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Sore on top of tongue. Not a smoker and heavy drinker.Reason?

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ENT Specialist
Practicing since : 1991
Answered : 2549 Questions
I have a sore on the top of my tongue in the middle (where the taste buds are). It's been there over two weeks. It seems to be like an ulcer with three white spots inside it. I thought maybe I must have burned and it blistered. But I don't remember such an incident. It feels better every morning, but as the day goes on, it begins to hurt again. I have an appmt with a ENT, but can't get if for a few weeks from now. I was afraid it was tongue cancer but when I google it, it seems that is mostly on the side of tongue and in other parts of the mouth. This is right on the top in the middle. Besides, I don't smoke, and I'm not a heavy drinker. Any ideas?
Posted Fri, 25 Oct 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 23 minutes later
Brief Answer:
There is no cause for worry.

Detailed Answer:

Thank you for your query.

1. The sore area on the dorsum (top) of the tongue will most probably be a glossitis. The ulcer may be a common apthous ulcer. The white spots are most likely to be inflamed papillae (taste buds).

2. Get the tongue and oral cavity examined. As you have rightly deduced, tongue cancer is rare in this area and hence is not a cause for concern.

3. There are certain common conditions (an image would have helped) such as Median Rhomboid Glossitis, Geographic Tongue, Transient Lingual Papillitis which are associated with nutritional deficiencies, acid reflux and stress.

4. Your doctor can examine the area and take a swab to rule out infection, including fungal (Thrush). Vitamin B Complex, Folic Acid and Zinc supplementation may be added. Certain auto-immune disorders can be ruled out by blood tests. If in doubt a small biopsy from the edge of the ulcerated area will settle the issue. (HPV tests can also be done). Pain medication and barrier ointments will help the area heal faster.

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

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