Bumps under the tongue often appear suddenly and without an identifiable cause. Although they may feel strange, bumps under the tongue are usually harmless.
In this article, we cover possible causes of bumps under the tongue and how doctors diagnose and treat them. We also discuss home remedies and when to seek medical treatment.
There are many possible causes of bumps under the tongue. Some of the more common ones are those below:
Canker sores, also known as aphthous ulcers, are open lesions that can develop anywhere inside the mouth, including under the tongue.
Canker sores appear suddenly. They have no known cause but are not contagious. Some researchers believe that canker sores are a type of immune system response.
Other factors can also trigger canker sores, such as:
- an injury or damage to the tissue underneath the tongue
- exposure to spicy, acidic, or dairy foods
- hormonal changes, such as those during menstruation, pregnancy, or menopause
- gastrointestinal (GI) disorders, such as celiac disease
- nutritional deficiencies, such as low iron, folate, and vitamin B12
- physical or emotional stress
Most canker sores are minor and resolve on their own within 4–14 days.
Oral mucous cyst
Mucous cysts are fluid filled sacs that form in the tissues of the fingers, toes, and mouth. An oral mucous cyst will develop near one of the openings of the salivary glands under the tongue or on the lips, cheeks, or floor of the mouth.
Mucous cysts appear as soft, swollen lumps that range in color from flesh-colored to dark blue. Mucous cysts tend to periodically disappear when they rupture and reappear when they become irritated by saliva.
Although a person can develop an oral mucous cyst at any age, they usually occur between the ages of 10 and 30 years.
Human papillomavirus, or HPV, is the most common sexually transmitted infection (STI) in the United States, according to the Centers for Disease Control and Prevention (CDC). Scientists have identified more than 180 HPV subtypes.
HPV infections lead to lesions in the skin and mucous membranes. According to the CDC, about 40 subtypes of HPV can infect the mouth and throat.
People with minor oral HPV infections do not develop symptoms. However, those who do may notice:
- small, hard bumps under the tongue or in the mucous membrane inside the mouth
- bumps that appear white, pink, red, or flesh-colored
- painless, smooth, and slightly raised bumps
- a single bump or cluster of bumps
These small, firm nodules sit just below the mucus membrane that lines the inside of the mouth. Lymphoepithelial cysts usually appear as flesh-colored, white, or yellow bumps under the tongue or on the floor of the mouth.
Sialolithiasis, also known as salivary stones, is a condition in which stones of crystalized minerals form in the ducts of the salivary glands. Sialolithiasis is the most common cause of salivary gland swelling.
A stone that forms in the sublingual gland, located underneath the tongue, can lead to a sore, painful bump.
Other symptoms of sialolithiasis include:
- pain or discomfort in the mouth that worsens when eating
- pain or swelling below the jaw
- infection in or near the affected gland
- dry mouth
Salivary gland tumor
A salivary gland tumor that forms in the sublingual gland can lead to a lump or swelling under the tongue or near the jaw.
Generally, if the tumor develops in a smaller salivary gland, there is a higher probability that it is malignant.
For example, although less than 1% of salivary gland tumors develop in the sublingual gland, 70–90% of sublingual gland tumors are malignant. A malignant tumor grows rapidly and can spread to other parts of the body.
Salivary gland tumors can lead to the following symptoms:
- a lump or painful swelling under the tongue or in the jaw, ear, or neck
- numbness or muscle weakness in part of the face
- difficulty opening the mouth or swallowing
- fluid draining from the ear
A doctor can diagnose most causes of bumps under the tongue by carrying out a physical examination and asking the person to describe their current symptoms. They may also review the medical history of the person and their family for indications of risk factors for certain diseases.
A doctor may use one or more diagnostic tests to confirm a diagnosis or rule out other potential causes. These tests can include:
- blood tests that measure white blood cell counts, to check for an infection
- a swab culture analysis, to identify infectious pathogens, such as bacteria or fungi
- imaging tests, such as a CT scan or MRI scan, to identify structural abnormalities in the mouth
- a biopsy, to analyze tissue samples for cancer cells
Treatment varies depending on the underlying cause. Many types of bumps under the tongue, such as canker sores and mild HPV infections, resolve on their own without medical intervention.
- HPV mouth sore: A doctor can freeze an HPV mouth sore using cryotherapy or inject it with an antiviral drug called interferon alfa-2B.
- Cysts: A doctor may attempt to drain lymphoepithelial cysts and oral mucous cysts. They may recommend removing a cyst using laser therapy or freezing it with cryotherapy.
- Sialolithiasis: A doctor may treat salivary stones with anti-inflammatory drugs. They can push the stone out by massaging the salivary gland or gently probing the affected area with a blunt object. A doctor may recommend surgery to remove a large salivary stone.
- Salivary gland tumors: A doctor will likely recommend surgery for salivary gland tumors. During surgery, they will remove the tumor along with some of the surrounding tissue. If they identify cancer cells elsewhere in the body, they may recommend a systemic treatment, such as radiation therapy or chemotherapy.
The following home remedies may promote healing and help relieve uncomfortable symptoms of tongue bumps:
- practicing good oral hygiene
- using medicated mouthwash
- avoiding acidic, spicy, and sugary foods
- using topical gels and numbing solutions on painful oral sores
- quitting smoking, if a smoker, and avoiding secondhand smoke
Most causes of bumps under the tongue heal on their own. However, people should speak with a doctor if they have a bump under the tongue that does not heal within 10 days.
People should also seek medical attention if they have a bump under the tongue or swelling in the mouth that interferes with their ability to speak, swallow, or chew.
Bumps under the tongue can appear suddenly and without an apparent cause. These bumps often resolve on their own without treatment.
Some bumps heal and reappear months or years later. Other types of tongue bumps resolve and never occur again.
People with more serious underlying conditions, such as HPV infections and salivary gland cancer, can have very positive outlooks if doctors catch the condition at an early stage.
Bumps can develop under the tongue due to a mouth injury, exposure to viruses, eating certain foods, or salivary stones, among other causes.
Regardless of the underlying cause, most bumps under the tongue resolve relatively quickly and do not require medical treatment. More serious tongue bumps, such as tumors, salivary stones, and infections, are easily treatable with medication or surgery.