Oral and Maxillofacial Surgery Expert Forum
Strange oral symptoms
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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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Strange oral symptoms

Hello Doctor,
I have been struggling with the following conditions for 6 months with what seems to me with no resolution in sight. This all started after unprotected oral sex. 1 day after my encounter I had a red spot on the tip of my tongue that was a bit painful. 2de day the middle of my upper lip swelled slightly and was red and more red spots that would keep moving day to day on my tongue. I also got an extreme metallic taste in my mouth and at this point unable to drink anything hot or eat spicy food. My bottom lip also started to swell especially on the inside, it almost looked like a translucent coating. A month later my tongue on the sides also had this translucent coating and my entire mouth started to go white (I checked my mouth every day and could clearly note the changes, wish I took photos). My doctor said it is oral thrush and I started using Nystatin. My parotid ducts where also slightly swollen, could feel this when I ran my tongue over them. Mouth wash did nothing much. My dentist said he does not see anything to worry about. For the past 3 months it has been getting better and better, but then a lot of white stuff formed on the back of my tongue. Went to see an ENT as my 95 day HIV test was negative (and all other STDs). The ENT said nothing to worry about. Retested at 5+ months for all stds and negative again. Went to see my dentist again and asked for fluconazole and I did get a 14 day course. After 5 days 90% of the white stuff on the back of my tongue was gone! Then about 10 days into the course it was coming back. After completing the course it is now getting less again. My bottom lip is still a bit swollen, but much better and so is my upper lip. My symptoms seems to be just "little" enough for it it be discarded by the medical professionals i have consulted.
I am seeing an oral pathologist, any input on specific tests I can discuss or any advice would be greatly appreciated.
Thank you for your time.
373693_tn?1324489102
It sounds like you have done everything you can up to this point and I understand your frustration.

I would advise you to insist on a scraping be obtained of multiple areas in your mouth.  Slides should be prepared for a pathologist to look at the specimens to confirm Fungal infection.  Furthermore, cultures should be obtained in an attempt to determine the precise type of fungus so that medications can be prescribed that will best treat the specific type of fungus you may have.

It is possible that you have a problem not related to fungus.  However, the oral pathologist or oral medicine specialist are the best doctors to help identify and treat your symptoms.

Keep us advised.

Dr. Kirsch
4 Comments
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Avatar_m_tn
I would like to add that neither my doctor nor my dentist had the ability to test for oral thrush! Not sure why this is so difficult to get done in NY. The ENT could also not test.
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Avatar_m_tn
Thank you doctor,
I am about 2 weeks away from my appointment. I have to admit I have no confidence yet again that a resolution might be forthcoming. The person taking my details did not understand why I want to make an appointment if I do not require surgery.
I know this may sound crazy, but I have even gone as far as looking at many photos of myself and can clearly see the differance especially with regards to my bottom lip. My life is on hold here, how can I kiss anyone knowing I might have some soft of an infection, an unknown one at that it seems.
I keep getting the "I have been doing this for 20 years" routine and that there is nothing wrong with me and then the doctors get upset when I want a test. If everything was based on experience there would be no need for tests to exist. At this point I will pay anything to get just even tested for oral thrush.
Sorry about the frustration, but doctor, in 6 months I could not even get tested for thrush. Is it really that difficult of an test?
I will post the diagnosis of the oral pathologist.
Thank you once again for your time doctor.
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Avatar_m_tn
Hello Doctor,
I went to see an oral surgeon and the doctor could see immediately what I was complaining about. He took two cultures one from each side of my cheeks and also said there are no signs of thrush. My tongue looks 95% better since my initial post here.
The result from the pathology lab indicated intracellular edema and also listed that it is consistent with Leukoedema. He also said that taking a culture from my lip is not recommended due to the nerve endings.The doctor also indicated that there is no chance that this is from a STD via oral transmission. I still cannot get over the fact that this started a few days after a sexual encounter.
It seems there really are no explanations for this condition. It looks like I will have to accept living with it and move on.
Thank you doctor for your time and please let me know if you would recommend any additional or different testing.
Thank you
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
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