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Have had oral sex. Developed bumps on the back of tongue. Are they related?

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ENT Specialist
Practicing since : 1991
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Hi there,

I have a question about my tongue. I have noticed lately my tongue has been wavy on the sides, rigid, as if it has conformed to my teeth on the sides and stayed that way. There is one place in particular in the front that has a little wavy bump to it that I feel against my cheek as it goes out of my mouth. I just wanted to make sure there is nothing to be worried about as it has become something I'm aware of as I move my tongue around.

Just to throw this out there, my sexual history is very little. I have never had intercourse, and I have only had oral sex with a few partners that are very clean and careful. I have not experienced oral sex with a new partner in almost 6 months. Just wanted to make sure something related to that is not an option, just as a worrier.
I would also like to ask about some bumps on the back of my tongue. These showed up several months ago when I had to take some Bactrim and got oral thrush from it. I have always assumed they were circumvallate papillae just from my own research but if you can confirm no need to worry, I would sure appreciate that as well. The photo for this particular worry is "tongue bumps 1.jpg"
One last thing. The bumps in the last photo I mentioned have been there for several months, since the aforementioned antibiotic usage that caused thrush. Sorry for three messages. Just trying to give as much info as possible.
I have attached photos that I hope will help clear my worried mind. Thank you very much. Happy Holidays.
Posted Tue, 11 Dec 2012 in Infections
 
 
Answered by Dr. Sumit Bhatti 11 hours later
Hi,

Thank you for your query.

1. The images show a Scalloped Tongue.

2. This scalloping implies a chronic inflammation or enlargement (macroglossia) which is often seen alone (no significance) or associated with many conditions such as Hypothyroidism, Fungal infections (Thrush), Multi-vitamin deficiencies, Amyloidosis, Sarcoidosis, tumors increasing the volume of the tongue, Obstructive Sleep Apnea Syndrome (OSAS), Temporo-Mandibular Joint (TMJ) disorders and so on.

3. If it is sensitive, you may use medical grade liquid glycerine and a topical anti-fungal oral paint for super-added fungal or yeast infection.

4. Multi-vitamins and anti-oxidants will help. Any acid reflux, if present must be controlled. Any cause for immuno-supression must be ruled out. Get a VDRL test done.

5. The bumps on the tongue are prominent circumvallate papillae. These are commonly seen associated with some of the conditions listed above.

6. The simplest course of action will be to get an oral examination and a dental opinion. It is important to differentiate between true and pseudo-macroglossia. If these are normal, only regular follow-up is required. A Tongue Doppler Study and Neck Ultrasound will help

7. I must emphasize that the cause is mostly unknown. It is usually a harmless condition related to Oral Thrush. It is not contagious. This does not seem to be associated with your history of exposure.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 4 minutes later
Would it be normal to see some of these bumps on what appears to be slightly off the side of the tongue in the back sides of my mouth? They may be attached to the tongue but it more appears on the back cheek sides next to where they are on the tongue you just saw. I cannot seem to get a photo that far back in my mouth. Also, you feel confident these are not hpv or anything like that? Thank you.
 
 
Answered by Dr. Sumit Bhatti 28 minutes later
Hi,

Thank you for writing back.

1. It is normal to see some of these bumps on the side of the tongue further back. However it will be better to show this to a local Dentist or ENT Specialist as images of these areas are difficult to capture.

2. There are no clinical signs for early HPV detection. You may try OraRisk Saliva testing or get a small biopsy examined. Herpes usually causes snail track ulcers. You may get a throat swab examined.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 3 minutes later
I had a full std blood profile done recently as a precaution. I am clean with hsv 1 and 2 along with syphilis. Do you feel these are likely harmless? By the way, I currently have a cold. Could that be to blame for the scalloping and things besides the bumps?
 
 
Answered by Dr. Sumit Bhatti 35 minutes later
Hi,

Thank you for writing back.

1. Most cases of Scalloped tongue are harmless. It must be remembered that some of the causes are non infective.

2. It is good to hear that you have tested negative for HSV and Syphilis. Have you done your Thyroid Function Tests and Vitamin B12 levels?

3. A cold is unlikely to be the sole cause for the scalloping and the bumps. Many possible causes will have to ruled out by a physician.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 2 hours later
Hi doctor - yes, I have had my thyroid and B12 checked and all is normal.

Regarding your previous HPV comment, I'm curious if the bumps would resemble that of an HPV infection. I'm assuming not, but it's just one of those questions for a worried mind.

