Spots on Tongue: Are They Dangerous?
If you’ve noticed a few spots or bumps on your tongue, chances are they’re nothing serious. However, in some cases, spots and bumps can act as signs of a larger, more serious disorder. If you’ve noticed any jarring changes in your oral health, talk with your dentist at your next cleaning. This is particularly important if the spots are growing, painful, and/or bleeding.
There are many normal, non-threatening reasons why you may have spots or bumps on your tongue. Here are a few of the more common causes:
The tongue is a complex muscle that goes through a lot on a daily basis. Eating hot or acidic foods/drinks can cause trauma-induced ulcers to appear. They are typically white and slightly raised. Depending on the severity of the ulcer, they can be quite annoying — and sometimes even painful. However, these kinds of ulcers are never serious and will typically go away on their own within a week. People who frequently get trauma-induced ulcers may be inclined to stay away from certain foods and drinks. Pineapple and other acidic foods are known to cause frequent, painful ulcers.
Aphthous stomatitis (known colloquially as “canker sores”) is the other common kind of ulcer. These non-contagious ulcers appear in approximately 10–25% of the general population. These ulcers vary widely in size, location, and the average rate of reoccurrence. Sometimes, they’re small and white — identical to trauma-induced ulcers. Other times, they’re smaller in diameter and appear in “crops” of many ulcers that can join together to form a larger ulcer. Some of these ulcers (the ones that take longer to heal) can cause scarring. You can typically find aphthous stomatitis ulcers on non-keratinized oral mucosa — so the soft tissues found on the inner lip, the floor of the mouth, and the inner cheeks. Though, these ulcers can appear anywhere inside the mouth.
The cause of aphthous stomatitis is still unknown, though it has been linked to genetics, stress, trauma, menstruation, and certain food allergies. If your ulcer lasts longer than two weeks, schedule an appointment to see a dentist immediately.
Are the spots on your tongue white and “soft” looking? There’s a good chance you could have a fungal infection called oral thrush. Thankfully, that sounds a lot scarier than it actually is. Oral thrush is simply a yeast infection that develops in your mouth. The fungus Candida albicans naturally occurs in your mouth but when it gets out of control, it can create white lesions and bumps on your tongue, inner cheeks, tonsils, and, in severe cases, esophagus.
For most people, oral thrush is a minor problem that will either go away on its own in a week or two or can be easily treated with home remedies (or a mild anti-fungal medication). Babies, elderly people, and people who are immuno-compromised have a harder time fighting off oral thrush since their immune systems are weaker. Persistent oral thrush is frequently seen in cancer patients, diabetic patients, and patients who’ve tested positive for HIV or AIDS.
A few common symptoms of oral thrush are:
- White, creamy lesions on the tongue, the roof of the mouth, and inner cheeks
- Dry, cottony feeling in the mouth
- Bad breath
- Difficulty eating or swallowing
Do the spots on your tongue look smooth and red? Do they migrate from one area of your tongue to another over time? You may have a geographic tongue — a harmless inflammatory condition where certain spots on the tongue lack papillae. Papillae are those short, almost hair-like bumps that give your tongue its unique texture. Without the papillae, those spots look like red, smooth “islands” with slightly raised edges. The appearance is often maplike, hence the term “geographic tongue.” The spots frequently heal and move to other places on the tongue.
The condition is completely harmless, though it can cause some mild discomfort if the lesions become sensitive. Unfortunately, there is no easy cure for a geographic tongue, nor does it have much of a timeline. Many patients experience these symptoms for months, and, in some cases, years. The cause of geographic tongue is unknown, though it has been loosely connected to psoriasis.
Oral lichen planus
Lichen planus is a chronic inflammatory condition that can attack many different areas of the body, from the scalp and nails to the eyes and mouth. When it appears in the mouth, it’s frequently white and has a distinctive “lacy” pattern. However, in some people, it manifests as red, swollen patches or open sores.
The condition can be quite painful and, if not closely monitored, dangerous. People with oral lichen planus often report the following symptoms:
- Painful patches on inner cheeks, palate, gums, inner lips, and/or tongue
- Thickened red patches on the tongue
- Bleeding when brushing
- Sensitivity to cold and hot
- General discomfort when eating, drinking, or speaking
Treatment for lichen planus includes managing the symptoms and going in for regular oral cancer screenings. People with oral lichen planus are much more likely to develop oral cancer. Luckily, oral cancer screenings are quick and painless.
Compared to the other conditions we’ve listed above, oral cancer is incredibly rare. Still, many people die from oral cancer every year. In 2021, it will cause over 9,750 deaths, killing roughly 1 person per hour, 24 hours per day. The five-year survival rate is only 57% which, compared to many other cancers, is very low.
In the past two decades, oral cancer rates have actually gone up instead of down. The biggest factors include tobacco use, age, gender (older males are more likely to get it), and HPV16. Staying away from tobacco and practicing safe-sex are the best ways to combat oral cancer.
Oral cancer can present itself in many different ways which is why you should always be vigilant when it comes to changes in your oral health. Lumps and bumps (both painful and painless) that last longer than fourteen days need to be examined by a doctor. If you notice any abnormal white or red lesions that aren’t going away, go to your dentist immediately. With any kind of cancer, it’s always about catching it in an early stage. If you notice something strange, don’t ignore it. Schedule an appointment as soon as you can. Oral cancer screenings are simple and only take a few minutes but they could save your life.
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