Why does under my tongue hurt when i stick it out

Red-faced, with flushed cheeks, stammering, stuttering, and unable to complete a thought. That, you may think, is the miserable condition of being tongue-tied. That’s only about half right.

Although we use the phrase “tongue-tied” colloquially to describe being too flustered to speak and often associate it with being socially awkward, there’s a technical meaning of tongue-tied that your dentist can probably help with. It all comes down to a lingual frenulum. Of course, as catchy as the phrase tongue-tied might be, it’s far from the reason most people will become aware of their lingual frenulum. So, what exactly is a lingual frenulum, what can go wrong with it, and what can you do about it when there is a problem?

What Is a Lingual Frenulum?

If you look in a mirror while lifting your tongue to the roof of your mouth, you will be able to look at your lingual frenulum.  It is the piece of tissue that connects your tongue and the floor of your mouth. It’s usually whitish in color and is very thin. The words themselves can give you a clue about what it means if you know your medical speak. Lingual is of or relating to the tongue. A frenulum is a piece of tissue that helps control how a piece of the body that is meant to move does so. The lingual frenulum helps your tongue work properly for chewing, swallowing, and speaking.

Why Does It Hurt? Sore or Swollen Lingual Frenulum

Chances are very good that you don’t think about this piece of your mouth very much or at all. Still, because things can go wrong, you may first notice your lingual frenulum because it is giving you pain. Unfortunately, such a small piece can cause some serious discomfort. Anything that can irritate your tongue can cause pain in your lingual frenulum. This may include vitamin deficiencies causing one or more types of anemia. Medications, alcohol-containing mouthwash, or autoimmune conditions that cause dry mouth can be extremely irritating to all the parts of your mouth and tongue, causing pain under the tongue. Canker sores or other cores in the mouth also can cause pain in the lingual frenulum.

Most of all, an injury to your mouth can cause pain in the lingual frenulum. Piercing across the lingual frenulum has become more common in recent years. Although you may not consider this an injury since it was done deliberately, your body does not distinguish between injuries you intended and those you did not intend. If you have a piercing or any other type of injury under your tongue that is red, irritated, swollen, or has colored or unpleasant smelling discharge coming from it, seek medical attention promptly. Those are signs of an infection and any injury with serious infection signs in your mouth should be evaluated by a dentist or doctor to prevent dangerous complications.

What About Tongue Tie?

Sometimes, infants are born with a lingual frenulum that is very short or very tight. This attached frenulum is also referred to as ankyloglossia. Very tight attachment can cause problems for infants with eating and in older children with eating or speaking. It’s possible to have a procedure to correct the problem, and symptoms generally resolve quickly. There even has been some advancement using laser surgery to correct the problem, though it still commonly done with sterile scissors. If you suspect your infant has limited tongue movement, a visit to your dentist or pediatrician familiar with the condition is warranted.

So What Do I Do When It Hurts?

Your first step should be to evaluate why you are having pain. If you have canker sores or other mouth ulcers, treating the ulcers will help resolve the pain. If your tongue is red and swollen, head to your doctor or dental care team for an evaluation. If you have a vitamin deficiency, correcting your diet or supplementing the missing nutrients will help eliminate the pain. If you are suffering from dry mouth, using mouth sprays, sugar-free gum, or moisturizing rinse not only will help reduce your discomfort, it will help slow the development of caries caused by dry mouth. If you have a recent injury to your lingual frenulum, you should have it evaluated, but such injuries usually heal without major medical intervention. If you treat the underlying cause, the pain will dissipate. While you are working on the underlying causes, some people find sucking on ice (not chewing it) can provide relief.

Your lingual frenulum is a tiny structure, but it is a hard worker in the mouth. A little care for it, and you can continue not to think about it while you benefit from its hard work all day.

There’s no need to wait until you’re in a dentist’s chair to open wide. Regularly inspecting your tongue in a mirror can help you detect issues in your mouth—and other parts of your body—before they become more serious. Stick it out and give yourself a quick health check.

More From Men’s Health: 7 Dental Problems You Can Fix Yourself

The sign: Swollen grey/white balloon under your tongue.

What it means: You could have a clogged salivary gland. When this occurs, something is blocking the tiny ducts so they can’t drain saliva, causing swelling, fluid build-up, and pain. One of the most common causes of a clogged duct is a salivary stone. “It’s a calcium deposit similar to a kidney stone,” says Mark Woff, D.D.S, chair of cariology and comprehensive care at New York University College of Dentistry. If it doesn’t go away on its own within a few days, make an appointment with your dentist—the deposit may need to be surgically removed.

The sign: Sores with a halo around them.

What it means: A healthy tongue is pink and relatively smooth with no lumps or bumps. If you notice any red or whitish patches, a spot with a red ring around it, white areas with a lace-like pattern, or an unhealing sore, alert your doctor or dentist—it could signal cancer. While rates of other types of cancer are on the decline, the incidence of oral cancer has increased approximately 25 percent over the past decade, possibly due to the rise in human papilloma virus (HPV), a risk factor for the disease.

The sign: Thick red tongue.

What it means: Check your diet—you could have a vitamin deficiency. Your tongue is one of the first places a vitamin B12 deficiency appears. The vitamin is essential for creating healthy red blood cells, and subpar levels can lead to anemia. With that disease, your tongue may feel sore and is sometimes said to appear “beefy.” If you eat a typical U.S. diet, you’re probably getting enough vitamin B12 since it’s mostly found in meat, poultry, milk, fish, and eggs. However, if you’re a vegetarian or vegan or have a digestive disorder such as celiac disease or Crohn’s disease, you may not be getting enough. Taking a multivitamin and eating fortified foods like cereal can help.

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The sign: Black, hairy-looking tongue.

What it means: Did you recently take antibiotics? A course of the drugs can disrupt the normal bacteria in your yapper, causing an overgrowth that builds up on tiny round projections on your tongue called papillae. Instead of sloughing off like they normally do, the papillae can grow and give your tongue a hairy appearance. The good news: For the most part, it’s harmless and should go away on its own. However, the bacteria can cause bad breath and affect your ability to taste. “Brush your tongue really well with a toothbrush and toothpaste each day and you’ll help the normal flora return,” Dr. Wolff says.

The sign: Swelling.

What it means: Of all the symptoms to watch for, this requires the most immediate attention, since you could be having an allergic reaction. “It isn’t actually so much swelling of the tongue that occurs, but swelling of the airway behind the tongue that pushes the tongue forward, making it appear larger,” Dr. Wolff says. Without quick treatment, swelling in your mouth can block your airway and become life-threatening, Dr. Wolff adds. Seek medical attention right away.

The sign: Dry, white glossy tongue.

What it means: Dry mouth, or xerostomia, occurs when the mouth doesn’t produce enough saliva. This can cause uncomfortable dryness on the tongue and affect the balance of bacteria, which may cause a change in your tongue’s color and appearance. When left untreated, dry mouth can increase your risk of gum disease and tooth decay—normally, saliva deposits minerals that help keep your teeth healthy—and it may also increase your risk of oral infections. Drinking plenty of water and using a humidifier if you live in a dry environment can help. If dry mouth is a chronic problem, medications you take for allergies, high blood pressure, asthma, and other conditions may be to blame. Talk to your doc about switching prescriptions. You can also treat dry mouth with over-the-counter mouth rinses, which work like an artificial saliva substitute.

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This article was written by Paige Fowler and originally appeared on MensHealth.com

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