Unhealed Ulcer Under Tongue: Concerns About Growth and Healing - Otolaryngology

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When dealing with an unhealed ulcer under the tongue, especially one that has persisted for over a week and appears to be growing tissue, it is essential to approach the situation with caution and seek professional medical advice. Here’s a comprehensive overview of what you might be experiencing and the steps you should consider.


Understanding Oral Ulcers
Oral ulcers, commonly known as canker sores, can arise due to various factors, including stress, nutritional deficiencies, hormonal changes, or underlying health conditions. While most ulcers heal within a week or two, persistent ulcers, especially those that last longer than two weeks, warrant further investigation.

Concerns About Growth and Healing
1. Duration and Characteristics: The fact that the ulcer has not healed after a week and is showing signs of growth (the formation of new tissue) could indicate a few possibilities. While it might be a benign condition, such as a traumatic ulcer or an aphthous ulcer, it could also be a sign of something more serious, such as an infection or, in rare cases, a precancerous lesion or oral cancer.

2. Symptoms to Monitor: Pay attention to any additional symptoms that may accompany the ulcer, such as:
- Increased pain or discomfort
- Swelling in the surrounding area
- Changes in color or texture of the ulcer
- Difficulty swallowing or speaking
- Any unusual discharge or bleeding

Recommended Actions
1. Consult a Healthcare Professional: Given the duration and the changes in the ulcer, it is crucial to consult a dentist or an oral specialist. They can perform a thorough examination and may recommend a biopsy if there are concerns about malignancy.
2. Diagnostic Tests: Depending on the examination, your healthcare provider might suggest:
- A biopsy of the ulcer to rule out cancerous changes.

- Blood tests to check for nutritional deficiencies (like vitamin B12, folate, or iron) or underlying systemic conditions (like autoimmune diseases).

- Imaging studies if there are concerns about deeper tissue involvement.

3. Treatment Options: While you have already used an oral ulcer treatment, further management may include:
- Prescription medications, such as corticosteroids, to reduce inflammation and promote healing.

- Antimicrobial mouth rinses if there is a risk of infection.

- Pain management strategies to improve comfort while eating and speaking.

4. Lifestyle Modifications: Since you mentioned high stress and lack of sleep, consider implementing stress-reduction techniques such as mindfulness, yoga, or regular exercise. Additionally, ensure you are maintaining a balanced diet rich in vitamins and minerals to support overall health and healing.


Conclusion
In summary, while many oral ulcers are benign and self-limiting, the persistence of your ulcer under the tongue, especially with the development of new tissue, necessitates a professional evaluation. Early diagnosis and intervention are key to addressing any potential issues effectively. Do not hesitate to seek medical advice, as it is better to err on the side of caution when it comes to changes in your oral health.