White spots on tongue, belching, ear ache, reddish, swollen skin behind ear, taken garlic, antifungal mouthwash

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Posted on Tue, 2 Oct 2012 in Ear, Nose and Throat Problems
Question: This week I've noticed white spots towards the tip of my tongue. It is as if the tongue's taste buds have slightly swollen and have turned white. There are specks of white near the tip and speckled here and there but only along 1/3rd but not deeper. I started taking garlic for the last 2 days thinking it could be oral thrush along with an antifungal mouthwash. Today I've noticed increased belching and a mild ache just behind the left ear lobe. I notice the pain when I lightly rub the sikn on the bone just behind the left ear. It is reddish and very slightly swollen. The corresponding area behind the right ear is fine without any pain or redness. Also I don't have a headache as such but just this dull pain on massaging the area behind my left ear. I had never observed this earlier as far as I can remember.
Please advise and many thanks.
doctor
Answered by Dr. Rakhi Tayal 6 hours later
Hello
Thanks for writing to us.
The swollen white spots on the tongue with pain behind the ear is suggestive of an infection of the tongue with secondarily inflamed lymph nodes behind the ear.
From the description that you have given the most likely causes can be-
1. Oral thrush- fungal infection of mouth. Usually covers the palate and tongue and is recurrent.
2. Viral infection- usually caused by coxsackie virus. The area is painful and recurrence is common.
3.Gingivostomatitis - Usually associated with swollen neck glands.

A careful examination is an integral part of diagnosis.
Till the time you XXXXXXX your dentist avoid smoking, use iodine mouth wash and listerine mouth wash to keep the area clean. Oral antibiotics might be needed for treatment. Avoiding hot and spicy foods will also help.
You can use topical ointments like numbing ointments, such as benzocaine (Oragel), anti-inflammatory (steroid) gels, benadryl allergy liquid mouthwash, oral preparations of steroids and vitamin supplement. Oral pain killers like Ibuprofen also help. But all these medicines are available under prescription and should be taken under a doctor’s guidance.
I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.
Regards.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rakhi Tayal 7 hours later
Thanks for the reply Dr XXXXXXX I don't have temperation/fever/exhaustion/weakness. So I am likely to eliminate coxsackie virus or Gingivostomatitis.
Please let me know your comments about the following -
1. Please check the uploaded pic (Tongue.jpg) which shows the white spots. Does that look like oral Thrush? I still have the dull pain just behind my left ear. I notice the pain only when I mildly rub the area behind my left ear with my fingers, not otherwise. I don't have white spots elsewhere in the mouth, only on the lower tongue (see pic). The white spot doesn't seem to come off if I rub it or brush over it with toothbrush. I am not 100% sure about this but it appears that the white spot is bigger/more visible when I get up in the morning compared to night time.
2. I am traveling, so I cannot get to a doctor for this month. Is there something you would like me to check & report to aid your diagnosis of my condition?
3. How severe could the oral thrush/fungal infection be? Could it have spread internally in the digestive track or colon?
4. I have started taking Oraldene mouthwash (anti fungal, contains Hexeditine) and listerine. Should I take Iodine supplement? I am also taking garlic.

Additional comment -
This started last week when I was eating pongal. I felt it was very spicy and got tears in my eyes/nose whereas my wife thought it was not that spicy. I felt that my throat/lower gums (near cheek) felt sore/burnt. I found it hard to swallow because the mouth was burning. I noticed after a day or two that I had white dots on my tongue tip. This week my tongue is feeling sore and burns a little when eating. However the sore/burnt feeling has disappeared in the rest of my mouth.

I am feeling fine otherwise except for the pain behind my left ear when I rub around that area. I have noticed a couple of non itchy minor rash (like pimples) near the left neck/ear area. This is not there on the right side. I had Eczema 2 months back which went off by application of vaseline.

Many thanks.
-XXXXXXX
doctor
Answered by Dr. Rakhi Tayal 14 minutes later
Hello.
Thanks for writing again.

Looking at the uploaded images, it looks more like inflamed tongue papillae rather than oral thrush.

This needs an additional multivitamin supplementation and if the inflammation spreads then oral antibiotics may be needed.

It will take 7-10 days to recover fully.

Applying benzocaine gel will help in reducing pain during meals. You can continue with the treatment you are taking including garlic.

Wishing you an early recovery.
Regards.


Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Rakhi Tayal 2 days later
Hello Dr XXXXXXX
Thanks for your reply. I believe you've found the exact cause! The white spots on the tongue have reduced in size and sensitivity has reduced.
While the pain behind my left ear has reduced, the redness of the skin has gone, there is a mild swelling and a mild sensation when I run my finger behind the left ear.

Is this related to tongue inflammation? Or could it be an infection or some other factor?

I am continuing with the multivitamin supplement, fish oil, anti fungal mouthwash, turmeric paste on the tongue and eating garlic. I noticed yesterday that the top gum line on my right canine tooth has become slightly lower making the tooth root more visible. Could the mouthwash be causing this?

Thanks again for your help. It is now reducing.
-XXXXXXX
doctor
Answered by Dr. Rakhi Tayal 3 hours later
Hello XXXXXXX

Thanks for writing again.

The mild pain behind the ear is likely to be related to the tongue inflammation only, a referred pain.It will also subside gradually.

The lowering of gum line is again due to inflammation. It will gradually heal on its own by continuing the treatment you are taking.

I hope, I have answered your query.

Wish you speedy recovery.

Regards.


Above answer was peer-reviewed by : Dr. Jyoti Patil
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Answered by
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Dr. Rakhi Tayal

OBGYN

Practicing since :2001

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