This article is to be published in the June 26, 2009 issue of the Cerritos Community NewspaperEveryone has experienced mouth sores in their lifetime. Fortunately, the tissues of the mouth quickly heal and the lesions disappear. Let me briefly review the types of lesions that can occur and what you should be concerned about.
Traumatic lesions such as lip and cheek biting, pizza burns, and gum scrapes are painful but short lived. The lesions are tender for about a week then heal over in the second week. During this time it is important not to re-injure the site and to avoid acid or astringent foods. Rinsing with warm water with a pinch of salt helps soothe and cleanse the wound. Topical use of benzocaine ointments (i.e. Orajel or Zilactin) gives temporary relief during the painful phase.
Traumatic wounds may become ulcerated. Ulcers are open wounds that have become infected. They may have a white border with a yellowish membrane over the middle. They are usually painful. Oral rinsing with prescription chlorohexidene to reduce the microbes in the ulcer and topical ointments are effective and will speed up recovery.
Blistering and sloughing are often associated with certain diseases. If some damage occurs to a component of the oral mucosa the layers can separate. This separation results in a blister. When a blister ruptures sloughing will occur and the area becomes ulcerated. These lesions may require topical or ingested steroid applications.
Swellings and growths can be the result of infections, reactions to a chronic stimulus, or a new unwanted growth (neoplasm). Your dentist should check these enlargements. Infections will usually respond to antibiotics and treatment or removal of the source of the infection. Overgrowth of the tissue should be evaluated to determine if it is serious or benign. A neoplasm should be biopsied and closely followed.
Pigmented lesions are usually dark. A pigmented lesion may be the result of a small fragment of old filling that got trapped in the gums or cheek or from naturally occurring melanin pigmentation or red blood cells. These lesions should be checked. They can be an innocent convolution of capillaries or be a sign of a malignant melanoma or sarcoma.
An oral lesion can appear white due to the thickening of the keratin layer of the mouth (similar to a skin scab turning white when it is wet). The white patch (leukoplakia) will not rub off and it is difficult to predict its biology. Some form of biopsy is needed to determine malignancy. A white patch can remain the same or change over time and should be monitored by your dentist. Red lesions indicate a thinner keratin layer and may often have a burning discomfort. Red lesions associated with smoking are of great concern and all should be examined for pre-malignancy.
Your dental office will provide an annual oral cancer exam. Some practitioners are utilizing specially developed screening tests to “see” through to the deeper layers of the mouth for beginning cellular changes. These screens are very accurate and will give peace of mind that everything is okay for now.
For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com
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