One of the strongest muscles in the body is the tongue. It assists us not only in speaking, but also with digestion. 
The tongue consists mainly of muscles, eight to be specific, and is wrapped by mucous membrane. It has three surfaces: the tip, the body and the base. Its surface is comprised of projections called lingual papillae, furnishing it with its rough exterior. [2,3,4]
A photo of the tongue pointing to its papillae, the numerous lingual projections which makes it rough.
The tongue is made up of around 10,000 taste buds, 80% of which are located superficially and 20% distributed beneath the tongue, on the buccal mucosa and on the palate. All of them are capable of determining the four common tastes: sweet, sour, salty and bitter. The tongue is made up of nerves, which recognizes those particular tastes and consequently, transmits those tastes into the brain. They have the ability to regenerate every two days. [1, 2]
A photo showing the various areas where taste buds are located in the tongue, along with its various tastes.
Even if it is one of the most strongest and resilient part of the body, it can still be injured. Tongue sores being one of the most common conditions with which tongues are affected.
What Are These Tongue Sores And How Do They Look Like?
Usually, tongue sores are just harmless trauma spots produced when the organ for taste and mastication is accidentally bitten. Other times, these sores can be more than just bite marks.
Simple Tongue Sore
A sore located on the tip of the tongue can usually appear as a small reddish painful bump. This can be a sign of an impending infection, either viral or bacterial, or hypersensitivity reaction from either a medication or food. 
An image showing a tongue sores at its tip.
Whitish or grayish patches, on the other hand, are termed Leukoplakia. These lesions thickened, elevated, and are visible on the side of the tongue. They can be signs of immunosuppression, simple irritation from tobacco and dentures, and even a prelude to malignancy. [5, 6, 7]
Leukoplakia shown as a whitish patch along the side of the tongue.
Canker Sore (Aphthous Ulcers)
Small round tongue sores with either white or yellow centers are termed canker sores or aphthous ulcers. They are mostly located on the beneath the tongue. They can root from viral and bacteria infections, hormonal changes, low immunity and even vitamin and mineral deficiencies. [3, 5, 8, 9, 10]
A photo showing a canker sore on the underside of the tongue.
What Causes These Sores?
The etiology of tongue sores depend on the each person’s health, environment, hygienic practices and way of living. The following are the leading risk factors increasing one’s s chances of having tongue sores, along with its concomitant diseases: [3, 8, 9,10]
- Tobacco use, either by chewing or smoking
- Virus: Herpes simplex, Human Immunodeficiency Virus, Coxsackie
- Fungi: Candida
- Bacteria: Staphylococcus
- Iron and Folic Acid deficiency
- Vitamin B12 deficiency
- Sodium Lauryl Sulfate substance found among toothpastes
- Bismuth among medications commonly utilized for stomach upsets and abdominal pains
- Foods containing too much spice, salt and acid
- Imbalance of hormones
- Tedious scraping of tongue and vigorous brushing of teeth
- Allergic reactions to food and medicines
- Immunosuppressed and immunocompromised
What Symptoms Accompany These Sores?
In most occasions, tongue sores are just tip of the icebergs. They are usually signs of an impending, or already occurring, illness. Other signs and symptoms which make up these illnesses include fever, body malaise, lymph node tenderness, dryness of the mouth, increased thirst, metallic and bitter taste, burning sensation on the oral cavity, abdominal pain, and the presence of ulcers and lesions on other parts of the body. [8, 9]
How Can I Treat Tongue Sores?
Tongue sores usually heal spontaneously within just a few days with any complications and sequelae, hence, not needing any medical management. Medical interventions are only needed if these sores are persistent, are large and affecting one’s usual activity. Some of the medicines used in managing these tongue sores are the following: [8, 9, 11, 12, 13]
- Zinc containing creams and ointments
- Antiviral medications for infections brought about by Herpes simplex
- Antibiotics for those infected with Staphylococcus-induced tongue sores
- Anti-inflammatory medicines for severe pain and discomfort
- Antifungal drugs for Candida
- Medicated mouthwash and oral sprays
- Diphenhydramine mixed with milk of magnesia as oral rinse
- Carbamide peroxide solutions for antisepsis and pain relief
- A topical solution with sulfuric acid and phenol also for pain relief
- Corticosteroid solutions, like those with hydrocortisone and triamcinolone acetonide, for pain relief and reduction of healing time
- Vitamin and mineral supplementation, particularly for those with vitamin B12, iron and folic acid deficiencies, and even malnutrition
What Else Can Be Done?
Aside from the said medications, the following methods can be use as adjuncts for the treatment of sores found on the tongue: [10,11, 13]
- Good oral hygienic practices: frequent brushing of teeth, using mouthwash, flossing and gentle tongue scraping
- Rinsing of the mouth with lukewarm saline solution
- Gargling a mixture of warm water and honey
- An ice cube application on the tongue done at regular intervals of time for pain reduction
- Glycerin application for pain relief
- Having an adequate diet including foods such as lentils, legumes, and green leafy vegetables
- Restriction of foods high in acid, salt, sugar and spices
An image depiciting the proper way of tongue scraping: with gentle strokes to prevent tongue sores.
Persistent Tongue Sores
If, unfortunately, the tongue sores do not improve, are persistent, or are recurring quite more often, a consult with the physician is warranted. One must remember that tongue lesions are at times a precursor for cancer. Hence, keen observation and immediate management is of utmost importance.
An image of a non healing tongue lesion, which had given way to oral cancer.
by on in Ear, Nose and Throat