What Causes White Spots on the Tongue?

White plaques on the tongue mucosa are divided into benign keratosis and premalignant white lesions according to their malignant tendency. The occurrence of oral leukoplakia is related to tobacco, alcohol, chronic friction, and hot and spicy food preferences and eating habits. Leukoplakia is a precancerous lesion of the oral cavity that usually occurs in people over 40 years of age. White spot transformation into cancer usually occurs 2 to 4 years after the appearance of white spot, but the malignant transformation rate seems to have nothing to do with the patient's age, mainly related to whether the local area continues to be subjected to physical and chemical stimulation. More men than women.

Basic Information

English name

leukoplakia lingualis

Visiting department

Stomatology

Multiple groups

Men over 40

Common locations

Back of tongue, belly or tongue

Common causes

Related to tobacco, alcohol, chronic friction, and hot and spicy food preferences and eating habits

Common symptoms

Milky white, off-white, or yellowish white particles on the back, belly, or margin of the tongue, with wartlike protrusions, or erosion

Cause of tongue white spot

White keratosis is mostly caused by external factors, mainly local mechanical, chemical, physical and inflammatory changes.

Local irritants play a very important role in the onset of white spots. Smoking is a common cause, with 80% to 90% of those who have a smoking habit, and the disease sites are mostly consistent with the irritation of smoke. Other stimuli such as chewing betel nut, wine, vinegar, spicy, hot, bad restorations, residual crowns, residual roots can also cause white spots. Among systemic factors, Candida albicans infection, iron deficiency anemia, vitamin B ₁₂ and folic acid deficiency, syphilis, radiation, and xerostomia are all closely related to white spots.

Clinical manifestations of leukoplakia

The white spots of the tongue mostly occur on the back of the tongue, the belly of the tongue, or the edge of the tongue. The white spots are clearly defined, slightly higher than the mucosal surface, and the color is milky white, grayish white, or slightly yellowish white. The surface of the lesion may be rough or granulated, or wart-like protrusions, or erosion. Red areas can also be scattered in the white spots. White spots can be divided into four types

Homogeneous type

The lesions were white plaques, slightly higher than the mucosal surface, and the surface was slightly rough, wrinkled paper-like, without symptoms or with astringent feeling.

2. Verrucous type

White plaques, thick and raised, with wart-like protrusions on the surface, hard and rough.

3.granular type

The reddish mucosa has fine white keratinizing granules that are higher than the mucosa, like villi.

4. Erosion type

There are erosions on white plaques, and ulcers can form. There is significant pain.

Differential diagnosis of leukoplakia

Lichen planus is mostly isolated lesions, and lichen planus can damage most mucous membranes. Lichen planus shows multiple shapes of lesions. In addition, lichen planus patients are often accompanied by skin lesions. White spots are confined to the oral cavity, and are occasionally seen in other parts of the mucosa without skin damage.

White tongue treatment

1. The first measure is to remove irritating factors, such as quitting smoking, banning alcohol, eating hot and spicy food, etc. Residual roots, residual crowns, and bad restorations should also be removed. Available vitamin A, vitamin E, phenols, silver nitrate, etc. are strictly prohibited to treat white spots.

2. Oral vitamin A or retinoic acid may cause headache and dizziness when first taken, and the dosage can be reduced, usually after a few days. The course of treatment is 1 to 2 months. Common side effects include dry lips and hair loss. Coronary heart disease, liver and kidney dysfunction and hyperlipidemia are contraindicated.

0.2% retinoic acid solution is suitable for topical application, but not for damage accompanied by congestion and erosion. When applying, dry the saliva first, apply the finest pen with a small amount of solution and apply it along the white area. Do not apply on the red lips and mucous membrane.

3. Long-term use of cod liver oil to rub the white spots, 2 to 3 times a day, 1 to 2 months as a course of treatment, can also be taken cod liver oil or vitamin A.

4. For those who do not heal for a long time and do not subside after treatment, when cleft palate, ulcers or hardened basal area are found in the white spot area, the surface thickening is obvious, or it has been proved to have precancerous changes, and it should be removed early.

White tongue prevention

Quit smoking and drinking. Eating hot and spicy foods is harmful to the mouth. Therefore, those who have a tobacco and alcohol hobby or have hot and spicy eating habits should pay attention to the following points:

1. When a person reaches middle age, he goes to the hospital for oral examination every 6 months. Always observe your oral mucosa frequently for any rough plaques that cannot be removed.

2. Always pay attention to whether there are broken teeth and excessively sharp dentures in the mouth, because the sharp edges can stimulate the edge of the tongue and induce white spots.

3. Always pay attention to changes in white spots, such as erythema around the white spots, hardening of the plaque, and even bleeding and ulcers, which are early signs of potential malignancy.