White/clear material accumulates in buccal mucosa transiently. What could it be?
Daily I've been getting small white/clear films/strings appearing on my buccal mucosa on the right or left or sometimes both sides.
Preceding the onset of the film/strings my mouth feels a little dry for some time. Then several hours later I see this material accumulate on my buccal mucosa only. It does not form or spread anywhere else in the mouth, not on the tongue (laterally, dorsally, ventrally etc), not on the floor or the mouth or the tonils or posterior pharyngeal wall etc.
The material is easily removed by running a finger over it. Once I do this all over the buccal mucosa I collect about 2-3mm of material on my finger tip.
There is no pain, swelling, altered taste, bleeding or smell etc. Nothing abnormal apart from the presence of the material itself.
For this reason I don't think it is pseudomembranous or erythematous candidosis
I personally think my buccal mucosa is exfoliating or shedding. Perhaps a reaction to excessive mouthwash use (which I did do) or toothpaste (I was brushing my teeth about 3 or 4x daily). I was previously using an antibacterial mouthwash TCP too which I dilute and gargle.
I have changed toothpaste and stopped using mouthwash completely but this problem still persists.
One time I used a blue listerene mouthwash and the material in my mouth actually got stained a blue colour!
I do have partially erupted lower wisdom teeth on both sides, there still is some gingiva covering the crowns occusal surface etc., could the material I find in my mouth be broken down gingival epithelium as the wisdom teeth erupt and it accumulates in the deepest part of the buccal sulcus? (as the gum is removed when the tooth erupts)?
The actual material, when removed from the mouth and when placed on my finger tip actually requires some force to pull apart the stringy material - another reason why I think this is epithelium.
Can you help answer my problem?
How long ago did you stop the mouthwash and switch toothpaste?
My initial guess is morsicatio labiorum, which is basically a frictional keratosis of the cheek from cheek biting. The skin is roughened and frayed due to the repeated cheek biting motion and can sometimes dislodge tissue if you wipe it. Its commonly seen in patients under alot of stress.
Thanks for replying Dr Tsang.
I don't bite my cheeks but I am under some stress!
I changed toothpastes first and stopped mouthwash back on Friday the 18th of March 2011 but I continued to have this problem.
I have an update to the situation:
I decided to change my toothpaste again. I switched from a colgate one to sensodyne.
I deliberately chose sensodyne as it does not contain sodium lauryl sulfate. Now after brushing my teeth, I don't get any white material accumulating on my buccal mucosa.
I was speaking to a consultant in a dental hospital the other day and he told me that he also thinks its just the squamous cells of my buccal mucosa exfoliating due to a reaction to the toothpaste/mouthwash chemicals.
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