Tongue Fibrosis and Leukoplakia: Key Insights for Patients

Fibrosis of the tongue and leukoplakia?

Good evening, Dr.
Cheng.
I have been experiencing tongue inflammation, so I often check my tongue.
Today, I suddenly noticed a white patch on the left edge of my tongue [about the length of a grain of rice, but it’s not a solid white area; it looks like a faint shadow].
It seems to have appeared recently, and I was worried, so I went to the ENT department at the hospital.
The doctor examined my mouth and tongue and mentioned that there is a slight fibrosis on the tongue edge and a small white patch.
The doctor said it is not very noticeable and that it’s probably nothing serious.
There’s no need to apply any oral gel.
I expressed my concerns to the doctor, who suggested that I could have a check-up every two years.
Dr.
Cheng, is the fibrosis a result of tissue left behind from a tongue injury, or can tongue inflammation also cause fibrosis and white patches? From my online research, I found that these conditions are often associated with serious issues.
The doctor mentioned that a small patch could potentially grow larger in the future.
I saw in your medical column that some patients have used laser treatment for white patches.
Is it true that any appearance of white patches on the tongue can be treated with laser? Could you please advise me on this? How often should I visit the ENT for check-ups? I apologize for these questions; I should have asked the doctor who examined me, but since he didn’t seem concerned, I hesitated to ask further and decided to seek advice online.
Thank you.

Kai Ma, 50~59 year old female. Ask Date: 2016/09/19

Dr. Zheng Jueyi reply Otolaryngology

Hello, fibrosis may be a result of the tongue's skin breaking or inflammation.
If the tongue has leukoplakia without persistent, unhealed ulcers, it can be monitored initially.
As for laser treatment, it is generally used for extensive leukoplakia, so it may not be immediately necessary.
In terms of lifestyle, it is recommended to chew evenly on both sides.
If there are dentures or cavities, dental treatment should be sought to reduce the intake of spicy and irritating foods.
Typically, if there are no significant changes, follow-up with an otolaryngologist can be done every 1-2 years.
However, if there are wounds that have not healed for more than two weeks, an earlier consultation is required.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Head of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/09/19

More Info

Tongue fibrosis and leukoplakia are important topics in oral health that can raise concerns for patients. Understanding these conditions can help alleviate anxiety and guide appropriate management.

Tongue Fibrosis:
Fibrosis refers to the thickening and scarring of connective tissue, which can occur in response to injury or inflammation. In the context of the tongue, fibrosis may develop after trauma, chronic irritation, or inflammation. For instance, if you have had recurrent inflammation of the tongue, such as from a burning sensation or irritation, it can lead to fibrotic changes. These changes are typically benign and can be a normal part of the healing process.
In your case, the doctor noted a slight fibrosis at the lateral border of your tongue, which is likely a result of previous inflammation or irritation. This does not necessarily indicate a serious condition, especially if the white patch (leukoplakia) is not prominent and the doctor has reassured you that it is not concerning.
Leukoplakia:
Leukoplakia is characterized by white patches on the mucous membranes of the mouth, including the tongue. These patches can arise from various causes, including chronic irritation (such as from tobacco use, alcohol, or friction from dental appliances), infections, or other underlying conditions. While leukoplakia can sometimes be a precursor to cancer, most cases are benign, especially when they are small and not associated with other symptoms.

The white patch you observed on your tongue may be a form of leukoplakia, but given that your doctor has assessed it as not significant, it is likely not a cause for concern at this time. The fact that it is small and not changing rapidly is reassuring.
Management and Follow-Up:
Regarding treatment, laser therapy is sometimes used for leukoplakia, particularly if the lesions are symptomatic or if there is a concern for dysplasia (abnormal cell growth). However, not all leukoplakic lesions require intervention. The decision to treat with laser or other modalities typically depends on the characteristics of the lesion, patient symptoms, and the clinical judgment of the healthcare provider.

Your doctor’s recommendation to have check-ups every two years is a reasonable approach, especially if there are no significant changes or symptoms. Regular monitoring allows for early detection of any changes that may require further evaluation or treatment.

In summary, tongue fibrosis and leukoplakia can be benign conditions resulting from inflammation or irritation. It is essential to maintain regular check-ups with your healthcare provider to monitor any changes. If you notice any new symptoms, such as changes in the size or appearance of the white patch, increased pain, or difficulty swallowing, you should seek medical advice sooner. Your health and peace of mind are paramount, and it’s always best to consult with your healthcare provider regarding any concerns you may have.

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