Should i worry?

[aqz]

Hi doc,
Ive had this lesion for over 6 months as far as i have been aware. Its not painful and does not bother me. I do get geographic tongue that can get irritated from time to time. Ive have anxiety over this but however have been overcoming it. And now its just on my mind again. It hasnt grown in size and is the same as when i first noticed it over 6 months ago. I have been to few dentists and my gp whom dont seem concerned and said its prib due to me smoking. Also i have alopecia so doc said it could be lichen as that is also an auto immune response. I also had mild crohns few years ago which has now gone. So we dont know why i had inflammation in the intestines. Sorry to go on, i hope you can put my mind at some sort of ease. I am a panicky person when it comes to health, which means i will always think the worst. Look forward to a response.

Kind regards

 

[honestdoc]

If it is there for more than 6 months and numerous dentists and your gp checked it, I'm also suspecting it is autoimmune response. Have your dentist/GP prescribe you Triamcinolone in Dental Paste and check to see if any improvements occur. In the meantime, please consider quitting smoking because it increases your risk of mouth cancer.

Something is causing an autoimmune response. Are you using anything irritating like different toothpaste, mouth rinses, herbal supplements, new medications, spices, and/or cinnamon products?

 

[aqz]

@honestdoc Thank you so much for your response. No i havnt been recommended anything to use on it as it is not painful and does not bother me. But when i wake up the area is always covered in whitish coating which then rubs off after eating etc.. The fact that i learned to forget checking it for 6 months and it still the same does it indicate something serious? I do eat spicy foods etc and my diet is not the best. I am a very anxious and stressful person. I am going through alopecia at the moment which i believe is also a auto immune response. I am scared of going back to docs as i assume i will hear the worst now. I have a sensitive mouth which gets irritated but nothing i cant handle.

 

[honestdoc]

Triamcinolone (in Dental Paste) is a corticosteroid which suppresses the autoimmune's destructive response. However, you indicated that you get a whitish coat which rubs off. Have it checked to make sure it is not a fungal infection (don't use the paste on fungal infections, it makes the area worse).

 

[aqz]

@honestdoc ok but if it was fungal can it still be there after 6 months? I do get geographical tongue area which can go white time to time. Also i would like to add i have a deviated septum so sleep with mouth opened hence wake up with dry mouth/tongue.

 

[aqz]

This is how it looks at the moment so its does improve slightly and the worsens etc.

 

[honestdoc]

I think it is a fungal infection. You must have some immune compromised condition(s). Do you have diabetes as well? Are you taking certain medications?

 

[aqz]

@honestdoc. So a fungal infection can linger for this long? No i dont have diabetes as far as i am aware and not on any medications. I was on pentasa for when they thought i had crohns disease. Im really worried to go back to docs/dentist, i fear i will be told its oral cancer...

 

[honestdoc]

I don't think you have cancer. I believe you have an immune system imbalance. It can damage your body if you don't address it. Also stop smoking and try to live a healthier lifestyle.

 

[aqz]

@honestdoc ok thanks for your advice. Do you suggest a biopsy?

 

[honestdoc]

That may be at last resort to minimize trauma of removing the lesion. Try to treat the lesion first (get your doctor/dentist evaluation).

 

[aqz]

Ok in your opinion how would you treat it qt first?

 

[aqz]

@honestdoc

 

[honestdoc]

Have your dentist prescribe you oral topical antifungals like Nystatin or azoles. Hopefully the lesion will respond within 2 weeks. Have your medical physician manage and control your Crohn's and other conditions because fungal infection can return. If the lesion does not get smaller, have it removed...most likely it is not cancerous.

If you continue to smoke, that lesion could get irritated and develop into a reactionary precancerous tissue.

 

[aqz]

@honestdoc thanks for your advice much appreciated. Also can i ask how long you have been a dentist and which country you based in?

 

[honestdoc]

I have been a dentist for over 20 yrs in the US. I'm in the beautiful Pacific NW.

 

[aqz]

@honestdoc great! Just another question if this was cancer would there have been significant change in 6 months of it being untreated?

 

[honestdoc]

Many cancers can get bigger in 6 mos. Some grow very slow and you won't notice the difference. In the study of pathology, when you hear hoof beats think horses not zebras (cancer is a zebra). Again, have the lesion treated and if it doesn't respond in ~2 to 4 wks, biopsy it.

 

[aqz]

Hi what do you mean by hoof beats? @honestdoc

 

[honestdoc]

It's just a saying that when you hear a bunch of horses running (hoof beats) you think the noise is from horses not from Zebras (not likely Zebras are in North America). When dentists evaluate lesions in the mouth, we think of the most likely reasons for the lesions (horses causing the hoof beats not zebras).