Yes, you can develop wart-like growths on your tongue, though medical professionals typically refer to them as oral papillomas or verrucae. These growths are benign, meaning they are non-cancerous, and they are directly linked to infection by the Human Papillomavirus (HPV). While the appearance of a growth in the mouth can be concerning, these lesions are generally harmless and represent a common manifestation of HPV in the oral cavity.
The Direct Answer: Oral Papillomas and Verrucae
The term “oral wart” is a common descriptor for several types of HPV-related growths that appear on the mucous membranes of the mouth. The most frequent of these benign lesions is the Squamous Papilloma, which is the oral equivalent of a common skin wart. Squamous papillomas are non-cancerous growths that often appear as a single, isolated lesion in the mouth.
Other types of HPV-related lesions can also manifest on the tongue and oral tissues, including Verruca Vulgaris and Focal Epithelial Hyperplasia, also known as Heck’s disease. Focal Epithelial Hyperplasia presents as multiple, small, painless nodules, often affecting the oral mucosa, lips, and tongue, particularly in children. These oral lesions are generally considered benign and pose no significant health risk aside from local irritation or cosmetic concerns.
The HPV Link: Causes and Transmission
The development of wart-like growths on the tongue is caused by the Human Papillomavirus (HPV), a highly common double-stranded DNA virus. Over 200 types of HPV exist, and a number of these can infect the oral cavity. The benign lesions found in the mouth are overwhelmingly caused by low-risk HPV types.
Specifically, low-risk types HPV-6 and HPV-11 are most frequently associated with Squamous Papillomas. Verruca Vulgaris is commonly linked to HPV types 2 and 4, while Focal Epithelial Hyperplasia is strongly associated with HPV types 13 and 32.
Transmission of the virus to the oral mucosa occurs primarily through direct contact with an infected area, such as skin-to-skin or mucosa-to-mucosa contact. Sexual contact, particularly oral sex, is a recognized method of spreading the virus to the mouth. The virus can also be transferred through autoinoculation, where a person transfers the virus from a wart on their hand or fingers to their mouth.
The virus requires an entry point, and breaks in the skin or mucous membranes, such such as cuts or abrasions, can increase the chance of infection. Most people who contract HPV, even in the mouth, will have their immune system clear the virus before any warts develop.
Recognizing the Lesions
Oral papillomas and verrucae have distinct visual characteristics that help in their identification. The classic presentation is a small, painless, exophytic mass, meaning it grows outward from the surface tissue. These growths often have a rough, pebbly surface texture that is frequently described as having a cauliflower-like appearance.
The color of the lesion can range from white to pink, depending on the level of keratinization, which is the buildup of a protective protein. Lesions that are highly keratinized tend to be whiter. Oral warts are generally slow-growing and can occur anywhere on the tongue, as well as the lips, gums, and the back of the throat.
While they are typically asymptomatic, their location may lead to irritation if they are repeatedly bitten or rubbed. Diagnosis usually begins with a visual examination by a healthcare professional, but a definitive diagnosis requires a biopsy. A small tissue sample is removed and examined under a microscope to confirm the presence of the viral infection and rule out other, more serious conditions.
Management and Removal
Many oral HPV infections and the warts they cause will spontaneously resolve, though this process can take months or even years. Treatment is generally recommended for lesions that cause discomfort, interfere with speaking or eating, or are a cosmetic concern.
The most common and effective method for managing oral papillomas is surgical excision, where the lesion is completely removed with a scalpel. This procedure is usually quick and performed under local anesthesia. Removing the entire lesion down to its base helps to prevent recurrence in that specific spot.
Other removal techniques include cryotherapy (freezing the tissue with liquid nitrogen), laser ablation, and electrosurgery (using an electrical current to remove the lesion). These ablative methods achieve similar results by destroying the infected tissue.
Topical treatments, such as over-the-counter wart medications, are generally ineffective and are not recommended for use on the moist, sensitive tissues of the mouth. The prognosis for oral papillomas is excellent, as they are benign growths with a low rate of recurrence after complete surgical removal.