Slow Healing of Tongue Ulcers: When to Seek Further Medical Evaluation - Otolaryngology

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When it comes to slow healing of tongue ulcers, particularly in the context you described, it is important to approach the situation with caution and a thorough understanding of potential underlying issues. Your father's experience of developing a deep ulcer on the side of his tongue, which has shown signs of improvement but is healing slowly, raises several considerations.

Firstly, it is not uncommon for ulcers in the oral cavity to take time to heal, especially if they are deep and large. Factors such as stress, dietary choices, and overall health can significantly impact the healing process. In your father's case, the combination of late nights and possibly consuming unhealthy processed foods could have contributed to the initial ulcer formation. The fact that he has seen both dental and ENT specialists who found no immediate abnormalities is reassuring, but it does not entirely rule out the need for further evaluation.

The key indicators for when to seek further medical evaluation include:
1. Duration of Symptoms: While it is common for ulcers to take several weeks to heal, if the ulcer has not shown significant improvement after one month, it may warrant further investigation. Typically, most oral ulcers should begin to heal within two weeks. If healing is not evident, it may be time to consider additional diagnostic tests.

2. Changes in Symptoms: If the ulcer begins to worsen, shows signs of infection (such as increased redness, swelling, or discharge), or if new symptoms develop (such as fever or systemic symptoms), these are red flags that should prompt immediate medical attention.

3. Underlying Health Conditions: If your father has any underlying health conditions, such as diabetes or autoimmune disorders, these could affect healing. In such cases, it is crucial to manage these conditions effectively to promote healing.

4. Persistent Pain or Discomfort: While you mentioned that the pain has decreased, if there is any return of significant pain or discomfort, this could indicate that the ulcer is not healing properly or that there may be another underlying issue.

5. Concern for Malignancy: Although the specialists have indicated that there are no signs of malignancy, if there is any concern about the nature of the ulcer, a biopsy may be warranted to rule out any serious conditions, including cancer.

In summary, while it is encouraging that the ulcer has not worsened and is becoming less painful, the slow healing process is a valid concern. It would be prudent to follow up with a healthcare provider, preferably an oral surgeon or a specialist in oral medicine, who can conduct a thorough examination and possibly recommend further diagnostic tests, such as a biopsy or imaging studies, if necessary. Additionally, maintaining good oral hygiene, avoiding irritants (such as spicy or acidic foods), and ensuring a balanced diet can support the healing process.

Ultimately, if there is any doubt or concern, it is always better to err on the side of caution and seek further medical evaluation. Your father's health and peace of mind are paramount, and addressing any lingering issues promptly can help ensure a full recovery.