Small dots, spots or white lumps in the throat can be symptoms of several illnesses or infections which are not necessarily worrying, but which should be treated.
A whitish granular deposit: white angina
The small white dots at the back of the throat, more precisely on the surface of the tonsils, are “typical of angina white (inflammation of the tonsils)especially if they are associated with other symptoms such as sore throat, difficulty swallowing, fatigue, a runny nose, cough and fever. These little white balls which form like granular deposits are not worrying and are well known to ENT doctors“, specifies Dr Maïlys Ducours, Assistant Clinical Head in the Department of Infectious and Tropical Diseases at Bordeaux University Hospital, Pellegrin Hospital Group. This is the caseum : an aggregate of tonsillar cells, food remains, bacteria and fibrin, a filamentous protein that lodges in the cavities of the tonsils.
► Should I be worried? Most often, white angina is benign. Nevertheless, if the fever increases or does not go away after 3 days, it is advisable to consult your general practitioner. Consultation is also necessary if red patches appear all over the body (suggestive of a scarlet fever), if the pain is only located on one side (suggestive of an abscess).
Stains like “curdled milk”: oral thrush
Scattered white dots in the throat can also be a sign of oral thrush, a fungal infection (also called “oral candidiasis”) caused by excessive growth of the fungus Candida albicans in the mouth. Predisposing factors are a weakened immune system, diabetes, use of antibiotics… These spots are “in clusters” and whitishwith an aspect of rotten milk or white cheese. They are lodged in the mucous membrane of the palate, cheeks and tongue.
Consultation is necessary if thrush persists
► Should I be worried? It’s an infection very frequentedespecially in infants, which generally does not cause any particular complications. Thrush heals spontaneously within a few days (up to 2 weeks maximum) when light. A consultation is necessary if thrush persists, which may require a prescription for an antifungal medication. Young children should also consult a doctor if white, painful lesions appear in their mouth or if they have diaper rash.
Lesions inside the cheeks: leukoplakia
Whitish spots inside the mouth, on the gums, inside of the cheeks, palate or tongue, which do not disappear when scratched, may be a sign of oral leukoplakia. This generally results frompersistent irritation of the mucous membranes from inside the mouth. Among the main risk factors: smoking a lotexcessive consumption of alcohol and/or spicy foods, wearing ill-fitting dental appliances, poor oral hygienea virus infection of Epstein-Barr or the virus Herpes 4…
► Should I be worried? The majority of cases of leukoplakia are benign and can disappear without intervention, simply by changing your habits (better dental hygiene, reducing or stopping smoking, etc.). Untreated or in more serious cases (lesions which are called “inhomogeneous”: irregular surface, painful), the lesions are pre-cancerous and are likely to develop into oral cancer, “usually not for around ten years“, specifies Dr. Christophe Lecart, dental surgeon and spokesperson for the French Union for Oral Health. In all cases, if leukoplakia occurs, it is essential to consult your treating physician in a first step who can refer you to an ENT if necessary.
“Online” spots: lichen planus
White spots or areas that develop on the mucous membranes of the cheeks, tongue and gums may be a sign of oral lichen planuswhose origin would be fromemotional order, trauma, shock or strong emotion may be responsible. These spots are usually colored “white-blue”, lace, online” or grouped into small branches. They are not painful but may be accompanied by redness or canker sores.
► Should I be worried? Lichen planus is not serious in itself but does not disappear spontaneouslyyou should therefore consult your doctor or a dermatologist who will prescribe a suitable treatment.
A sign of Covid?
White dots or lumps in the throat are not signs of Covid. “Ideally, the distinction between angina and Covid-19 is made during the doctor’s clinical examination. In case of angina, the appearance of the tonsils is modified: the tonsils are very swollen and red in case of red angina or covered with a whitish coating in case of white angina. On the other hand, this modification of the tonsils is absolutely not visible for a Covid infection“, explains our interlocutor.