According to experts at the International Medical College, white, flat lesions on the tongue have a dozen or more causes. These causes may be complicated, such as a symptom of another disease, or could be relatively simple, like a need to improve your oral hygiene. If you smoke and have thought about quitting, the risk of developing lesions is another reason to give up tobacco: smokers get more oral lesions than nonsmokers.
Considerations
To determine the cause of your tongue lesion, a doctor takes into consideration several variables. Some types of lesions are more common based on age, gender and level of oral hygiene and whether you smoke or drink alcohol regularly. Other lesions are more common in individuals of certain races and those with specific genetic makeups or other chronic medical conditions. Some lesions are benign and can be treated with over-the-counter products; others are precancerous or cancerous and require immediate medical care.
Types
White lesions of the tongue and other areas of your mouth fall into two categories. The International Medical College instructs that lesions in the one category are those that can be scraped off; lesions in the other category cannot. If the lesion can be scraped off it may be pseudomembranous, which describes lesions that form their own membranes on the tongue. The cause of lesions that can be scraped off may be fungal overgrowth.
Lesions that cannot be scraped off may be the result of a thickening of the cells of your tongue. They can also be the result of a disease process has causes an overgrowth of cells on the surface of the tongue. The white color relates to the retention of fluid in the cells, which causes more light to reflect off their surfaces.
Disease-Related Lesions
White lesions on your tongue may be related to the presence of a chronic disease. Some possibilities include nicotine stomatitis, an irritation caused by using tobacco products. Other causes may be leukoplakia, or white patches that form in the mouth for unknown reasons, or lichen planus, lupus erythematosus and scleroderma which are autoimmune diseases. HIV and herpes are viral causes of tongue lesions. Lesions can also be oral precancerous or cancerous growths. The best way to determine the cause of your tongue lesion is to visit your health care provider. He can perform tests that will reveal the cause of the lesions.
Common Causes
A study published in the journal "American Family Physician" suggests that white, flat lesions are often caused by candidiasis, an infection known as thrush that's caused by species of the fungus candida. The authors of the article believe that 60 percent of healthy adults carry this fungus as part of their normal oral makeup. An overgrowth of this organism can be due to dentures, use of a steroid inhaler for asthma, endocrine disorders, HIV, leukemia, malnutrition and reduced immunity related to radiation therapy, chemotherapy and antibiotics. Because antibiotics can kill harmless bacteria in your mouth without affecting the fungus, candidia can grow quickly and result in lesions. Not everyone who takes antibiotics gets thrush, but it can be a problem if you have a weakened immune systems.
Treatment
Treatment for your tongue lesions is directly related to their cause. Self-limited problems, such as mild thrush, will go away on their own and require no treatment. Treatments for other fungal lesions include anti-fungal mouthwash and pills. If a virus is responsible for your lesions, your doctor can treat them with antiviral medications. Other treatments for lesions include special toothpaste, lozenges, zinc supplements, topical steroids and anesthetic rinses. Effective oral hygiene, including thorough cleaning of your tongue by scraping, is also helpful in managing certain tongue lesions. Your health care provider will determine which treatment is best for you based on the cause of your problem.
References
- "American Family Physician": Common Oral Lesions: Part I. Superficial Mucosal Lesions, Wanda C. Consalves, M.D., et al.; February 2007
- "Cancer Journal for Clinicians": Oral Cancer and Precancerous Lesions, Brad W. Neville, D.D.S. and Terry A. Day, M.D., F.A.C.S.; 2002
- Emory University: Oral Hairy Leukoplakia
- International Medical College: White Lesions: Oral Pathology
