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It’s common to notice bumps, bubbles, or pimples under your tongue (ventral surface). They may appear suddenly and may not cause any pain or other symptoms.
These bumps can have a variety of causes, some more severe than others. They’re usually related to viral infections, irritation, or lifestyle factors such as diet, smoking, and sex.
If you have bumps on the underside of your tongue or the floor of your mouth, a doctor can help identify the cause and establish a treatment plan. In this article, we’ll talk about some common causes of bumps on the ventral surface of the tongue, as well as how they’re diagnosed and treated.
One common type of bump on the ventral surface of the tongue is an oral mucous cyst. Mucous cysts are small sacs of fluid that form due to inflammation or trauma.
Lip biting and other local injuries often cause mucous cysts to form, although some don’t have a clear cause. They go away with time as you heal from the injury but may come and go periodically.
Another type of benign cyst that can appear under your tongue is a lymphoepithelial cyst. It’s less common and often associated with HIV infection or autoimmune disorders.
Both oral cysts appear smooth and round and can vary in color (often white, yellow, or red). But unlike mucous cysts, lymphoepithelial cysts slowly continue to grow and risk becoming malignant (cancerous).
In most cases, an oral mucous cyst will heal independently if it isn’t continually irritated or injured. However, lasers, cryotherapy (freezing the cyst), and surgery are options for more severe or persistent cysts.1
Canker sores, or aphthous ulcers, are a very common type of mouth sore. They’re typically painful but aren’t a cause for serious concern. They tend to have a white center surrounded by a red border.
These ulcers tend to go away independently within about a week and a half. However, they may frequently recur, causing persistent mouth pain. The cause of canker sores isn’t clear, but they may be associated with vitamin deficiencies or an immune response.2
There is no definitive cure for canker sores. However, dietary supplements such as B vitamins, zinc, or iron may be helpful. Your doctor may recommend a strong mouthwash or pain medication if they’re especially severe and persistent.
Infection with human papillomavirus (HPV) is very common and can cause bumps to appear under your tongue. Most sexually active people will have an HPV infection at some point in their lives, and many cases have no symptoms.3,4
However, HPV can cause lesions in your mouth and other areas of your body. Like the cysts associated with HIV infection, these lesions can be precancerous.
HPV lesions may give the floor of your mouth a cobbled appearance. They’re often painless but may feel sore when touched or while eating.
While your body may be able to clear HPV on its own, no treatment can eliminate it. HPV lesions have to be removed via surgery or cryotherapy (freezing). Periodic follow-up tests can determine whether you still have HPV.
HPV can be prevented with vaccination, regular STI screenings, and using protection during sex, including oral sex.
Also known as sialoliths, salivary stones are mineral deposits that can form in your salivary glands. They’re similar to tonsil stones, but whereas tonsil stones often go unnoticed, salivary stones are hardened and can be painful.
The exact cause of salivary stones isn’t clear, but they seem to be related to dehydration or reduced saliva flow. Smoking, gum disease, and certain medications (like diuretics and anticholinergics) may increase your risk.5
Other symptoms associated with salivary stones include:
Doctors often recommend conservative treatment for salivary stones, especially at first. This encourages the stone to be expelled on its own and can include:
If the stone doesn’t respond to these treatments, it can be surgically removed. This usually involves a minimally invasive procedure, but an especially difficult stone may require a more invasive one to remove.
Though rare, a bump under your tongue can be a salivary gland tumor. In this case, the swelling may be visible even when your mouth is closed.
Very few salivary gland tumors develop in the sublingual gland (directly under your tongue), but of those that do, most are malignant.6
Salivary gland tumors may have other symptoms, including:
Like other forms of cancer, salivary gland tumors may be treated with one or more of the following:
The best course of action will depend on the specific type and stage of cancer and your overall medical condition.
While the causes of most bumps on the ventral surface of the tongue aren’t emergencies, there can be signs that you need medical attention.
You should seek medical treatment if any of the following symptoms accompany the bumps under your tongue:
These could be signs of mouth cancer or a lesion that requires more immediate evaluation by a medical provider. Prompt diagnosis and treatment will be needed to prevent further complications.
To diagnose what’s causing the bumps under your tongue, your doctor will physically examine you and ask about your symptoms. They may also ask you specific questions about your medical history or any possible risk factors you may have been exposed to.
Some additional tests may be needed, such as:
The right treatment for bumps under your tongue will depend on the underlying cause. They range from very conservative treatments that encourage your body to heal on its own to more intensive ones such as:
In many cases, bumps under your tongue aren’t a cause for serious concern. Mucous cysts, canker sores, and salivary stones, for example, often resolve independently. Practicing good oral hygiene can promote healing and reduce the risk of infection.
In cases of potentially cancerous cysts or lesions due to HIV or HPV, prompt treatment is key. It can greatly increase your chances of recovery and reduce the risk of further complications.
Talk to your doctor or dentist if you notice any unusual sensations or symptoms involving your mouth or sudden changes in your mouth’s appearance.
For some bumps on the ventral surface of the tongue, such as canker sores or salivary stones, conservative treatment may be the best option. To help relieve pain and assist healing, you can try the following remedies at home:
It’s relatively common for people to notice bumps or sores under their tongues. The causes range from harmless cysts and canker sores to salivary stones or potentially cancerous lesions.
Be sure to see your dentist or doctor if you have any unusual changes or symptoms involving your mouth. It’s also best to see your dentist at least twice yearly for regular checkups and cleanings.
In addition to being important for your oral health, seeing your dentist regularly will allow any unusual bumps, growths, or other issues to be noticed early.
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