Most tongue ulcers are minor canker sores that heal on their own within two to three weeks, but you can speed up healing and reduce pain with a few simple strategies. These small, shallow sores (typically under 1 cm) are the most common type, and while they’re not dangerous, they can make eating and talking miserable in the meantime.
Saltwater and Baking Soda Rinses
A warm saltwater rinse is one of the simplest and most effective things you can do at home. Salt kills bacteria through osmosis, pulling water out of bacterial cells, and it shifts the pH of your mouth toward alkaline, making it harder for bacteria to survive. Beyond that, saltwater actively promotes wound healing by stimulating the cells responsible for tissue repair. Mix one teaspoon of salt into eight ounces of warm water and swish gently for 30 seconds, then spit. If it stings too much, cut the salt to half a teaspoon for the first day or two. Repeat several times a day, especially after meals.
Baking soda rinses work similarly by neutralizing acids in the mouth that irritate open sores. Dissolve about a teaspoon in a glass of warm water and use it the same way.
Over-the-Counter Pain Relief
Topical gels and pastes containing benzocaine or other numbing agents can be applied directly to the ulcer to temporarily block pain. These are available at most pharmacies and work best when applied before meals so you can eat more comfortably. Some people also find relief from over-the-counter mouth rinses designed for oral sores, which combine a mild antiseptic with a coating agent that protects the ulcer from further irritation.
If your ulcers are particularly painful or slow to heal, a doctor can prescribe a corticosteroid dental paste. The standard version contains a low-concentration steroid that reduces inflammation directly at the sore. You press a small dab onto the ulcer until a thin film forms (don’t rub it in). Applying it at bedtime lets the medication sit on the sore all night. For more severe cases, it can be used two or three times daily after meals.
Avoid Irritating the Sore
What you eat matters while you’re healing. Acidic foods like citrus, tomatoes, and vinegar-based dressings can sting and slow recovery. Spicy foods, rough-textured chips, and crusty bread can physically aggravate the ulcer. Stick with softer, blander foods until the sore closes up. Drinking through a straw can help liquids bypass a sore on the front of the tongue.
Some people notice ulcers flare up after switching toothpaste brands. Sodium lauryl sulfate (SLS), the foaming agent in most toothpastes, has long been suspected as a trigger. The evidence here is mixed. A 2019 review found there wasn’t enough data to confirm that SLS-free toothpastes reduce ulcer frequency, duration, or pain. That said, if you notice a pattern, trying an SLS-free option for a few months is low-risk and worth experimenting with.
Check for Nutritional Gaps
Recurring tongue ulcers sometimes point to a nutritional deficiency rather than just bad luck. In one study of 273 people with recurrent ulcers, about 20% were anemic, 20% had low iron levels, nearly 5% were deficient in vitamin B12, and close to 3% were low in folic acid. These deficiencies don’t always cause obvious symptoms beyond the ulcers themselves, so they’re easy to miss.
If you get tongue ulcers frequently (several times a year or more), it’s worth asking your doctor to check your blood levels of iron, B12, and folate. Correcting a deficiency can sometimes stop the cycle entirely. B12 deficiency in particular has been clearly linked to recurrent canker sores in multiple case studies, with ulcers resolving once levels were brought back to normal.
When Ulcers Signal Something Bigger
Occasional canker sores are common and harmless. But recurring or unusually severe mouth ulcers can be a feature of certain systemic conditions. Celiac disease, for example, can cause persistent oral ulcers alongside digestive symptoms like bloating, diarrhea, and fatigue. Behçet’s disease is a rarer inflammatory condition where mouth ulcers appear alongside genital sores, skin lesions that resemble acne or tender nodules on the lower legs, eye inflammation causing redness and blurred vision, and joint pain (often in the knees). If your tongue ulcers come with any of these other symptoms, that’s a different conversation to have with your doctor.
People with weakened immune systems, including those with HIV, can develop ulcers that take months to heal and may need more aggressive treatment.
Signs a Tongue Ulcer Needs Medical Attention
The key timeline to remember is three weeks. If a tongue ulcer hasn’t healed by then, it needs to be evaluated. Most canker sores resolve well before that point, so one that lingers is worth investigating.
There are also physical differences between a harmless canker sore and something more concerning. Canker sores are flat, with red, inflamed edges. Oral cancers, by contrast, often have a small lump or bump beneath the surface that you can feel with your tongue or finger. A spot that starts small and grows, a white patch that turns red, or a sore that begins bleeding when it previously didn’t are all reasons to get checked. MD Anderson Cancer Center specifically flags these as warning signs that warrant a professional evaluation and potentially a biopsy.