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What's going on in my mouth??
Jan 6, 2002

Hi Dr. Reznik:

I have swollen fungiform papillae and a thin white coating on my tongue. Also, in the morning I wake-up with a white coating covering the inside of my cheeks and lips which fades somewhat during the day. I ocassionally get red spots in my mouth that don't hurt. I also have very slightly swollen lymph nodes in the back of my neck and under my jaw which have been that way for about a year. I had diarhea and increased metabolism for a year (although my Thyroid hormone is low!) but I seem to be pretty much back to normal in that respect. What would cause the fungiform papillae to swell and what would cause the white coating inside my mouth? I was tested for candidiasis and it came back negative. I have tested negative for Lupus. I also had a scope to check for Crohn's and that was negative. I have had blood counts and differentials done and have submitted stools for culture - everything comes back normal. I tested negative for HIV a few months ago and am going to get tested again. Do people with HIV often get a white coating like this in their mouth early in the course of the disease? Do you think this could be caused by an immune response - or autoimmune response - or by some sort of pathogen itself???

Thank you. Anita

Response from Dr. Reznik

The most common cause of what you have described is dry mouth (xerostomia) or mouth breathing. When there is not enough saliva present to perform normal cleansing and lubricating activities, it is very common to see enlarged papillae as well as a white coating in the mouth. From what you have described here, I do not think there is a pathogen or autoimmune response involved.


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