White spots on my Tongue

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I noticed in another post that there was mention of an issue someone had with a white tongue that wasn’t thrush but due to reduced saliva.

I have had this issue since my first maxillectomy in 2019 and it has become worse since my second maxillectomy in 2022. Initially I thought it was thrush but when I consulted the surgeon that performed my ops he said it was because of lack of saliva since radiotherapy. Also he mentioned that my diet which is puree may be a contributing factor. My whole tongue is not coated just spots of white here and there over a large portion of my tongue. I have had Fluconizale once or twice as I have had thrush but the white spots never go away. My mouth is very dry from 2 lots of radiotherapy and I use Biotene gel at night and Biotene spray and Therabreath dry mouth lozenges which help considerably during the day.

My breathing is mainly mouth breathing as I no longer have an upper jaw so everything  has collapsed down obstructing my nasal passages. I was wondering if this also has an effect on my tongue.

I use a tongue scraper and brush my tongue with a soft toothbrush and some of the material comes off but not all of it. I clean what teeth I have left regularly with Biotene toothpaste and rinse my mouth with Biotene mouth wash daily.

Does anyone else have this issue and has anyone found a way of reducing the white spots? It looks as though this maybe an ongoing issue as I have not been able to clean up my tongue since my first maxillectomy. My surgeon does not have any suggestions except to use a tongue scraper.

Any thoughts gratefully received.

Lyn

  • Hi Lyn, I am now 5 years and 2 months, post treatment, and my tongue still has a coating on it. My consultant told me more or less, what yours said, it's a result of RT. Hope you are keeping well.

    Regards Ray.

  • Hi Lyn

    I don't have white spot issue on my tongue but I can suffer with food residue coating my tongue.  I can suffer with dry tongue too. What I do find useful after my shakes and soups is to drink a clear warm fluid  afterwards such as a  shop bought boxed herbal tea, or green tea,  any tea nice tasting to me, to wash it down when I notice my tongue getting food residue on it. Apologies if you have tried this. I just thought I  would respond as your consultant thinks it could be down to your pureed diet contributing to your problem as well as the  other things, and any little bit of info could help.

    I do hope you can improve your problem.

    Best wishes 

    NIcky

  • My surgeon does not have any suggestions except to use a tongue scraper.

    Hi Lyn. It's a difficult one. Lack of saliva and chewing hard food to scrape the tongue normally. It's the physical act that's missing. I fear a tongue scraper is the only solution. Might I suggest that you use a copper one. It has bactericidal properties and does a better job

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

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  • Hi Lyn I’m  totally  the opposite my tongue is always bright red no bacteria in it at all. It’s strange how different we all are. Sadly I think like Dani says  it’s a tongue scraper.  Have you seen surgeon yet ? 
    hugs Hazel xx

    Hazel aka RadioactiveRaz 

    My blog is www.radioactiveraz.wordpress.com  HPV 16+ tonsil cancer Now  6 years  post treatment. 35 radiotherapy 2 chemo T2N2NM.Happily getting on with living always happy to help

    2 videos I’ve been involved with raising awareness of HNC and HPV cancers 

    https://www.instagram.com/merckhealthcare/reel/DBs8Y0niJ8N/

  • Good evening Lyn, my gums and a bit of my tongue is white where they did surgery and radiotherapy even my dentist asked why, mine is permanent and has not caused me any issues, maybe yours is similar, I make sure my mouth and teeth are as clean as possible by brushing and using mouthwash, have you tried foam mouth swabs during the day as they are a lot kinder and gentler. Wishing you all the best, take care.

                                                                              Chris x

    Its sometimes not easy but its worth it ! 

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  • foam mouth swabs

    I’ve never heard of these. Thanks for posting the tip. 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

    Community Champion badge
  • Hi Ray

    Thanks for the feedback. I'm glad I'm not the only one with this issue. I now realise this is my 'new normal'  and won't worry so much about trying to clear it up.

    I am keeping very well and back into life and enjoying it. Am still waiting for my reconstruction surgery but getting on with things in the meantime.

    Hope you are keeping well too.

    Lyn

    Sophie66

  • Hi Nicky

    Thanks so much for the feedback. Yes I definitely have a food residue issue as well. I have not tried a herbal tea so will try and find one that I like and give it a go. I have a lot of soup and milk based drinks as well as Sustagen,pureed fruit and Weet bix so they are a bit sticky.

    Lyn

    Sophie66

  • Hi Dani

    Thanks for the feedback about the tongue scraper. I have ordered one on EBay and will give it a go. The copper ones have good write ups about their benefits which I did not know anything about. I'm always learning something from this forum.

    Thanks again

    Lyn

    Sophie66

  • Hi Hazel

    Yes funny isn’t it that we can all be so different. Thank goodness that usually someone on the forum has experienced something similar and can give some input.

    I had a phone consult with my maxiofacial surgeon a couple of weeks ago and think I may have already mentioned that he and the prosthodontist are still designing the prosthesis that is to replace the teeth in my upper jaw. Although with no upper jaw they are going to attach it to implants in my cheek bones. They are still working on it and when the design is complete it is to be made in Germany and will take 2 months to make. Patience is a virtue.

    Lyn

    Sophie66