A child’s tongue should normally be pink, velvety and moist. Appearance of fur, blotches or other spots on the tongue is an obvious pathological symptom. For example, oral candidiasis, aphthous stomatitis (canker sore), allergic diathesis, gastritis, cholecystitis, pancreatitis, tonsillitis, etc. Unfortunately, white spots on a child’s tongue can appear even at early infancy. Any changes on the mucous membrane of the tongue should be supervised by a pediatrician, but sometimes it is extremely important to consult a subject matter expert: gastroenterologist, otolaryngologist or allergologist, depending on the underlying cause of the fur.
Thrush – white spots on a baby’s tongue
Candida infection is able to affect mucous membrane of the oral cavity even at early infancy. In newborn babies acute oral thrush develops at passing through infected maternal passages, in case of infection from contact with surrounding objects (untreated pacifiers, feeding bottles, other dishware and toys). Poor hygiene of mother’s nipples can be another cause, though formula-fed babies are most exposed to the thrush. Acid reaction of saliva in new born babies and over sensitivity of their mucous membranes, which can easily be traumatized, constitute an important background for candidiasis.
In toddlers fungal stomatitis appears on the background of weakened organism in the result of previous infectious diseases, long-lasting digestion disorders, diabetes mellitus and intake of antibiotics and corticosteroids.
Candidiasis is expressed in the form of multiple white coats on the mucous membrane of a child’s tongue and requires immediate treatment. In new-born babies it can be constrained to local treatment with antiseptic solutions (for example, with the help of a pacifier) and maintenance of strict hygiene for both the mother and the baby. For older kids it is recommended to supplement the treatment with immunostimulative drugs, in some cases, general antifungal drugs and anti-dysbacteriosis medication. Apart from a pediatrician it is required to consult also Ear Nose Throat doctor and dentist (to find focuses of chronic infection), gastroenterologist (in case the thrush is accompanied by digestive tract diseases) and immunologist.
Allergy – an important etiological factor, causing white spots on child’s tongue
The most common disorders in the immune reaction – allergic diathesis and chronicaphthous stomatitis, are the main causes of white blotches on child’s tongue. In the first case they appear in the form of islets of fur on the scarlet mucous membrane, resembling a “geographic tongue”. Such a picture is conditioned by disturbed regeneration of papillae, covering the back of tongue. Retardation of regeneration of the surface epithelium is a sufficient cause for the appearance of red spots – areas on the “map”.
Only the allergologist can find out the allergic agent, help to prevent its contact with the child and prescribe a relevant treatment. Quite often it may be required to consult a gastroenterologist, as such a clinical setting can characterize the course of hypoacid gastritis.
Chronic recurrent aphthous stomatitis (AS) is an autoimmune process, which is provoked by allergization of the organism due to conditionally pathogenic bacteria of the digestive tract, viruses, antigens of alimentary origin. Diseases, which can be complicated by AS include:
- Biliary dyskinesia;
- Colitis and enteritis;
- Chronic gastritis;
- Helminthic infection (intestinal worms);
- Chronic ENT diseases (reoccurring otitis, rhinitis, pharyngitis, tonsillitis);
- Bronchial asthma, etc.
The most common locations for white sprues are the tongue, particularly its frenulum, and the lips. Cheeks and the palate are affected less often. The sprue looks like a round-shaped erosion, covered with light fur and surrounded by an inflammatory “zone”. Its diameter reaches up to 1 cm. It is rather painful and provokes massive production of saliva (excessive salivation is observed). Normally, the sprue should heal in 10 days, without leaving any adhesion.
We distinguish 3 degrees of severity. Defining the degree of severity, as well as finding out the underlying cause of stomatitis can be done with the help of a dentist at initial consultation. The dentist will also point to the list of subject matter specialists, who should additionally be consulted.
- ENT doctor;
General diseases and white fur on child’s tongue
Disturbed regeneration of the epithelium of papillae, covering the tongue, can be induced, among the mentioned factors, by such diseases, as tonsillitis (quinsy), gastritis, cholecystitis, pancreatitis, and others.
Having white spots on child’s tongue is also a distinctive symptom used to differentiate tonsillitis and pharyngitis, since viral infection of the tongue, which is the case with pharyngitis, is usually not characterized by coated tongue. In case of diphtheria pathological covering can have a grayish hue.
The volume of treatment of tonsillitis should be defined by an otolaryngologist. Apart from local application of antiseptic medication, it also assumes antibiotic therapy.
Appearance of a fur over the tongue in case of intestinal diseases is most typical, since the tongue is a part of this system. In case of affection of the liver and pancreatic gland these blotches can have yellowish coloring, while the papillae picture can undergo alteration according to the changes in the level of intragastric acidity. These facts point to the close interconnection of the tongue to other organs of the gastro-intestinal tract.
In order to remove the fur, it is required to treat the underlying disease. This process should be trusted to a gastroenterologist, after carrying out all the necessary examinations.
Thus, white spots on child’s tongue are hardly ever associated with exclusively local pathology. After the pediatrician’s examination, it is required to consult also ENT doctor, dentist, allergologist and immunologist, depending on the anticipated agent of this condition.