Oral and Maxillofacial Surgery Expert Forum
White spots in mouth
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White spots in mouth

I am hoping you can help me with this as I'm not sure where this question fits.  Over the last 6 months I have had white patches in my cheeks my tongue.  THey come and go and move around to different places in my mouth.  I had an HIV test outside of the window period and it was negative so it is highly unlikely to be OHL.  I have read a lot about uclers, lichen planus, OHL, cheek biting, etc.but I am still scared it is OHL

I had A case of  significant dry mouth after a round of antibiotics for a sinus infection.  Started sucking on breath savers & life savers 24x7 to ease dry mouth symptoms.  Went to  2 Dr's and they said not thrush and saw nothing abnormal.  2 weeks later I then freak out and assume I have HIV as I have had unprotected sex about 10x witha single partner so I go get the standard blood based antibody test outside window period (negative).

I am now scraping the hell out of my mouth and tongue... creating big sores.  About 1 month after the test I develop white streaks along the border of my tongue that get really bad and thick and then go away and then come back off and on for about a month.  Then my cheeks turn whiteish and feel rough.  I haven't noticed anything on my tongue really for a couple of months now but the cheek thing is still there.

THe problem is ALWAYS way worse in the morning.  I sleep with life savers in my mouth (2-4 of them) to promote saliva during the night.  They just dissolve at some point as I sleep.  My mouth wakes up pretty white but after sucking on a mint and brushing my teeth it goes back to normal color but cheeks still feel rough.

Bottom line - I've had these odd migrating white patches around my mouth (cheeks and tongue). The only information I can find on this type of recurring issue is Oral Lichen Planus.  Everything I've read about OHL states that it comes and doesn't really change (unless it gets worse) without antiviral treatment. Is this true or can OHL migrate around the mouth and come and go?

Thank you.
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White patches that rub off leaving a red and/or sore area is most consistent with an oral fungal infection.  This can be confirmed by a simple scraping in the doctors office.  Often times a presumptive diagnosis will be made based on clinical exam and topical antifungal medications may be prescribed.  A feeling of dry mouth is also consistent with this diagnosis.

I strongly urge you to stop "self treating" by scraping the lesions in your mouth and sleeping with candy.  Both of these measures are more likely to worsen your condition and potentially increase the risk for developing cavities.

In any case, you should be seen by an Oral and Maxillofacial Surgeon who will take a complete history and after the clinical exam may prescribe a medication or recommend a biopsy.

Any lesion(s) that persist or recur in the oral cavity should be biopsied.

If you still believe that you may be at risk for an infectious or sexually transmitted disease I suggest you see an Infectious Disease Specialist.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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Doctor - thank you for the response. Although I know you can't diagnose over the internet does Oral Hairy Leukoplakia go through several significant changes?  Meaning whole tongue then part of tongue then no tongue is infected???  I have been told by over a dozen HIV specialists I am negative based on my test results and timing so I don't believe what I am seeing is caused by HIV.  Just trying to see if OHL has this kind of up and down history with it?  Anything you can share would be helpful as I thought my negative test and reassurances from my Dr's and HIV specialists would help.  It seems many Dr's aren't that familiar with OHL.

Thank you and this is my last question.
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Typically, Oral Hairy Leukoplakia isn't easily scrapped off and has many different presentations. If you've seen more than 12 HIV specialists and they have all concluded that you don't have HIV, I would guess you don't have it either.
If you want to confirm the diagnosis of either oral candidiasis or OHL, you should see a doctor or oral surgeon that could biopsy the area and have the specimen checked for candida or Epstein-Barr virus (which causes OHL).
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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