white ring on gums

[sk1212]

Hello, I am a 25 year old male. I have this weird kind of white ring on my back lower left gums, between the base of my last two molars. It doesn't look like an ulceration to me and in the white ring appears to me like normal gum tissue. I noticed it a little over a week ago. I used to smoke cigarettes (maybe 1 to 2 packs a week, never more than half a pack a day at worst) in college and a year after. I quit cigarettes in may and occasionally smoke out of a pipe (1 or 2 times a week but not for the last 2 weeks). I drink occasionally, but haven't since this showed up. I am a bit of a hypochondriac and within the last month have been to the dentist who said everything was fine, but that was before I noticed this. I don't have dental insurance and I really don't want to spend over $100 again just to have him look at this if it is nothing serious. Of course I am worried it's early leukoplakia or an early SCC, but I can't find any kind of pictures that appear like this. Any ideas?

http://www.flickr.com/photos/43482803@N04/4004862169/
http://www.flickr.com/photos/43482803@N04/4004862179/

[Jerome Tsang, DDS]

Sorry.  There's no definitive way to say what it is with a clinical observation.  It would need to be biopsied in order to find out what it is.  With your smoking history, it does put you in a higher risk category and the best thing to do is to find an oral surgeon who can perform a biopsy for your peace of mind.

[sk1212]

no one's got any help for me? no ideas at all? I talked with my dentist over the phone and he seemed unconcerned but said to see him if it doesn't clear up, but I still want to have an idea of WHAT this may be

[sk1212]

So to reiterate, even though I am 25 years old, have smoked less than 1 pack a day for less than 10 years, that puts me in a HIGH risk category? Even though it is a white area with an acute onset of less than a month ago? I had thought that SCC and pre-malignanant lesions were slow developing over the course of months or years in people in their 5th and 6th decade. Do you see a lot of people with pre-malignancies and SCC that are under 30?

[Jerome Tsang, DDS]

I haven't personally seen any patients with SCC under 30.  But the biopsies that I have sent for have turned back negative so far so I tend to be overly cautious.  But smoking does put you at HIGHER risk than a non-smoker.  I didn't mean to imply you are at the highest risk possible.  But the most definitive way to find out is to do a biopsy.