White Bumps Under the Tongue: When to Seek Help

A lump has developed under the tongue?

After rolling up the tongue, there is a band (frenulum?) in the middle underneath the tongue, and there used to be a small white bump around it.
I visited an ENT specialist who said it was nothing to worry about, but recently it seems to have grown a bit larger.
What could this be?

Qiang, 30~39 year old female. Ask Date: 2016/12/14

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description, it is most likely a minor salivary gland cyst.
However, due to insufficient information, it is difficult to provide an accurate answer.
It is recommended that you consult an otolaryngologist for a proper evaluation.
Wishing you peace and happiness.
This is purely an exchange of ideas; everything should be based on the actual examination by a physician.
Director Chi Chao-Yun, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2016/12/14

More Info

Understanding white bumps under the tongue can be concerning, especially when changes occur in size or appearance. The area under the tongue is rich in blood vessels and salivary glands, making it susceptible to various conditions.
The white bump you described could be a number of things. Common possibilities include:
1. Mucocele: This is a cyst that forms when a salivary gland is blocked or damaged. It often appears as a painless, fluid-filled bump and can be white or bluish in color. Mucoceles are generally harmless but can become bothersome if they grow larger or become painful.

2. Fordyce Spots: These are small, painless, pale bumps that are actually enlarged sebaceous (oil) glands. They are completely normal and do not require treatment.

3. Oral Thrush: This is a fungal infection caused by an overgrowth of Candida yeast. It can cause white patches or bumps in the mouth, including under the tongue. This condition may require antifungal treatment.

4. Lichen Planus: This is an inflammatory condition that can affect the mucous membranes in the mouth, leading to white patches or bumps. It can be associated with discomfort or pain.

5. Oral Cancer: While less common, any persistent changes in the mouth, especially if accompanied by other symptoms like pain, difficulty swallowing, or changes in taste, should be evaluated by a healthcare professional.

Given that you mentioned the bump has increased in size, it is advisable to seek further evaluation. While the initial assessment by an ENT specialist indicated that it was not a cause for concern, any changes in size or appearance warrant a follow-up.
When to seek help:
- If the bump continues to grow or changes in appearance.

- If you experience pain, discomfort, or difficulty swallowing.

- If you notice any other symptoms such as persistent sores, bleeding, or changes in taste.

In terms of management, if the bump is determined to be a mucocele or another benign condition, treatment may not be necessary unless it causes discomfort. In cases of oral thrush or other infections, appropriate antifungal or antimicrobial treatments may be required.
Additionally, maintaining good oral hygiene can help prevent infections and other oral health issues. Regular dental check-ups are also essential for monitoring changes in the oral cavity and addressing any concerns early on.

In conclusion, while many causes of white bumps under the tongue are benign, any changes in size or symptoms should prompt a follow-up with a healthcare provider. Early intervention can help ensure that any potential issues are addressed promptly and effectively.

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