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Q. I have a whitish spot on the lateral side of the tongue. Is this a precancerous lesion?

Answered by
Dr. Mohammad Emranul Islam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jan 06, 2021 and last reviewed on: Mar 12, 2021

Hi doctor,

I have a whitish spot on the lateral side of the tongue for the past six days. I have attached my photo. It does not come off during brushing but I have pain in it while brushing. I do not have pain while eating but my tongue seems to be sore. My lymph nodes are normal. I am worried. I want to know whether it is a precancerous lesion or tongue injury? I have stopped drinking for the past few years. Can a picture give you a clue about the condition?

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#

Hi,

Welcome to icliniq.com.

Kindly share some more information. Please mention whether you have done any dental treatment recently. Please mention the condition of the tooth on that side. Please mention whether you have any sharp tooth or broken tooth, any injury on the tongue. Please mention whether you have consulted a dentist for this problem. Please mention whether you have a smoking or chewing habit or any other diseases and taken any medication. Please mention whether there is any growth on the lesion and how do you say that your lymph nodes are normal.

It looks like leukoplakia (attachment removed to protect patient identity) and there is a slight elevation on the whitish spot. But leukoplakia does not cause pain. It grows slowly and it becomes thick. But you can have different presentations. You can have a reddish lesion above the white lesion. It can be painful and it needs proper treatment. I have asked some questions and please answer them. It helps to achieve a proper diagnosis and appropriate treatment can be given.

Thank you doctor,

I have done a dental filling on both sides of the tooth. I am not aware of the tooth condition now. Can I have it due to biting od the tongue? I might do it during sleeping. I have done a self-examination and so I told that my lymph nodes are normal. I quitted smoking before three months. I took Benzodiazepine under the guidance of my doctor. I am aware of this whitish lesion for the past six days only. I have soreness in my middle part of the tongue and the whitish part causes stinging. Do I need a biopsy? Is it possible for you to differentiate tongue injury and leucoplakia from the picture?

#

Hi,

Welcome back to icliniq.com.

It seems to be a leukoplakia. A traumatic ulcer seems to be reddish or yellowish in color and painful. Usually, it does not grow and it disappears within seven to ten days. Leukoplakia is a precancerous lesion and it is usually whitish in color without pain. It grows larger. Initially, it seems to be faint translucent and gradually it becomes thick leathery. I suggest you avoid smoking and drinking. You need to wait for a week to see the difference. If it does not disappear, then you need to consult a dentist immediately. A biopsy should be done to confirm the diagnosis.

If it is leukoplakia, then it has to be treated by doing surgical removal. It is a minor surgical procedure done under local anesthesia. But it is important to avoid having smoking or drinking habits as it can reappear and result in cancer. If the lymph node is palpable, then FNAC (fine needle aspiration cytology) has to be done if malignancy is suspected. The alarming signs that indicate malignancy are sudden rapid growth, nodular growth, firmness, and redness. Observe the lesion carefully.

Thank you doctor,

I went to the dentist and the doctor told me that the condition is frictional keratosis. The white part is still present there. I am not sure about the change. I noticed a lump on the base of the tongue on both the right and left sides. Is this normal?

#

Hi,

Welcome back to icliniq.com.

Frictional keratosis occurs due to chronic friction from the sharp or broken tooth. It seems that you do not have such sharpness. You might be pushing the tongue on that side of the tooth or you may have a bulky tongue. You do not have any bite injury. There is some disappearance in the whiteness when compared to the earlier picture. But still, you have swelling. I advise you do warm saline water mouth rinsing five to seven times a day. The swelling present on the base of the tongue can get subsided on mouth rinsing. If it does not subside, then you need to do a biopsy. You have not mentioned the details prescribed by your dentist. Please give me the details. Do not be worried about the lesion. It can be treated soon.

Thank you doctor,

I am worried about the lump present on the base of the tongue rather than the white patch. The dentist told me to do saltwater gargling. She told me that the lump on the base of the tongue is a part of the tongue anatomy. But I was not entirely convinced. Is it part of tongue anatomy? She has not advised me to do a biopsy. Please suggest.

#

Hi,

Welcome back to icliniq.com.

Your dentist is right. I suggest you do warm saline water mouth rinsing five to seven times a day and keep observing it for a couple of days. Your lesions and lump can get subside. Please mention whether it causes pain while brushing. I think that it is getting smaller. If it does not subside within four or five days, then you need to do a biopsy. You need to do mouth rinsing. Your lump looks like a normal tissue with slight swelling. You can have inflammation. Please mention whether your dentist checked your lymph nodes.


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