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White coating in tongue that cannot be scrapped away.

Resolved Question:


I'm 22 years old with no history of smoking or drinking. For months my tongue has appeared white and this coating cannot be scraped away, doctors and dentists have been unconcerned. I also have swollen lymph nodes in my neck, the GP says that these nodes are about 1cm big and are reactive. Is this cancer/ lukoplakia or something else? My parents and siblings also have coated tongues, could this just be a genetic thing? How do I get doctors to take my concerns seriously?

Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Thank you for your query at DoctorSpring.com
In some people coated tongue can be present without any symptoms, and could be genetic. But the percentage of that happening is very low. How many lymph nodes are enlarged in the neck? How can the doctor say they are reactive without taking a biopsy? Did you suffer from any recent throat infection or any history of mono in the recent past?
Has blood work been done for you specifically CBC and ESR?
Kindly reply and I will get back to you,

Patient replied :

My parents and siblings also have a coated tongue does this point to it being genetic? The doctor says that all lymph nodes being 1cm or less and firm/ movable suggests they are reactive. I also had an ultrasound on my neck. All bloodwork has come back clear. I just saw my own dentist who said my coated tongue was normal. It looks white to me though?
No throat infections but I have an infected gum around my wisdom tooth.
Does this look like cancer?

Expert:  Dr. Sunil Jalan replied 3 Days.

No this is definitely not suggestive of leukoplakia or cancer.
But, can you upload a higher resolution image? This one is very unclear and blurred.

Patient replied :

Just to confirm you don't think that it looks lile leukoplakia or cancer? My dentist said that my gum infection could be the cause of all my lymph nodes swelling and my tongue. Is this true? I am having the tooth taken out in a few weeks. Is this photo any clearer?

Expert:  Dr. Sunil Jalan replied 2 Days.

Yes this photo slightly more clearer.
But there is just a mild coating and this is nothing to worry about. For sure, there is no reason to worry about leukoplakia or cancer.
The gum infection does cause enlargement of lymph nodes.
If you have a history of acid reflux, the coating could be due to that for which you will need Omeprazole, otherwise with a history of coating in the family, this can be ignored.

Dr. Sunil Jalan
Category: ENT Specialist
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
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