What causes persistent white coating with bumps on the tongue and occasional bleeding?

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

I appreciate the clear pictures you have provided (attachments removed to protect the patient's identity), which are quite helpful. It is evident that the tongue patch is not purely white; it is a combination of white and red lesions, and it appears to be extensive. Given that it has persisted for months without improvement, we must proceed cautiously with non-surgical measures. This might be an aggressive bacterial, viral, fungal, or even precancerous lesion. Understanding when it bleeds is essential for a proper diagnosis. Does the bleeding occur when you brush your teeth, eat, or seemingly at random? Additionally, in your family or personal medical history, is there any known history of cancer?

There is no need to panic, but diagnosis is our top priority. I am asking these questions to gain a better understanding of your condition. Many persistent bacterial infections, when left untreated, can progress to precancerous stages. This underscores the importance of addressing the initial lesion.

Answering the questions I have asked, will aid in making an accurate diagnosis and developing a treatment plan.

Thank you.

Hi,

Welcome back to icliniq.com.

I want to reassure you that, as long as you follow my non-surgical remedies, your risk of developing a cancerous lesion is unlikely. To further assist you, I need to know the specific mouthwash and toothpaste you are using and the number of cigarettes you smoke each day. It is essential to understand that smoking and a history of HPV both pose a high risk of cancer. Given that these ulcers with the white patch at the center of your tongue have persisted for several months, it is a matter of concern.

It is important that you cease smoking completely. Once you provide information on the products you are using, I can make adjustments and provide you with a list of instructions. The extent of the lesion should be resolved within a maximum of 15 days by following the instructions I will provide. If not, a biopsy may be necessary to determine the nature of the cells involved.

Thank you.

Hello,

Welcome back to icliniq.com.

You are using the correct mouthwash. Please continue to rinse with Benzydamine twice a day. You can also use Chlorhexidine gluconate mouthwash after your morning brush, but just once a day. The folate deficiency you mentioned highlights the possibility of a HPV (human papilloma virus) vitamin deficiency, which could increase your risk of precancerous conditions. To address this, I suggest you start with Lycopene supplements and incorporate Lycopene-rich foods into your diet, such as tomatoes, citrus fruits, watermelons, papaya, grapes, and more.

Regarding the nature of your condition, are you sure your dentist confirmed that it's not bacterial or fungal? Did you undergo an in-clinic check-up, and is that what they communicated? Please confirm this because I need this information to prescribe an appropriate oral application.

Thank you.