Your tongue is comprised of many tiny bumps called papillae. Millions of taste buds cover the papillae which is completely normal. If you also see oval, white, red, grey or other types of bumps on your tongue, however, you may have an infection, a vitamin deficiency or other condition that could require medical intervention.
Significance
Poor oral health can contribute to lesions on your tongue as can certain medical treatments and other diseases. Two common conditions that can cause raised, oval areas on the tongue include oral thrush and oral leukoplakia.
Thrush is caused by a fungus called candida albicans which causes bumps or plaques on the tongue, the interior of the mouth and the throat. If you have diabetes and your sugar is poorly controlled, it can result in thrush. This happens because your saliva has a high amount of sugar which results in an overgrowth of the fungus in your mouth.
Leukoplakia is a condition that is benign but may be precancerous. Leukoplakia growths are often oval, or round and begin as a small bump.
Considerations
According to MedlinePlus, both leukoplakia and thrush are more common in older people. Thrush is often seen in infants and others with a compromised immune system due to illness or medical treatment such as chemotherapy. Leukoplakia plaques can develop inside your cheek but are usually found on your tongue and are often confused with thrush because they look similar but have different causations. If you are a smoker, you are at higher risk for developing leukoplakia.
Leukoplakia
Leukoplakia grows slowly. You might have noticed a small spot on your tongue that has grown over time. The lesion is usually oval or round, white or gray and may also become thickened and hard. Because it is caused by irritation, if your dentures or a filling or cap is rubbing against your tongue, see your dentist to have the problem corrected. The condition is common in pipe smokers - if this applies to you it is best to stop smoking. It can take months to build up a lesion due to repeated irritation of your tongue.
The goal of treatment is removal of the lesion. See your health care provider because a biopsy may be required to confirm the diagnosis. If necessary, the lesion can be surgically removed. Your health care provider can perform this procedure in their office using local anesthesia. (see Ref 3)
Thrush
Oral thrush is caused by a fungus that can attack your tongue, and the sides of your mouth. If you leave it untreated, thrush can spread to your throat and tonsils. It is often painful, and if you scrape the white patches and bumps, they can bleed. You are more prone to thrush if your immune system is compromised or if you have diabetes or are under going chemotherapy.
Because thrush is an infection, in severe cases it can spread to your gastrointestinal system, lungs and liver. Thrush infection can make it difficult to eat because of pain experienced during chewing and swallowing. Thrush in your intestines reduces your ability to absorb important nutrients from your food.
Your health care provider will treat you with different types of antifungal medications to kill the thrush. These can include mouth rinses, lozenges and tablets. If you have an infant with thrush and you are breast-feeding, both you and your baby will need treatment. This is essential to avoid reinfecting each other.
Warning
Generally, leukoplakia is not dangerous. There are two exceptions: If the lesion in your mouth is red, it is known as erythroplakia and is often precancerous. The second exception is a lesion known as hairy leukoplakia. It is an unusual form of the disease seen most often in individuals with HIV and AIDS. It can also be present if your immune system is not functioning well due to other causes. Sometimes, the presence of hairy leukoplakia is the first sign that your immune system is not working well. It is caused by the Epstein-Barr virus, which can be harmful to people with a compromised immune system. If you have chronic, non-healing or growing lesions in your mouth or tongue, see your health care provider who will be able to diagnose the lesion and provide the appropriate treatment.
