What is the differential diagnosis for ulcers on the lateral tongue and inner cheek (buccal mucosa)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 29, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Mouth Sores on the Side of Tongue and Inner Cheek

Single Most Likely Diagnosis

  • Recurrent Aphthous Stomatitis (Canker Sores): This is the most common cause of mouth sores and often presents on the movable parts of the mouth, such as the tongue and inner cheeks. The sores are typically painful, shallow, and can be triggered by stress, trauma, or certain foods.

Other Likely Diagnoses

  • Oral Lichen Planus: An autoimmune condition that can cause white, lacy patches or sores on the mucous membranes inside the mouth, including the tongue and inner cheeks.
  • Traumatic Ulcers: These can occur due to accidental bites, sharp teeth, or dental appliances, leading to sores on the tongue or inner cheek.
  • Herpes Simplex Virus (HSV) Infection: Although more commonly associated with lip sores (cold sores), HSV can also cause sores inside the mouth, including on the tongue and inner cheeks.
  • Nicotine or Tobacco Use: Can lead to oral lesions, including sores on the tongue and inner cheeks, due to irritation and decreased saliva production.

Do Not Miss Diagnoses

  • Oral Cancer: Although less common, mouth sores that do not heal can be a sign of oral cancer. It's crucial to rule out this diagnosis, especially in patients with risk factors such as tobacco use, alcohol consumption, or a history of radiation therapy.
  • Syphilis: Secondary syphilis can cause mouth sores, and it's essential to consider this diagnosis, especially in patients with other symptoms like rash, fever, or lymphadenopathy.
  • HIV/AIDS: Oral manifestations, including sores, can be an early sign of HIV infection, making it a critical diagnosis not to miss.

Rare Diagnoses

  • Behçet's Disease: A rare autoimmune disorder that can cause mouth sores, among other symptoms like genital sores and eye inflammation.
  • Pemphigus Vulgaris: A rare autoimmune disease that causes blistering of the skin and mucous membranes, including the mouth.
  • Erythema Multiforme: A rare skin condition that can also affect the mucous membranes, leading to sores in the mouth, including on the tongue and inner cheeks.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.