Persistent Tongue Sores: Causes, Concerns, and Treatment Options

The tongue has been continuously ulcerated for one month?

My tongue has been continuously ulcerated.
In the past, the ulcers would heal within a few days, but this time they have persisted.
Some areas seem to be healing, but new ulcers keep appearing in different locations (not the same wound lasting a month).
I previously visited a clinic and received medication, which helped a lot, but then the ulcers started again.
Currently, I am using Albothyl (policresulen), which is very effective, but new sores keep appearing in other areas.
Could this be due to nutritional deficiencies, or is it caused by some other bacterial infection? I have heard that mouth ulcers lasting over a month could raise concerns about oral cancer, and I am a bit worried, but I do not smoke or chew betel nut.

Li, 20~29 year old female. Ask Date: 2015/07/02

Dr. Zeng Guanghui reply Dentistry

The above situation is unlikely to be oral cancer; rather, it is more likely related to the immune system being affected by significant emotional stress and lack of sleep, leading to oral symptoms.
It is recommended to consult an oral surgeon for further diagnosis and treatment.

Reply Date: 2015/07/02

More Info

Persistent tongue sores can be a frustrating and concerning issue, especially when they do not heal as expected. There are several potential causes for recurrent or persistent sores on the tongue, and understanding these can help guide treatment options and alleviate concerns.

Causes of Persistent Tongue Sores
1. Nutritional Deficiencies: One common cause of recurrent mouth sores is nutritional deficiencies, particularly deficiencies in vitamins such as B12, folate, and iron. These nutrients are essential for maintaining the health of mucous membranes, and their absence can lead to sores and ulcers.

2. Oral Hygiene and Irritation: Poor oral hygiene or irritation from dental appliances, such as braces or dentures, can also lead to persistent sores. Additionally, certain foods (spicy, acidic, or abrasive) can irritate the tongue and contribute to the development of sores.

3. Infections: Viral infections, such as herpes simplex virus, can cause sores on the tongue and in the mouth. Fungal infections, like oral thrush (candidiasis), can also lead to lesions that may be mistaken for sores.

4. Autoimmune Conditions: Conditions such as lichen planus or pemphigus vulgaris can cause chronic sores in the mouth. These conditions are often accompanied by other symptoms and may require specific treatment from a healthcare provider.

5. Stress and Hormonal Changes: Stress can exacerbate the frequency and severity of mouth sores. Hormonal changes, such as those occurring during menstruation, can also play a role in the development of these lesions.

6. Underlying Health Conditions: Certain systemic conditions, such as inflammatory bowel disease (IBD) or Behçet's disease, can manifest as recurrent mouth sores. If you have other symptoms or a history of such conditions, it may be worth discussing with your healthcare provider.

Concerns About Oral Cancer
While it is understandable to be concerned about the possibility of oral cancer, especially with persistent sores, it is important to consider the characteristics of the sores. Oral cancer typically presents as a sore that does not heal, is often accompanied by other symptoms (such as difficulty swallowing, unexplained weight loss, or a lump in the neck), and may have a different appearance than typical canker sores or ulcers.

If your sores have persisted for over a month, it is advisable to consult with a healthcare professional for a thorough evaluation. They may perform a physical examination and, if necessary, a biopsy to rule out any serious conditions, including cancer.

Treatment Options
1. Topical Treatments: You mentioned using Albothyl (policresulen), which is effective for treating ulcers. Other topical treatments include corticosteroids to reduce inflammation and pain, and antiseptic mouthwashes to prevent infection.

2. Nutritional Supplements: If nutritional deficiencies are suspected, a healthcare provider may recommend dietary changes or supplements to address these deficiencies.

3. Oral Hygiene: Maintaining good oral hygiene is crucial. Regular brushing, flossing, and using an antibacterial mouthwash can help prevent infections and promote healing.

4. Avoiding Irritants: Identifying and avoiding foods or substances that trigger irritation can help reduce the frequency of sores.

5. Medical Evaluation: If sores persist despite treatment, or if you experience other concerning symptoms, a visit to a healthcare provider is essential. They may refer you to a specialist, such as an oral surgeon or an ear, nose, and throat (ENT) doctor, for further evaluation.

Conclusion
Persistent tongue sores can arise from various causes, including nutritional deficiencies, infections, and underlying health conditions. While concerns about oral cancer are valid, it is essential to consult with a healthcare provider for an accurate diagnosis and appropriate treatment. Maintaining good oral hygiene, addressing any nutritional deficiencies, and avoiding irritants can help manage and reduce the occurrence of these sores. If symptoms persist or worsen, seeking medical advice is crucial for your health and peace of mind.

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