Oral and Maxillofacial Surgery Expert Forum
Oral irritation
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Oral irritation

Hello Doctor,

First let me state I'm a smoker and concerned.

I have had this issue now for roughly 2 months. It all started with minor irritation of my inner cheek and area in lower cheek near bottom of last molar on right side. I developed a single small white spot which which went away in a day or 2. I began using mouth wash and developed several more small white spots in the same area that again went away in several days. My teeth both upper and lower began to get sensitive and I developed some swelling under my jaw on the right side.

GP claims I bit my cheek. Nothing more, see you later.

I have been to the dentist 3 times to check for bad teeth/root issues....Nothing found. Claims white slougthing could have been viral.

I have been to the endodontist just to make sure.....Nothing found

I have been to an ENT 3-4 times now....Nothing to report. No visual signs of oral/ent issues. Same comment on white spots...could have been viral but nothing specific.

I have had a facial/maxillary CT done, all normal.

I continue to have a dull ache in the right jaw, sensitive teeth and inner cheek/gum pain.
the ENT has given me anti inflamitory medication and now a dose of antibiotics. Thinks the w\swelling under jaw is salivary gland swelling not lymph, but nothing indicative on CT.

Any ideas? Where should I go next?

Thanks
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428321_tn?1298666741
Hello Sticks2,
Being a smoker, I understand your concern. However, this presentation is not typical for carcinomas of the oral cavity. It's difficult to say what this may be, but a viral etiology is definitely possible.
If the oral lesions have resolved and all you have remaining is the swelling you should return to your ENT or see and Oral & Maxillofacial Surgeon for a full evaluation. Some questions you might want to discuss with them are: Do you have dry mouth? Are you taking any medications regulary? Did the antibiotics help with the swelling? Would an MRI help evaluate the soft tissue swelling?
All the best,
DrT
4 Comments
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428321_tn?1298666741
Just to clarify, I meant: "You being a smoker, I understand". I do not smoke and neither should you.
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Thanks for the reply.
Went to the ENT for CT follow-up today. Nada....
The only symptoms I currently have are...sensitive teeth (upper and lower right molars), sensitive gums...same location....and Jaw soreness mostly due to inflamation (inflammation) of glands under jaw midway between chin and ear. The glands seem to swell a bit then recede within 15 minutes or so.
Arrrg. Very frustrating not being able to figure it out.
Will try some peroxide mouthwash, and the antibiotics which were just prescribed and wait and see.
The anti-inflamatory's (naproxen) seems to help, but not completely!
Thanks.
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my name is egiptianmagician,
Ohhhhhhhhhhhhh my tooth hurts!  what should I do?
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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