Pain and Black Spots at the Base of the Tongue

Pain at the base of the tongue with the presence of black spots?

About a week ago, I suddenly felt pain at the base of my left tongue.
After looking in the mirror, I noticed a black spot at the base of my tongue, and there were also some protrusions on the sides and above it.
Additionally, there is a sore underneath the base of my tongue.
I am very worried that it might be something serious.
I usually go to bed after 1 AM and do not drink much water.
Neither I nor the people around me smoke or drink alcohol.
If I drink more water during the day, it alleviates the discomfort, and I may not feel any discomfort at all, except when eating.
Should I seek further treatment, or would it be sufficient to adjust my sleep schedule, drink more water, and avoid irritating foods? Thank you for your assistance! Here is the link to the video and photos: https://youtu.be/OLNSxJeOoqY

Ms. Li, 40~49 year old female. Ask Date: 2021/07/29

Dr. Zheng Jueyi reply Otolaryngology

Hello, the dark spots may be surface blood vessels.
If the ulcer has not improved after more than two weeks or if the dark spots continue to enlarge, it is recommended to visit an otolaryngologist for examination.
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: 2021/07/29

More Info

The symptoms you describe, including pain at the base of your tongue, the presence of a black spot, and a sore area with a hole, can be concerning and warrant further investigation. While it is good to hear that drinking water alleviates some discomfort, the presence of a black spot and the sore area are signs that should not be ignored.

There are several potential causes for the symptoms you are experiencing. One possibility is that the black spot could be a benign condition, such as a pigmented lesion or a result of irritation or trauma to the area. However, it is also important to consider other possibilities, including:
1. Oral Candidiasis: This is a fungal infection that can cause white patches or lesions in the mouth, which may sometimes appear as dark spots if there is bleeding or irritation.

2. Aphthous Ulcers: These are common canker sores that can occur on the tongue or inside the mouth. They can be painful and may present with a white or grayish base and a red halo.

3. Oral Lichen Planus: This is an inflammatory condition that can cause white patches, sores, or lesions in the mouth, and may sometimes present with discomfort or pain.

4. Malignant Lesions: Although less common, any new or unusual growth in the mouth, especially one that is painful or changing, should be evaluated to rule out oral cancer.

5. Trauma or Irritation: Sometimes, biting the tongue or irritation from dental appliances can lead to localized pain and changes in the tissue.

Given the duration of your symptoms and the presence of the black spot, it is advisable to consult a healthcare professional, preferably an oral surgeon or an ear, nose, and throat (ENT) specialist. They can perform a thorough examination, possibly including a biopsy of the lesion if deemed necessary, to determine the exact nature of the black spot and the sore area.

In the meantime, adjusting your lifestyle as you mentioned—getting adequate sleep, staying hydrated, and avoiding spicy or irritating foods—can be beneficial for your overall oral health. Maintaining good oral hygiene is also crucial. However, these measures should not replace a professional evaluation, especially since the symptoms have persisted for over a week.

In summary, while some lifestyle changes may help alleviate discomfort, it is essential to seek medical advice to ensure that any serious conditions are ruled out and to receive appropriate treatment based on a proper diagnosis. Your health and peace of mind are important, and addressing these symptoms promptly is the best course of action.

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