by
Ralph W. Fortson, D.D.S.
The
first Question. What is it?
You feel a change in or around your mouth. You may notice an enlargement,
a change in appearance, mechanical difficulty chewing, or pain. The
Second Question. What should you do?
You should see your dentist or physician right away. If you don't
have a physician or dentist, I recommend you ask your friends and
co-workers for names. Then you can make an informed choice. Call and
schedule an appointment immediately.
Why see a dentist?
A general dentist should be able to help you evaluate the problem,
make a referral when necessary, and find the diagnosis if the problem
is related to the oral cavity.
What
could it be?
Some
of the possibilities are:
An Abscess which is an infection around your teeth or gums. This
may be caused by periodontal (gum) disease, caries (tooth decay),
trauma, or idiopathic (meaning we don't know what caused it).
A Canker Sore (Recurrent Apthos Ulcer). These are painful ulcers
that form at the junctions of the attached gingiva (gums) and the
mucosa (the soft flexible tissues in your mouth). These last approximately
10 to 14 days.
A Traumatic or Frictional Injury. A traumatic injury may be caused
by external forces like a blow to the face or internal forces like
biting of the cheek. A frictional injury may be caused by an ill
fitting denture or a foreign body that was trapped under the denture.
These are very common injuries.
Chemical or Thermal Burns. Placing an aspirin against your gums
can cause a chemical burn. You should not do this. It doesn't help.
Thermal burns are caused by hot foods such as cheese in pizza. Many
times people will burn their mouths and not realize it until the
next day. They don't relate eating the hot food to the bump in their
mouth until the dentist asks what they have eaten recently.
Muscular or TMJ Problems. The muscles of your face or your Temporal
Mandibular Joint (TMJ) can become swollen, painful, or red. This
can be caused by trauma, your occlusion (the way your teeth fit
together), clenching or grinding your teeth.
Normal Anatomy. There are many structures in your mouth that are
normal and you may not have noticed them. Tori (enlargements of
the bone) are common in some areas of the mouth.
Benign Cysts or Tumors. Benign means not cancerous. These have many
causes. Many times we do not know if a cyst or tumor is cancerous
until a sample is submitted for a biopsy (microscopic examination).
Systemic Diseases. Diseases that originate in other areas of your
body often are first discovered by changes in your mouth.
A Malignancy. This means that the area is cancerous. There are many
risk factors. Some examples are excessive alcohol consumption, smoking,
or a family history of cancer. In some cases there are no risk factors
associated with the malignancy.
What
is the normal sequence of events?
Your
dentist can determine if your problem is related to your teeth or
gums. If the nerve (pulp) in your tooth is involved the dentist
may treat it or refer you to a dentist who specializes in this area.
Other dental conditions will probably be treated in the office of
the dentist.
If it is a cyst or tumor, you may be referred to an oral surgeon.
The oral surgeon may recommend a biopsy of the area. A biopsy is
a sample of the area. It is sent to a pathology laboratory. A pathologist
would evaluate the sample with a microscope and send a report to
the oral surgeon. The oral surgeon would notify you of the results.
If the tumor is benign (non-cancerous), the oral surgeon or Head
and Neck surgeon would usually treat it. If the tumor is malignant
(cancerous), you would probably be referred to an E.N.T. (Ears,
Nose, and Throat also known as an otorhinolaryngology) physician.
The E.N.T. would also work with an Oncologist (a physician who specializes
in treating cancer).
If your condition is related to a systemic problem you would be
referred to a general physician.In summary: If you have noticed
a change in your mouth see your dentist immediately. He or she can
help guide you to the proper care. Early treatment is very important!
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