Oral Ulcers: Causes of Tongue, Throat, and Ear Pain

Q: Oral Ulcers: Causes of Tongue, Throat, and Ear Pain

Hello： Commonly, oral ulcers can be caused by burns. <br>If the wound has not healed after two weeks, it is necessary to seek medical evaluation. <br>If there is persistent pain or difficulty swallowing, you may visit an otolaryngologist for examination and medication treatment.

Ulcer at the base of the tongue, sore throat, ear pain?

Hello, Doctor.
About four days ago, after drinking hot soup, I noticed a white patch on the mucosa of my lower lip that is peeling.
The next day, I developed a white ulcer at the base of the right side of my tongue, which has started to hurt.
The gums on the right side are also painful and bleeding.
For the past two days, I have experienced pain while chewing.
Today, I woke up to find that my throat has also started to hurt, and my ear is also painful.
Could this be oral cancer, tongue cancer, or tonsil cancer? When I used a flashlight to examine my tongue, I noticed that the veins underneath appear black, and there are red bumps on both sides underneath the tongue.
The tongue coating is slightly white, and there are also small red bumps on the coating.
Could you please provide some insight, Doctor? Thank you.

Zhao, 20~29 year old female. Ask Date: 2021/06/21

Dr. Zheng Jueyi reply Otolaryngology

Hello: Commonly, oral ulcers can be caused by burns.
If the wound has not healed after two weeks, it is necessary to seek medical evaluation.
If there is persistent pain or difficulty swallowing, you may visit an otolaryngologist for examination and medication treatment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/06/21

More Info

Oral ulcers, also known as canker sores or aphthous ulcers, can manifest in various forms and may be accompanied by pain in the throat, tongue, and even the ears. The symptoms you describe, including the appearance of white patches on the lip and tongue, painful ulcers, bleeding gums, and throat pain, can be indicative of several underlying conditions.

Possible Causes
1. Trauma or Irritation: The initial white patch on your lip could be a result of thermal injury from the hot soup you consumed. This can lead to localized inflammation and ulceration.

2. Infections: Viral infections, such as herpes simplex virus, can cause painful ulcers in the mouth and throat. Additionally, conditions like hand, foot, and mouth disease, which is caused by enteroviruses, can also lead to oral ulcers and systemic symptoms.

3. Candidiasis: Oral thrush, a fungal infection caused by Candida species, can present as white patches in the mouth and may cause discomfort and pain.

4. Systemic Conditions: Conditions such as Behçet's disease, inflammatory bowel disease, or even nutritional deficiencies (like vitamin B12, folate, or iron) can lead to recurrent oral ulcers.

5. Cancer: While the symptoms you describe could raise concerns about oral cancer (including tongue cancer or tonsillar cancer), it is essential to note that many benign conditions can present similarly. The presence of black veins under the tongue and red spots may not necessarily indicate malignancy, but they warrant further investigation.

Symptoms and Diagnosis
The symptoms of pain in the throat and ears can be due to referred pain from the oral cavity. The throat pain may be due to inflammation or infection spreading from the oral ulcers. Ear pain can occur due to the shared nerve pathways (the trigeminal nerve) that innervate the throat and ear regions.

Recommended Actions
1. Consultation with a Specialist: Given the persistence and severity of your symptoms, it is crucial to consult an Ear, Nose, and Throat (ENT) specialist or an oral surgeon. They can perform a thorough examination, possibly including imaging studies or biopsies, to rule out malignancy and diagnose the underlying cause.

2. Symptomatic Treatment: In the meantime, you can manage the pain and discomfort with over-the-counter medications such as acetaminophen or ibuprofen. Topical anesthetics like benzocaine can also provide temporary relief for oral ulcers.

3. Oral Hygiene: Maintain good oral hygiene to prevent secondary infections. Rinse your mouth with warm salt water or a baking soda solution to help soothe the ulcers.

4. Dietary Adjustments: Avoid spicy, acidic, or abrasive foods that can exacerbate the pain. Soft, bland foods may be easier to tolerate.

5. Hydration: Ensure you stay hydrated, especially if eating and drinking are painful. Consider smoothies or nutritional shakes if solid foods are challenging.

Conclusion
While your symptoms may be concerning, many conditions can cause oral ulcers and associated pain. It is essential to seek professional medical advice for an accurate diagnosis and appropriate treatment. Early intervention can significantly improve outcomes and alleviate discomfort. Remember, self-diagnosis can lead to unnecessary anxiety, so it is best to rely on medical expertise for clarity and guidance.

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