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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Wednesday, February 8, 2012
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Wednesday, February 8, 2012
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Mouth Diseases |
Tongue Lesions10/04/2004 |
Six months ago, the sharp hooks on my partial plate got caught in the side of my tongue. This caused painful holes that have not yet healed. A local oral surgeon biopsied these lesions, and they are not cancerous, but he did not have any idea what else to do. My G.P. prescribed Triamcinolone Acetonide Dental Paste USP, 0.1% which gives brief soothing, but has not made a difference. She has no idea what else to do either. Any acidic food burns, and the lesions are sore most of the time. Another oral surgeon proposed cauterizing the sores, but the older surgeon said that he didn`t recommend that. Now what?
The chronic traumatic ulcer is a common, annoying condition, and healing can be delayed for several reasons. Sometimes a sharp edge of a denture, filling or tooth is not identified, and keeps rubbing the open sore, preventing its healing. Sometimes a mild yeast infection develops around the edge of the ulcer, which can delay healing. If the biopsy was sent to an oral pathology laboratory, the yeast infection probably would have been identified microscopically by the oral pathologist. If it was sent to a general pathology laboratory, it is more likely to have been overlooked. The triamcinolone (a corticosteroid) that is being applied will usually delay the healing process and increase the likelihood of a yeast infection. We generally do not recommend the use of this type of drug in this setting.
Patients with dry mouths (usually caused by any one of a variety of prescription medications) who develop a traumatic ulcer will usually have delayed healing. Increasing the lubrication of the mouth with an over-the-counter product, such as OralBalance, or taking one of the prescription medications that stimulate salivary flow may help heal the ulcer.
Clinical evaluation of the sores by an oral pathologist would be ideal. If all of these recommendations have been followed and the ulcer persists, it sometimes has to be removed completely by an oral surgeon so the edges of the wound can be sutured together for better healing. Of course, the excised tissue should be submitted to an oral pathology laboratory for microscopic evaluation.
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Carl M Allen, DDS, MSD Professor & Director of Oral & Maxillofacial Surgery and Pathology Dental Faculty Practice Section of Oral and Maxillofacial Pathology College of Dentistry The Ohio State University |
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