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Mark Bornfeld
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5718
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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Whenever I get under a lot of stress I seem to get sores on

Customer Question

Whenever I get under a lot of stress I seem to get sores on my tongue. they are extremely painful yet you can't really see them other than a ref spot and sometims a little white spot on my tongue. What causes this an dhow do i treat it?
Submitted: 3 years ago.
Category: Health
Expert:  Dr. Su S replied 3 years ago.
Greetings,

Since how long the symptoms are there? Was any test done? Are you on any medication? Is there any significant past illness? When did you visit doctor last?


Regards.
Customer: replied 3 years ago.
Well, it has been happening for years. This time they popped up about a week ago. They are extremely painful and it's difficult to eat. I use either hydrogen peroxide or Gly Oxide on them. No tests have ever been done, I've just been given topical creams to numb them. Xylocaine (sp?) was the last suggestion but it's so messy to use. But, it does work for a bit. My hope is to learn what is triggering them and something better to treat them. Or, better, to CURE them. I had mono or an acute case of Epstein Barr about 4 years ago. Also suffering right now from a problem with my feet related to osteoporosis--split bones and a fybromatosis. So even exercisign is hard and that's my best stress releasser. I'm seeing a doctor for my foot issues, before that I had a physical in early November.
Expert:  Dr. Su S replied 3 years ago.
Thank you for the input.

The recurrent mouth ulcers may be due to recurrent aphthous stomatitis or recurrent canker sores. The other causes may be due to injury from teeth, infection from virus like herpes , STD,vasculitis , allergy etc. As you have recurrent outbreaks it is likely to be aphthous. Stress can precipitate the condition. Sometimes foods like eggs, cereals, almonds,chocolate, coffee, peanuts, cheese strawberries and tomatoes etc. can be the precipitating factor. Aphthous ulcer is usually painful. But it needs to be seen by a doctor for precise diagnosis & sometimes steroid may be necessary to cure it in difficult or recurrent ones.

Any query, please feel free to ask.
It will be my privilege to assist you.
Regards.
Customer: replied 3 years ago.
What is recurrent aphthous stomatitis? Since I don't get the traditional canker sores, I dont' see how these sires on my tongue can be related to cankers. Other thoughts? The seem to come up just under the skin but you can feel them and usually see the redness and a little swelling where thye are on my tongue, usually the side or front edge. what is this Aphthous ulcer? I dont' get open sores, just the bumps on the tongue that are extremely painful. They are often associated with stress, lack of sleep, and business. thank you.
Expert:  Dr. Su S replied 3 years ago.
Recurrent aphthous stomatitis can present as minor or major forms. In minor forms there occur shallow lesions or ulcers. But if you don't see an ulcer, you should get it checked when it appears. But their appearance with stress suggests aphthous ulcers more.
Customer: replied 3 years ago.
OK, I guess this could be what it is but just to confirm. When these episodes occur, you often cannot see anything at all on my tongue, maybe just redness where the pain is. So, even though you often cannot see anything other than sometimes a small raised area or redness, it is still considered an ulcer? That's the part that confuses me, that it does not look like a canker sore and is more like a small pimple under the skin. thanks.
Expert:  Dr. Su S replied 3 years ago.
Aphthous ulcer can vary in size from 1mm to 10 mm in minor cases. It can be so small that you do not see an ulcer.
Expert:  replied 3 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

You are correct in your assumption that your description is not consistent with a diagnosis of apthous ulcer ("canker sores"). Apthae are conspicuously ulcerated, and they are certainly visible-- even the smallest apthae (i.e., the herpetiform variant), which appear in clusters, are quite obviously nothing like what you are describing. Also, apthous ulcers never occur on the top (dorsal) surface of the tongue, so if your lesions are located there, you can confidently dismiss apthous ulcer from the list of possibilities.

The difficulty with offering an diagnosis from a visual description is that the mouth in general, and the tongue in particular, has a relatively small repertoire of presenting signs and symptoms for a wide variety of different conditions and disorders. Certainly, there are those conditions that are so characteristic in appearance that they can be identified on sight, but the vast majority of others are non-specific in their presentation.

If I was to provide a likely name to put to your condition, I would say that it sounds most like "transient lingual papillitis", known in the vernacular as "lye bumps". These lesions, although uncomfortable, are considered benign and self-limited. They are of unknown cause, although sufferers often associate them with stress or the consumption of certain foods (pineapple seems to be a particular offender).

However, the severity of the condition suggested by your narrative would make it prudent to seek a more formal diagnosis, if only to rule out some of the more significant health problems that sometimes manifest as tongue pain. For this reason, you should consult with an oral pathologist. Clinicians in this specialty are particularly skilled and experience in the identification of oral conditions that may frustrate the diagnostic efforts of doctors not specifically trained in this field. Your dentist can provide you with a referral, or you may consult the online directory of the American Academy of Oral &:Maxillofacial Pathology.

Hope this helps...
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5718
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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