Oral and Maxillofacial Surgery Expert Forum
Thin white patch on gum under tooth #21
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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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Thin white patch on gum under tooth #21

I had my teeth cleaned three weeks ago and my dentist discovered a white patch (which I had not noticed) on my gum under the tooth he identified as #21. I have since seen an oral surgeon since it did not resolve in two weeks. The oral surgeon said he is not alarmed with it but recommended removal for biopsy and this will necesitate a graft from skin from my cheek. He said if I wanted to wait 6 months or a year to do that he would not have any qualms about that. But he also said that it had caused a bit of erosion to the gum so he wants to have the tissue biopsied. He said usually this would be benign but could be squamous cell carcinoma.
I will be having the procedure next week. My question is does this sound like something that you would consider benign (I realize you can't see it here) but the patch is soft, with no lump and is not rough. It does not hurt or bleed. The skin does seem softer in the white spot than other gum tissue seems. I have no fever and no reason to think of HIV. Thank you
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373693_tn?1324489102
Any lesion that persists in the mouth for more than two weeks should be biopsied.  If one of the differential diagnosis includes a malignancy then the standard of care in NJ would be to take only a sample of the lesion.  The reason being is if the entire lesion is removed and in fact cancer then the surgeon will be unable to determine the "margins" when definitive treatment is rendered.  If the lesion is benign then perhaps laser excision may eliminate the need for grafting.  In any case make sure you have it treated promptly.
373693_tn?1324489102
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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