Can Canker Sores Occur on the Tongue?
Yes, canker sores (recurrent aphthous stomatitis) can occur on the tongue, though they more commonly affect non-keratinized oral mucosa such as the buccal mucosa, labial mucosa, and soft palate. 1, 2
Location Patterns of Canker Sores
Canker sores typically appear on non-keratinized oral surfaces including the tongue, inner cheeks (buccal mucosa), inner lips (labial mucosa), and soft palate 1, 2
The tongue is a recognized site for aphthous ulcers, presenting as well-demarcated, oval or round ulcers with a white or yellow pseudomembrane surrounded by an erythematous halo 3
Multiple small, slightly elevated papules on the tongue can also occur with certain HPV-related conditions (Heck disease), though these are distinct from typical canker sores 4
Key Distinguishing Features
Location helps differentiate canker sores from cold sores (herpes simplex): Cold sores predominantly affect keratinized surfaces like the lips and hard palate, while canker sores favor non-keratinized mucosa including the tongue 1, 5
Canker sores on the tongue appear as painful ulcers with characteristic features: round or oval shape, white/yellow center, red border, and typically measure less than 1 cm in minor aphthous ulcers 3, 2
Clinical Significance
Recurrent aphthous stomatitis is the most common ulcerative condition of the oral cavity, affecting 20-60% of all persons, with lesions beginning in the second decade and peaking in the third decade 6, 2
Tongue ulcers persisting beyond 2 weeks or not responding to 1-2 weeks of treatment require comprehensive workup including blood tests (full blood count, HIV antibody, syphilis serology) and possible biopsy to exclude malignancy or systemic disease 3, 7