Uncertain Oral Symptoms: Is It a Wart or Something Else? - Internal Medicine

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When it comes to oral symptoms that are uncertain, such as the white lesions you are experiencing under your tongue, it is essential to consider several possibilities. Based on your description and the context of recent oral sexual activity, there are a few potential causes for the symptoms you are observing.

1. Oral Thrush (Candidiasis): This is a fungal infection caused by an overgrowth of Candida yeast. It can present as white patches or lesions in the mouth, including under the tongue. While it is often associated with discomfort, it can sometimes be painless. Risk factors include recent antibiotic use, immunosuppression, or diabetes.

2. Fordyce Spots: These are small, painless, pale bumps that can appear on the lips or inside the cheeks, and sometimes under the tongue. They are sebaceous glands that are not associated with any disease and are considered a normal anatomical variation.

3. Oral Lichen Planus: This is a chronic inflammatory condition that can cause white patches or lesions in the mouth. It may be associated with discomfort or pain, but not always. The exact cause is unknown, but it is thought to be related to an immune response.

4. Leukoplakia: This condition is characterized by white patches in the mouth that cannot be scraped off. It can be caused by irritation, such as from tobacco use or ill-fitting dentures, and in some cases, it can be precancerous.
5. Herpes Simplex Virus (HSV): If there was any prior exposure to HSV, it could manifest as lesions in the oral cavity. However, these typically present with pain and discomfort.

6. Other Infections: Various viral or bacterial infections can cause lesions in the mouth. For example, syphilis can cause oral lesions, and it is essential to consider sexually transmitted infections (STIs) if there was any risk of exposure.

Given that your symptoms have persisted for three days without improvement, it is advisable to seek medical attention. You should consider visiting a healthcare provider who specializes in oral health, such as a dentist or an oral surgeon. They can perform a thorough examination and may recommend further diagnostic tests, such as a biopsy, if necessary, to determine the exact nature of the lesions.

In the meantime, here are some general recommendations:
- Maintain Oral Hygiene: Continue to brush your teeth and tongue gently, and use an alcohol-free mouthwash to help keep your mouth clean.

- Avoid Irritants: Stay away from spicy, acidic, or abrasive foods that may irritate the lesions.

- Monitor Symptoms: Keep an eye on any changes in the lesions, such as increased pain, swelling, or the development of new symptoms.

In conclusion, while it is understandable to feel anxious about new oral symptoms, many conditions can cause white lesions under the tongue, and many of them are benign. However, given the potential for more serious conditions, it is crucial to consult a healthcare professional for an accurate diagnosis and appropriate management.