Painful Tongue Tip with White Spots After Fish Bone Injury - Dentistry

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It sounds like you have been dealing with a painful situation after injuring your tongue with a fish bone. From your description, it seems that the initial injury has led to some complications, such as the development of white spots on the tongue tip. This can be concerning, especially when pain persists and there are visible changes in the tissue.

Firstly, it's important to understand that injuries to the tongue, particularly from sharp objects like fish bones, can lead to localized trauma. The pain you are experiencing when the tongue touches your teeth is likely due to inflammation and irritation at the injury site. The white spots you are observing could be a result of several factors, including:
1. Healing Process: After an injury, the body initiates a healing response, which can sometimes lead to the formation of a whitish coating or spots as new tissue forms. This is often part of the normal healing process.

2. Oral Candidiasis: If the white spots persist and are accompanied by pain, it could indicate a fungal infection, such as oral thrush (candidiasis). This can occur if the natural balance of bacteria in the mouth is disrupted, often due to trauma, antibiotic use, or other factors.

3. Necrotic Tissue: In some cases, if the injury was deeper than initially thought, there could be necrotic (dead) tissue that appears white. This would require medical evaluation to determine if debridement (removal of dead tissue) is necessary.

4. Ulceration: The injury could have led to an ulcer, which can appear white at the center with a red halo. These can be quite painful and may take time to heal.

Given that you have already consulted with an ENT specialist and have been using an oral ointment without improvement, it may be time to consider a few additional steps:
- Follow-Up Appointment: Schedule a follow-up visit with your ENT or a dentist who specializes in oral health. They can perform a thorough examination to assess the injury and the white spots. They may also consider taking a culture of the area if an infection is suspected.

- Maintain Oral Hygiene: Continue to practice good oral hygiene, but be gentle around the injured area. Rinse your mouth with a saline solution (a mixture of salt and warm water) to help keep the area clean and promote healing.

- Avoid Irritants: Stay away from spicy, acidic, or very hot foods that could further irritate the injury. Stick to soft, bland foods until the pain subsides.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage discomfort. However, consult with a healthcare provider before taking any medication, especially if you have underlying health conditions.

- Monitor Symptoms: Keep an eye on the white spots and any other symptoms. If they worsen, or if you develop fever, increased swelling, or difficulty swallowing, seek medical attention promptly.

In summary, while it is common for tongue injuries to take time to heal, persistent pain and changes in the appearance of the tissue warrant further evaluation. A healthcare professional can provide a definitive diagnosis and appropriate treatment to ensure proper healing and address any potential complications.