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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes a white spot on the tongue?

Answered by
Dr.
Dr. Neha Sumra

Dentist

Practicing since :2011

Answered : 725 Questions

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Posted on Mon, 12 Sep 2016 in Ear, Nose and Throat Problems
Question: Dear Doctor,

My concerns regarding the white lump which I have wrote about earlier worsens.

I just realised that the lump is not on my tonsillar pillar, but is actually on my tongue.

The white area is accompanied by a rather large pappilae (kindy refer to the photo attached). It is quite painful to the touch, discomfort / slight pain even when not touching / stretching the mouth.

I am rather worried as it looks quite nasty. Kindly get back to me.

Made a dentist appointment tomorrow, hope it's nothing serious.

This might have nothing to do with it, but I did have unprotected oral sex with another guy back in late XXXXXXX Would this be of any concern (Gonhorrea/Chlymadia etc...)?

Many thanks
XXXX
doctor
Answered by Dr. Neha Sumra 2 hours later
Brief Answer:
Can be premalignant lesion, go for biopsy

Detailed Answer:
Hi

Thanks for writing in, i've reviewed the images.

As per your description, image of the area and symptoms, you might be having premalignant lesion like:
1. leukoplakia
2. candidiasis
3. oral sub mucous fibrosis
4. syphilitic ulcer

To rule out, you need to go for biopsy.
Management is to be planned accordingly.
Meanwhile take multivitamin(eg. Cap Becosule once daily after breakfast) and avoid sour/spicy food.

Please Consult an oral surgeon for further management / treatment plan.

Hope I've answered your query, please let me know if there's any further queries, i'll be glad to clarify.

Wishing you good health

Regards
Dr. Neha Sumra

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Neha Sumra 15 hours later
I have visited both my Dentist and GP today.

They both examined my tongue.

Here's how it went:

DENTIST:
Said that it is nothing that worries him, looks like trauma of the tongue (which could be from my teeth or earlier late last week after using the tongue scraper on that side of the tongue) or a blocked salivary gland, although he is not sure about it, he wants to examine me in 5 days time. He prescribed me a toothpaste/gel and a mouthwash

DOCTOR:
I visited the GP last Thursday complaining of what seemed to be a cold, altough it was not severe, no fever.
GP said that the viral which I previously had might have caused this, asked me to try and remove to white sluff gently with a toothbrush, said that he wants it gone in 7 days, otherwise he would refer me to an ENT specialist. Prescribed me Solupred 5mg. DOSAGE: 1-1-1-1

The white sluff on my tongue did improve after gently brushing the area, although it bleeded a little bit and caused pain.

You said it could be a syphillis ulcer, but syphillis ulcers are usually painless and usually appear in the first site of contact. The spot where this thing is, is quite unreachable, don't you think?

Thanks and regards,
XXXX

Might I add that the both the GP and the Dentist noticed mildly swollen tonsills / lymph nodes (where they both said that it is from the previous viral/cold).

What do you think.

Thanks again,
XXXX
doctor
Answered by Dr. Neha Sumra 8 hours later
Brief Answer:
Can be due to traumatic injury or viral infection.

Detailed Answer:
Hi

I restudied your case, and as per your doctors feedback along with your reports, I would suggest you to follow up their advice for one more week and if it still persists, then get a biopsy done.
Lymph node enlargement and swollen tonsils are common symptoms of throat infection but it has nothing to do with that white lump on your tongue. Many things can be suspected from such condition and few of them I have already discussed.
For now, you just clean your tongue with a tongue cleaner, do betadine gargles and take multivitamin supplements.
If this is due to viral infection or physical trauma, it will go away within a week.
But in case it persists longer than that, it's my sincere advice that you get a biopsy done.
Need not worry. All will be fine.
If you get a biopsy done, then get back to me and I would be happier to see the reports.

Hope I answered your query

Wishing you a good health.

