White Spots on Tongue Edges: When to Seek Medical Advice?

White spots on the edge of the tongue that are not painful?

Doctor, I have two white spots on the edge of my tongue, each about 0.1 cm in size.
They are not painful and have a uniform white color.
I have already visited the hospital twice, and the doctor said they are caused by friction.
I was prescribed an ointment, but it has been a few weeks and the spots have not improved; their size remains the same and they are still painless.
Should I see a doctor again, or is it normal to just observe them since there are no ulcers? Thank you.

A-Ling, 20~29 year old female. Ask Date: 2019/02/10

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have already been examined by a physician and there are no obvious ulcers, you may start with self-observation.
However, if the white spots continue to enlarge or if ulcers develop, it is recommended to return for follow-up and treatment.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/02/10

More Info

When it comes to white spots on the edges of the tongue, it is essential to understand the potential causes and when to seek medical advice. Based on your description, you have two white spots on the edges of your tongue that are approximately 0.1 cm in size, are uniform in color, and do not cause any pain. You have already consulted with a doctor twice, who indicated that these spots are likely due to friction, and you have been prescribed an ointment. However, despite the treatment, the spots have not improved over the past few weeks.

In general, white spots on the tongue can arise from various conditions, including oral lichen planus, leukoplakia, oral thrush (a fungal infection), or simply irritation from friction due to dental appliances, rough teeth, or habits like biting the tongue. Since your doctor has already assessed the spots and attributed them to friction, it is likely that they are benign, especially since they are not painful and have remained stable in size.

However, there are several factors to consider when deciding whether to seek further medical advice:
1. Duration: If the white spots persist for more than two weeks without improvement, it is advisable to follow up with a healthcare professional. Chronic lesions in the mouth can sometimes indicate underlying conditions that may require further investigation.

2. Changes in Appearance: If the spots change in size, color, or texture, or if you develop new symptoms such as pain, swelling, or difficulty swallowing, you should seek medical attention promptly.

3. Underlying Health Conditions: If you have a history of immune system issues, smoking, or other risk factors for oral cancers, it is prudent to have any persistent lesions evaluated more thoroughly.

4. Self-Monitoring: While it is reasonable to observe the spots if they are stable and asymptomatic, maintaining good oral hygiene and avoiding irritants (such as spicy foods, tobacco, or alcohol) can help prevent further irritation.

5. Consultation with a Specialist: If you remain concerned or if the spots do not resolve, consider consulting an oral specialist or an ENT (ear, nose, and throat) doctor. They may perform a more detailed examination, including a biopsy if necessary, to rule out any serious conditions.

In summary, while your current situation may not warrant immediate concern given the lack of pain and the doctor's initial assessment, it is essential to remain vigilant. If the white spots do not improve or if you notice any changes, do not hesitate to seek further medical advice. Regular dental check-ups and open communication with your healthcare provider are crucial in managing oral health effectively.

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