White Lesions on the Tongue: Causes and Concerns - Internal Medicine

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White lesions on the tongue can be concerning, and understanding their potential causes is crucial for proper diagnosis and treatment. The presence of white patches or lesions on the tongue can arise from various conditions, some benign and others requiring medical attention.

One common cause of white lesions on the tongue is oral thrush, which is a fungal infection caused by the overgrowth of Candida species. This condition typically presents as creamy white lesions that can be wiped off, revealing a red, inflamed surface underneath. Oral thrush is more common in individuals with weakened immune systems, those taking antibiotics, or those with diabetes.

Another possibility is leukoplakia, which refers to white patches that cannot be scraped off. This condition can be caused by chronic irritation, often due to tobacco use, alcohol consumption, or ill-fitting dentures. While leukoplakia itself is not cancerous, it can sometimes be a precursor to oral cancer, especially if the lesions are persistent or changing in appearance.

Lichen planus is another condition that can cause white lesions on the tongue. This autoimmune disorder can manifest as white, lacy patches or lesions and may be associated with discomfort or pain. The exact cause of lichen planus is unknown, but it is believed to involve an immune response affecting the mucous membranes.

In some cases, geographic tongue may present as irregular, smooth, red patches bordered by white. This benign condition is characterized by the loss of papillae on the tongue's surface and can change in appearance over time. While it is generally harmless, it can sometimes cause sensitivity to certain foods.

If the white lesions on your tongue are thick, persistent, and do not resolve over time, it is essential to seek a thorough evaluation from a healthcare professional, such as a dentist or an ear, nose, and throat (ENT) specialist. They may perform a physical examination and, if necessary, a biopsy to rule out more serious conditions, including oral cancer.

In summary, while white lesions on the tongue can be caused by various factors, including infections, irritations, and autoimmune conditions, it is crucial to monitor their characteristics and seek medical advice if they persist or cause discomfort. Early diagnosis and intervention can help manage any underlying issues effectively and ensure better oral health.