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Long term white coated tongues. LEUKOPLAKIA/ORAL CANCER?

Resolved Question:

For 6 months my tongue has had a white coating, my parents and siblings also have long-term coated tongues. The GP seems unconcerned. I am 22, a non-smoker and non-drinker. What has caused this? Is it leukoplakia or oral cancer, and if so how can I get my GP to take the concerns seriously?

Category: ENT Specialist

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Category: ENT Specialist
 32 Doctors Online

Thanks for your query at DoctorSpring.com
I understand your concern
Your tongue is white-coated but it is very less. I can assure you that this is not leukoplakia or
cancer and need not worry about it.
If you do not have any burning sensation then nothing is required as your GP says.
other than normal it can be mild candidiasis (fungal infection), which is very easy to treat. By KOH
scraping it can be confirmed. and if positive it can be treated with
candid mouth paint for local application for 2 weeks
Tab. fluconazole 100 mg once daily for 10 days
Hope this helps
Best regards


Patient replied :

Hello,
My tounge was tested for thrush and the swab came back negative. So, I assume that rules that out?
Also, I have swollen lymph nodes in my neck. My GP says that this is because I am very slight, and so they are more easily palpable in me than in other people. They are under my chin and in my cervical chain of my neck. I was reffered to a Hematologist who said they were fine. They feel hard to me, but I assume they can't be as I would have undergone more investigation? Two of the lymph nodes feel attached to each other and growing. This is the main reasons why I am worried about oral cancer.


Hello,

Test for oral thrush is negative, you need not to start any medicine. There are more then 300 nodes in neck. If a node is more then 1 cm and growing in size then only we need to evualate it. As hematologist already seen you, I don't think there is any significant node. Leukoplakia looks very different and in your case I can assure you with full confidence that you don't have any laukoplakia or growth or cancer.

Hope this helps

Best regards


Dr. Sunil Jalan


Patient replied :

Thank you for all of your help, it is very reassuring to hear. My GP didn't know what the gunk on my tongue was or why it wouldn't scrape away.
Since visiting the haemotologist in December and the subsequent ultrasound I had on my neck, one or two of my lymph nodes have grown. GP says that this nothing to worry about as they are still oval shaped. Is this true?


Hello,

This minimal coating if tongue is very common, so you can ignore it safely. Can drink frequent sips of water to avoid dryness.

As your USG neck was normal and GP is examining neck node regularly, I think all fine and you don't require any further investigation or treatment.

Hope this helps


Patient replied :

So, can lymph nodes continue to grow over a few month period if benign? My GP suggested they could in a similar way that non-cancerous moles can grow. You can not see the nodes in my neck and have to push down fairly hard to feel them, but they are bigger than 1cm.
Also, the top white layer of my tongue can scrape away, leaving a paler white underneath that can't be removed. Is this ok?


Hello,
it will be little difficult for giving opinion about neck node without examination but based on opnion
by GP , Hematologist and ultrasound finding i feel it is safe to wait atleast for a month and if it is
growing further we can get opinion from another local physician.
There is no need to scrape top layer of tongue, you can leave it as such.

Hope this helps


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
Dr. Sunil Jalan and 4 other Medical Specialists are ready to help you

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