They burn and they hurt. Beyond that, tongue ulcers have little in common as far as their cause.

According to WrongDiagnosis.com, tongue ulcers have 24 distinct causes. Among the most common are injuries from biting and chewing, too much heat on the tongue and the herpes virus. Canker sores, histoplasmosis, cancer and even tuberculosis might prove to be the underlying cause.

Canker sores, with the medical term aphthous ulcers, are perhaps the most common type of tongue ulcer. The Mayo Clinic reports that that they usually go away on their on in a week or so. While minor ones typically don’t require any special treatment, ulcers that are particularly painful, large or persistent need medical intervention.

Treatment options for canker sores include:

Mouth rinses. If you see you doctor, he or she might prescribe a rinse that contains a steroid known as dexamethasone. Its use should cut the level of pain and inflammation. While oral suspensions of tetracycline, an antibiotic, can also minimize pain and healing time, doctors are sometimes reluctant to prescribe it because it can lead to the development of oral thrush for some individuals and can also discolor a child’s teeth permanently.

Debacterol. It can cut the healing time to around a week by chemically cauterizing tongue ulcers. It’s a topical solution targeted for canker sore and gum problems.

Oral medications. Sometimes a medication developed for an entirely different purpose can be beneficial to a particular condition. This is the case with the cimetidine (brand name Tagamet), used to treat heartburn, and colchicine, a medication for gout. Both of them might be helpful for treating canker sores in some patients. When the ulcers don’t clear up after other types of treatment, doctors sometimes resort to prescribing oral steroids. However, due to their potential side effects, steroids remain the drug of least choice for this condition.

Topical pastes. Sometimes over-the-counter and prescription pastes can successfully treat tongue ulcers. Common brand names include Kenalog in Orabase, Aphthasol and Lidex. However, in order to reduce pain and healing time, it’s essential to apply the paste at the first sign of each lesion.

Nutritional supplements. The family doctor is likely to check the patient’s blood work for levels of folic acid, zinc and vitamins B-6 and B-12. If any of them is low, he or she will probably suggest a nutritional supplement to compensate.

Alternative treatments. Some of them employ over-the-counter medications like vitamins, while others are strictly home remedies. Among the recent ways to treat and prevent canker sores are zinc lozenges, probiotics like acidolphilus and mega doses of vitamins C and B complex. Lysine supplements reportedly help some patients. Others mix a paste of slippery elm powder, deglycyrrhizinated licorice or alum, then apply it directly to each lesion.

Others. In the case of certain other ailments, such as inflammatory bowel disease, doctors must treat the underlying condition to get it under control before the ulcers will heal.

Since tongue ulcers have so many potential causes, it’s important to see a physician for an exam if they don’t disappear within a week or two.