Oral Mucosa and Tonsil Issues: Symptoms and Solutions

Q: Oral Mucosa and Tonsil Issues: Symptoms and Solutions

Dear Sir/Madam： <br>Q： Are the small white spots on the oral mucosa truly salivary glands? They appear normal now, but is there a possibility they could worsen into another serious condition in the future? Could it be oral cancer? <br>A： Currently, it does not seem to be.<br>Q： I

Oral mucosa and tonsil issues?

Dear Doctor,
I have a few questions I would like to ask:
1.
Last July and August, I noticed many small white spots (approximately 0.1-0.2 cm in diameter) on the mucous membrane of the right side of my mouth.
The areas with white spots feel slightly rough when touched by my tongue, and I experience a burning and prickling discomfort (this sensation is limited to the right side of my mouth, including the mucosa, tongue, and the right side of my upper and lower gums).
Additionally, ulcers frequently occur in these areas (but they heal on their own within 6-7 days without the application of any oral ointment), and I occasionally experience pain in my right ear.
This condition has been recurring since July of last year.
I sought medical advice regarding this issue, and the doctor stated that these are normal structures in the oral cavity, specifically salivary glands, and there is no need for concern or treatment.
2.
Similarly, my right tonsil has been repeatedly inflamed.
Each time I seek medical attention during an episode of inflammation, I am only prescribed a few antibiotics (Cephalexin 500 mg) and analgesics.
Initially, the treatment seemed effective, but the efficacy has diminished with each subsequent episode (three episodes from July 1998 to February 1999).

I would like to ask the following questions:
1.
Are the small white spots on the oral mucosa truly salivary glands? They appear normal now, but is there a possibility they could worsen into a more serious condition in the future? Could this be oral cancer? (I do not have a betel nut chewing habit, I quit smoking five years ago, and I do not drink alcohol.) Is there a need for a biopsy? If I wish to continue seeking treatment, which specialty should I consult?
2.
Is there a potential correlation between the issues with the oral mucosa and the inflammation of the tonsils?
3.
I am located in Kaohsiung.
Could you please advise me on which specialist I should consult to obtain accurate answers and complete treatment for my condition?
I apologize for the lengthy and somewhat unclear nature of my questions, but I am confused and urgently need your clarification.
Thank you for your assistance, and I wish you all the best in the Year of the Tiger, with everything going smoothly and your family in good health.

Charles, 40~49 year old female. Ask Date: 2010/02/18

Dr. Ye Dawei reply Otolaryngology

Dear Sir/Madam:
Q: Are the small white spots on the oral mucosa truly salivary glands? They appear normal now, but is there a possibility they could worsen into another serious condition in the future? Could it be oral cancer?
A: Currently, it does not seem to be.
Q: I do not have a habit of chewing betel nut, I quit smoking five years ago, and I do not drink alcohol.
Is there a need for a biopsy?
A: There is no urgency at this time.
Q: If I wish to continue seeking medical advice, which specialty should I consult?
A: You should consult either dentistry or otolaryngology.
Q: Is there a possible correlation between issues with the oral mucosa and tonsillitis?
A: It is possible.
Q: I am located in Kaohsiung.
Could you please advise which doctor I should see for my condition to receive accurate answers and complete treatment?
A: A medical center hospital.
Dr.
Yeh Da-Wei, the head of the otolaryngology department at Hsinchu Hospital.

Reply Date: 2010/02/18

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your oral health. Based on the symptoms you've described, it seems you are experiencing a complex interplay of oral mucosal issues and recurrent tonsillitis. Let's address your questions systematically.

1. Oral Mucosa White Spots: The small white spots you mentioned on the right side of your oral mucosa could be several things. While your previous physician suggested they are normal salivary glands, the presence of roughness and discomfort, along with recurrent ulcers, warrants further investigation. These symptoms could potentially indicate conditions such as oral lichen planus, leukoplakia, or even candidiasis, among others. Although the ulcers heal within a week, the persistence of the white spots and discomfort is concerning. While the risk of these lesions progressing to oral cancer is relatively low, it is not impossible, especially if there are other risk factors involved. A biopsy may be warranted to rule out any serious conditions, including malignancy. I recommend consulting with an oral and maxillofacial surgeon or an oral medicine specialist for a thorough examination and possible biopsy.

2. Tonsil Issues: The recurrent inflammation of your tonsils could indeed be related to your oral mucosal issues. Chronic irritation or infection in the oral cavity can lead to inflammation of the tonsils, as they are part of the immune system and respond to infections in the surrounding areas. If your tonsillitis is recurrent and the antibiotics are becoming less effective, it may be worth discussing the possibility of a tonsillectomy with an ENT (Ear, Nose, and Throat) specialist. This procedure can help alleviate chronic infections and improve your overall health.

3. Specialist Recommendations: Given your symptoms, I recommend you seek care from both an oral medicine specialist for your oral mucosa issues and an ENT specialist for your tonsillitis. In Kaohsiung, you can look for a university hospital or a specialized clinic that offers both oral medicine and ENT services. This way, you can ensure that both aspects of your health are addressed comprehensively.

In summary, your symptoms require a multi-faceted approach. The white spots on your oral mucosa should be evaluated further, possibly through a biopsy, to rule out any serious conditions. Concurrently, addressing your recurrent tonsillitis with an ENT specialist may provide relief and prevent future complications.
Please do not hesitate to seek further medical attention, as early intervention can often lead to better outcomes. Your health is paramount, and it’s essential to address these issues before they escalate.
Wishing you good health and a speedy resolution to your concerns.

Best regards.

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