off. It even hurts those affected a lot when you try to remove it. If the covering can still be partially removed, the subsurface is bloody and severely inflamed. The first indication of a fungal infection is often the visual inspection of the tongue. However, if those affected do not open their mouth for dental hygiene, for example during daily care, they will first be noticed by a special bad breath. In addition, those affected often state that they can no longer taste properly. This can be explained by the fact that the whitish coating overgrows the taste buds on the tongue. As a result, they no longer properly perceive sweet, sour, spicy, or bitter components of food. Often times, a fungal infection is a visual diagnosis and can be treated well. Waiting is not justified as the infection is not self-limiting. Remember that it occurs especially in immunosuppressed people and after long antibiotic therapy. Supportive wound healing with medication is necessary because the immune system of those affected is still too weak and there is a risk of further spread. Antifungal drugs are the drug of choice here. They can be applied locally as a brush or spray and systemically as a tablet. However, it takes some patience until the infection is cured. Application several times a day for one to two weeks is usually necessary.

You might also be interested in this topic: Oral thrush

Swollen tongue on the right / left / one side

A strictly unilateral swelling of the tongue is extremely rare. Often it is based on a one-sided injury to the tongue from a sharp or hot object. As a result, a wound is limited to one side of the tongue and only leads to a one-sided restriction. If no external injuries can be seen on the tongue, a neurological disorder is suspected. The tongue can be visually divided into two halves by the dividing furrow. They are innervated in pairs from the left and right by different cranial nerves. If one side of the innervation fails, this is reflected in a one-sided functional failure. If the sensitive innervation of the tongue is disturbed on one side, this often manifests itself in a feeling of numbness on the affected side. This side is reactively perceived as being swollen and too big. This is comparable to the feeling after an anesthetic injection at the dentist. Those affected often feel that their cheeks are excessively thick. However, the swelling is only subjective and cannot be objectively proven. It is important to have the functional failure checked with various tests and, depending on the individual case, to treat it appropriately.

Swollen tongue and ear pain

Earache often occurs as part of an otitis media. The pathogens can get into the middle ear in different ways. One possibility is the route via the so-called "Eustachian tube" from the nasopharynx to the middle ear. The mouth to the throat is in the area of ​​the pharynx. The close anatomical position of the tonsils to the tongue explains the possible occurrence of earache and a swollen tongue parallel to each other. However, the swelling of the tongue is then usually limited to the back third of the tongue. It is also a mostly harmless swelling. Those affected usually notice them through difficulty swallowing. The swelling of the tongue itself is explained by the activation of the lymphatic tissue in the back of the tongue. It is used to recognize invading pathogens and present them to the immune system. An adequate defense reaction can then be initiated. Overall, however, it is rather rare that the tongue swells when there is an earache. Often, the swelling of the pharynx mucous membranes simulates a swollen tongue as part of the inflammatory reaction caused by the infection. The mucous membrane of the throat attaches to the side of the base of the tongue and can lift it slightly when it swells. Those affected then often perceive this as a swollen tongue.

Also read our topic: Symptoms of earache

Swollen tongue and throat

From an anatomical point of view, the tongue and the throat are adjacent. From a purely visual point of view, looking into the open mouth, you can see that the base of the tongue is anchored in the throat area. An inflammation or infection of one of the two structures can spread to the other. The throat is quite often affected by viral infections in autumn and winter. Inflammation of his mucous membranes is usually the result. Those affected notice this in the form of a scratchy throat, a dry cough or difficulty swallowing. Before the infection spreads to the tongue, however, it usually first spreads along the entire throat towards the nose and larynx. An infection of the tongue usually occurs last. In this case, only the back part of the tongue, which has the most contact with the throat, is usually affected. The result is a narrowing of the passage for food and breath. Sufferers may notice this in the form of difficulty swallowing or difficulty breathing when inhaling through the mouth. These effects are of course intensified by the additionally swollen pharynx. The swollen tongue can therefore be seen as a result of the spreading infection of the throat and indicates a more complicated course of the disease, which requires a doctor's examination if it is clearly impaired.

Swollen tongue and toothache

Toothache combined with a swollen tongue should usually always be treated by a dentist. In most cases, it is inflamed tooth roots or severe tooth decay, which lead to inflammation of the adjacent gums. If the inflammation spreads further, it can also reach the tongue and lead to a painful swelling there. Here, however, the chronological sequence of the symptoms is typical, as the toothache occurs first and then the swollen tongue. A dental restoration also removes the swelling of the tongue.

You might also be interested in the following topic: Root inflammation

Dental prints as an indication of a swollen tongue

Tooth prints on the tongue do not necessarily mean a swollen tongue. Often the tooth prints are created by an unconscious pressing of the tongue against the teeth as a result of stress. It then makes you think that the tongue is too big and that is why the marks are formed. In truth, however, it only fakes it. It often helps here if those affected ask themselves whether they are currently under stress. In addition, headache or neck pain during the day and teeth grinding at night can often be observed. If so, strategies for reducing stress should be learned. If the tongue is really swollen to such an extent that the tooth marks are formed due to its increased volume, in most cases those affected are no longer aware of this. Such a massive swelling means that the airways are blocked. Artificial ventilation is therefore necessary. However, this is rarely the case. Much more common, as I said, is the unconscious tensing of the tongue and pressing against the palate. As a result, the tongue widens and presses against the teeth. The imprints recede when you stop pressing. Consequential damage is not to be expected.

Are you interested in this topic? Read our next article on this below: Big tongue