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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes a white patch under the tongue?

Answered by
Dr.
Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Sat, 27 Aug 2016 in General Health
Question: Hi. I went to a doctor last week Monday when I noticed a small white sore underneath my backside of my tongue. The doctor examined it and said it was like a canker sore. I've had this almost 2 weeks and it's still the same.. It is not painful but noticeable when I eat. He did prescribe magic mouthwash which I did use and didn't seem to do much. I should say that I had a terrible sore throat the week before that and was prescribed antibiotics which is now totally gone. I've attached a picture although not clear that shows the white spot at the very back underneath the tongue. It's not a bump and smooth. Should I be concerned as I'm really worried?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
Some possibilities.

Detailed Answer:
Hi -

I couldn't really see the white spot well because of reflection, although in mouth3.jpg I could see a white patch toward the left side under your tongue.

It looks like a sore from a small trauma to the mucus membrane that is now in the healing phase, but I can't tell for sure from the picture.

Given that this followed use of antibiotics, it's possible that it a small area of oral candidiasis (thrush). I can't know for sure from the pictures - it should be seen in person. Usually oral candida causes what looks like a white patch. If this is the case, treatment is an oral anti fungal such as Nystatin 4-6 ml, swish and swallow 4 times per day. Clotrimazole is another option.

If you don't smoke cigarettes, chew tobacco, or use tobacco in any other form, the chance of this being something serious such as cancer of the mouth is very low.

Leukoplakia, is another possibility. It can cause a whitened area from recurrent irritation. Treatment is to remove the irritation (such as if something is rubbing there).

So I think the thing to do at this point is go back in to be seen. If your primary doctor can't tell, then the next step is an ENT. And if you can't get in to see an ENT, a dentist may provide information and you might be able to get in to see one sooner.

I hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 23 minutes later
Could thid be apthous ulcer?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 28 minutes later
Brief Answer:
About aphthous ulcers

Detailed Answer:
An aphthous ulcer is just a canker sore. It doesn't look like a canker sore, which usually has more of a crater appearance - white in the central crater surrounded by red inflammation.

It's possible that it started out as a canker sore, but is now healed over.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 11 hours later
I went to a dentist and thr veloscope test came back dark or negative. However she felt a bump and is referring me to an oral medicine specialist. I saw my family doctor afterwards and he looked at the white sore and said it was a canker sore from after my antibioics and viral infection. He said that hes been practicing for over 40 years and would know if its something very serious. Im going to get a 2nd opinion from another dentist and go from there. Ill have to say the 1st dentist worries me .
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 16 minutes later
Brief Answer:
2nd dentist.

Detailed Answer:
Hi - I can understand being worried, but the chance of it being cancerous is very low without tobacco use. Also, that it came on after a viral infection makes it less likely too - is more likely to be related to that or the antibiotic use. Also, I think a physician who has been in practice for 40+ years is reassuring as he has likely seen pretty much everything.

Seeing a 2nd dentist is a good idea, but try to put your mind at ease if you can as the chance of it being something serious is very low.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 2 hours later
I saw the 2nd dentist and he could not find anything abnormal. He did a thorough check through my mouth and tongue and told me not too worry. He siad if i wanted i could be referred to a oral specialist .
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
I'd be reassured by this.

Detailed Answer:
If it were me, I'd be reassured by the second dentist and the physician with 40 years experience who saw the white area in person. It may be a healing, or healed, mucosal irritation or have been a canker sore that is healing or healed.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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