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Dental and Oral Health Center

Change in Tongue and Soft Palate

11/30/2009

Question:

I have what seems like a thick white coating on the top surface of my tongue way at the back with some deep fissures that are bright red, there are also some very small white to clear tiny dot like lesions on my soft palate that have been present but not always exactly in the same locations for 3 weeks. I have also had severe coughing fits with some irritation in the back of my throat. No doctors even seem to care about my tongue or soft palate.

Answer:

Without actually examining your mouth, what you are describing is a variation of normal.

The dorsum of the tongue (top surface) is covered with small finger like projections know as papilla. Sometimes these projections will become elongated and in turn act like a sponge and collect food particles, sloughed oral mucosa, bacteria or yeast particles to name a few. This constellation of events can appear as a "coating" of the tongue. Brushing the tongue surface or using a "tongue scraper" can reduce this from being pronounced.

The posterior aspect of the tongue also has 8-12 large (1-3 mm) projections or papilla known as the vallate papilla. In some cases these can appear like large red/pink growths, but again normal.

Some people have deep fissures that run along the top of the tongue surface, referred to as "fissured tongue or scrotal tongue". This occurrence seems to be genetically linked and in some cases may be associated with geographic tongue or irregular shaped surface and color changes on the dorsum of the tongue (erythema or redness).

The changes can be the result of hypersensitivity to environmental factors, or certain foods that produce morphological changes. These can also be related to yeast carriage and result in a white coated tongue and changes in papillary structure.

The palatal changes you are describing are probably inflamed minor salivary glands, and depending on the force and frequency of coughing, could be related to oral pharyngeal inflammation.

I forgot to mention that allergies and sinus congestion can exacerbate the symptoms you are describing.


Are you a mouth breather? Are you on decongestants, antihistamines or medications that can alter your salivary flow? These can be related to the symptoms you describe, but again variations of normal. Thank you for visiting NetWellness.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University