Patient's Query
Hello doctor,
I am experiencing tongue issues, and so far, doctors have not been able to identify the problem.
I have had a white coating on my tongue for months, which does not seem to disappear. There is also a cluster of bumps in the middle of my tongue that occasionally bleeds.
Please help.
Thank you.
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.
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.
Patient's Query
Hello doctor,
Thank you for your response.
The doctors I consulted do not believe it is a bacterial or fungal infection, and mouthwash treatments have not been effective.
The condition causes bleeding during brushing, occasional pain, and intermittent discomfort. I have been urgently referred to a maxillofacial specialist, though I am yet to hear from them.
My medical history includes smoking and a previous HPV (human papillomavirus) infection with precancerous cervical cells.
While I do not have a personal history of oral cancer, there is a family history of other cancers. I have also noticed persistent white strips on both sides of my tongue that do not respond to brushing.
Thank you.
Hello,
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, as well as 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.
Patient's Query
Hello doctor,
I have been using a mouthwash called Benzydamine, but unfortunately, it has not yielded any improvement. My dentist has referred me to a maxillofacial specialist, and I'm currently awaiting an appointment.
Additionally, I was prescribed folic acid tablets due to slightly low folate levels, but there has been no improvement in my condition despite taking them.
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 papillomavirus) 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,
Please confirm this because I need this information to prescribe an appropriate oral application.
Thank you.
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Answered byDr. Achanta Krishna Swaroop
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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