As I mentioned before, it appears that on the sides of the tongue way back, the bumps are not on the tongue at all but rather on the inside of the cheek skin back there. But again i could be wrong as it it's hard to tell what they connect to.

Overall, would you think an otherwise healthy 28 year old would have anything to worry about?
Hi doctor...just a quick note in addition to the previous one. I was able to get a picture of the bumps that may or may not be attached to the tongue I spoke of before that were hard to photograph. I have drawn a circle on the photo to show them.

I want to also mention my cold and much sinus drainage that has irritated my throat.

But mainly I am concerned about these bumps. Now that you can see all of them, what are your thoughts? Thank you so much.
 
 
Answered by Dr. Sumit Bhatti 5 hours later
Hi,

Thank you for writing back.

1. The two bumps in the image are accessory lymphoid tissue (similar to the tonsil) which is distributed throughout the oral cavity and throat.

2. This is very common. These can be easily biopsied and checked for HPV if you suspect any other serotype.

3. These bumps occur in response to a local inflammation , allergy or irritation such as from Oral Thrush, Post Nasal Drip (PND), Acid Reflux and so on.

4. These bumps may subside on their own or with minimal treatment as outlined above.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 8 minutes later
Hi, so I just want to make sure I understand clear so I can go to bed with a clear mind tonight :)

1. You do not suspect these to be anything to worry about right?

2. And do you see any reason they should be biopsied for HPV given my history of only 5 total oral sex encounters in the past year with 2 females partners that are each known to be clean?

Bless you and thank you once again. I hope that you find much prosperity in this new coming year.
 
 
Answered by Dr. Sumit Bhatti 8 hours later
Hi,

Thank you for writing back.

1. There is no cause for worry. If these bumps are symptomatic, they need simple, routine treatment.

2. You may consider a biopsy only if these lumps do not respond and persist in spite of treatment.

Wishing you good health,

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 3 hours later
Is it a possibility I have them as just part of the normal landscape of my mouth and have just never noticed them before? Do some people just have these things?
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

1. These lymphoid lumps are not normal. The circumvallate papillae are normally visible. You have noticed them now.

2. Many people have such lumps and they are easily treated.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 2 minutes later
Could you kindly list a few common causes of specifically the lymphoid lumps? Thank you so much again.
Also doctor, something else to add to the mix of consideration...I was going thru some old photos I took of my mouth during a period in July that I had oral thrush when this all started. These same lymphoid lumps can be seen in these pictures that are four months old. Either these have been present this whole period, or, they have just returned. Either way, I have attached this photo I am speaking of for you to view. With all of this being said, what are your thoughts?
 
 
Answered by Dr. Sumit Bhatti 10 hours later
Hi,

Thank you for writing back.

1. The most common causes for these small lymphoid tissue lumps is allergy, infection, thermal damage and foreign body reactions. Tumors are rare.

2. This lymphoid tissue is present and distributed randomly throughout the oral cavity and throat. This may be a larger aggregation prone to repeated inflammation. You have these lumps since birth and they will remain unless physically removed or cauterized. A radiofrequency ablation will work in your case.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 2 hours later
I saw a healthcare professional in person today just to ease a continued troubled mind. She stated that she felt these bumps were in relation to sinus/allergy things and that she sees them pretty often here in XXXXXXX with all our allergens we have here. She also mentioned she saw some "marbling" and that those spots were a part of that. She seemed not worried at all. Does this seem pretty on course with your diagnosis?
 
 
Answered by Dr. Sumit Bhatti 7 hours later
Hi,

Thank you for writing back.

1. Yes, this is consistent with my diagnosis. There is no cause for worry.

2. 'Marbling' in the throat is due to lymphoid tissue hypertrophy. as explained in detail above, this tissue is randomly distributed all over the oral cavity and throat. For example, such an appearance on the back of the throat (posterior pharyngeal wall) is known as 'Granular Pharyngitis' and is extremely common.

3. Interestingly, while many body parts have a precise definition of normal and abnormal, the throat is peculiar in that there is no precise definition of what constitutes a normal throat. There are definitions for abnormal appearances in the throat but a normal throat is one that is asymptomatic.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had oral sex. Developed bumps on the back of tongue. Are they related? 54 minutes later
Thank you so much again for the great information and patience with my questions doctor. I am going to close the conversation now and give you a perfect review. Thanks!!!!
 
 
Answered by Dr. Sumit Bhatti 2 hours later
Hi,

Thank you for writing back.

Wishing you good health,

Regards.
Above answer was peer-reviewed by
 
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