Kind Regards
DR. Neha Sumra
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neha Sumra 25 minutes later
Hi again,

I apologise for the constant messages, but the issue is quite stressing me out.

The lump is not actually white, it's actually the 'sluff' / 'coating' it's like a swollen tastebud with white coating, as per my doctors suggestion, he asked me to clean the white sluff with the tooth brush

I will be getting back to you as soon as I have further news. Hope for nothing serious, as Im quite worried about this issue.

The rest of my mouth, lips, teeth and gums are in good health, no other ulcers/lumps or pain.

Many thanks for your replies.
XXXX
doctor
Answered by Dr. Neha Sumra 15 minutes later
Brief Answer:
Maintain good oral hygiene and wait for 1 more week.

Detailed Answer:
No worries.

I understand your concern and I am happy to answer your query.

This white coating can be due to poor oral hygiene.
You just do regular brushing, flossing and, mouthwash, it will be fine.
Wait and watch, all will be fine.
Also send me your new reports and picture of lesion after a week.
Nothing is serious.
Get well soon.

Kind Regards
Dr. Neha Sumra
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neha Sumra 20 minutes later
The issue is that when I talk. It pains me. Although when Im hydrated or drinking something, the pain lessens .
doctor
Answered by Dr. Neha Sumra 1 hour later
Brief Answer:
Apply topical anaestetic gel over it

Detailed Answer:
Hi

You may apply topical anaesthetic gel over that area like benzocaine tube and spit after 5 minutes.
Hope this relieves you.

Kind Regards
Dr. Neha Sumra
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neha Sumra 12 hours later
Dear Doctor,

Here I am, once again writing to you about my constant worries and anticipation about this 'condition'.

I attached a log (Health Log.pdf) of how this think is looking, dated and time stamped.

Pain persists.

Thanks and regards,
XXXX

doctor
Answered by Dr. Neha Sumra 35 hours later
Brief Answer:
Apply topical anaesthetic gel and wait.

Detailed Answer:
Hi

Apologies for late reply.

I just saw the attachment.
It seems to be lip bite and you need to wait and watch as told earlier.
Regarding pain, it's better to apply anaesthetic gel for numbness and relieve.
Also take multivitamins for better healing.
Get back to me after 1 week.


Wishing you good health

Kind Regards
Dr. Neha Sumra






Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neha Sumra 20 hours later
Visited an ENT, said that it could be something dental related, although it seems that the right gland is slightly hurting.

Visited the dentist, took an x-ray, and found out that my left wisdom tooth is not emerging as supposed, which might be causing all this.

What do you think?

Thanks again,
XXXX

Hi again,

Thank you for the quick response.

My dentist did not prescribe me with any meds, actually only recommended me to get these removed as soon as possible.

So it is all clear now, and I can stop worrying that it is something more serious such as cancer or STD related?

Many thanks for your constant answers and support.
Best regards,
XXXX
doctor
Answered by Dr. Neha Sumra 1 hour later
Brief Answer:
Pericoronitis due to impacted wisdom tooth.

Detailed Answer:
Hi

Now the picture is completely clear.

You are having pericoronitis which occurs due to impacted wisdom teeth. It is a very common problem and occurs when there is very little space available for third molar eruption.

For this, you need to start a course of painkiller and antibiotic, which your dentist might have presecribed. Also, do warm saline rinses 3-4 times a day. If problem still persists then go for operculumectomy, that is removal of flap covering third molar.

Hope I answered your query

Kind regards
Dr. Neha Sumra

Brief Answer:
Yes, get it removed as early as possible

Detailed Answer:
Hi

If you still have pain then go for Antibiotics like Co-Amoxiclav 625 mg combination twice a day along with Diclofenac- Paracetamol (50/500 mg) combination thrice a day, 5 days before going for extraction (you'll be needing prescription by your local physician for them)..
It will make your surgical procedure less painful.

I am always happy to answer all your queries.

No worries

Get well soon.

Kind Regards
Dr. Neha Sumra


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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