Gum Cancer Symptoms and Dental Concerns: A Patient's Guide

Oral issues

Hello Doctor, I would like to ask you about the main symptoms of gum cancer, which are ulcers or non-healing wounds after tooth extraction.
Is it possible that in the early stages there are no obvious symptoms, but there is swelling and subtle pain in the gums? I have noticed that the gum tissue behind my last upper left tooth (not sure if it's a wisdom tooth, but it doesn't hurt significantly) feels quite swollen and appears somewhat white, which is noticeably different from the right side.
It feels uncomfortable and has a dull ache.
In mid-January, I had a molar extracted, which was difficult and took 45 minutes, as it had been decayed for a long time before I finally decided to have it removed.
Since then, the entire left side of my cheek and gum has felt uncomfortable, with a slight swelling in my mouth.
I feel like the gum tissue is constantly rubbing against the inside of my cheek, or perhaps the remaining tooth is causing irritation.
When I breathe in, I feel a soreness in the extraction site (not sure if it's just my perception or if the back of my gums is sore).
My cheek has a persistent tingling and aching sensation, and I am worried about changes in the oral mucosa.
I consulted a dentist abroad who said the mucosa looked fine but couldn't explain the tingling sensation.
The doctor took a full-mouth X-ray and said the extraction site looked okay, and there were no apparent issues with the other teeth.
However, the doctor mentioned that there was swelling in the area of the back teeth, which appeared to be bone on the X-ray, and there were no signs of a tumor, so I shouldn't worry.

Can X-rays detect tumors in the gums? Or is it that early-stage tumors might not be visible on X-rays? What kind of examination can confirm that there is nothing growing in the gums or gum tissue? My mouth has been uncomfortable, and the texture of my cheek mucosa feels strange, which makes me very anxious.
I am also concerned that there might be a misdiagnosis due to the less common awareness of oral or gum cancer abroad, potentially missing the early treatment window.
Should I seek a consultation with an oral medicine specialist or just a general dentist?
After the tooth extraction, I noticed an ulcer on the gum above the adjacent tooth that has not completely healed after a month and a half, leaving a small white area.
Due to my anxiety, I had a biopsy done abroad, which showed it was a benign ulcer with no malignant findings.
However, the wound still has a small white area, and I wonder if the biopsy was not deep enough and only tested the surface.

Could you recommend a good oral specialist in Taipei? I have a 4-month-old baby, so I cannot travel far to see a doctor.
Thank you very much, and I wish you good health.

Miss Chen, 40~49 year old female. Ask Date: 2019/03/07

Dr. Zeng Guanghui reply Dentistry

If you are concerned about slow healing of the extraction site or suspect the possibility of a gum tumor, you can consult an oral surgeon at a major hospital for further evaluation.

Reply Date: 2019/03/07

More Info

Understanding gum cancer symptoms and dental concerns can be quite complex, especially when dealing with discomfort and uncertainty regarding oral health. Your concerns about gum cancer, particularly the symptoms of swelling and pain, are valid and warrant careful consideration.

Gum cancer, or oral squamous cell carcinoma, can manifest in various ways. While the most common symptoms include non-healing ulcers, persistent lumps, and changes in the color or texture of the gums, it is important to note that early-stage gum cancer may not always present with obvious symptoms. Swelling and discomfort in the gums, as you described, can occur without the presence of a visible ulcer or lesion. This can lead to confusion, especially when other dental issues are present, such as the extraction of a tooth or the presence of a cyst or benign growth.

In your case, the swelling and discomfort in the area behind your last upper tooth, along with the white discoloration, could be indicative of several conditions. These may include inflammation due to infection, a benign cyst, or, less commonly, a malignant process. The fact that you have had a tooth extraction and are experiencing ongoing discomfort could also suggest that the healing process is not progressing as expected. It's not uncommon for the surrounding gum tissue to become irritated or inflamed after a tooth extraction, especially if there was significant decay or if the extraction was complicated.

Regarding your concerns about X-rays and their ability to detect tumors, it is important to understand that while X-rays are a valuable diagnostic tool, they have limitations. Traditional X-rays can reveal changes in bone density and the presence of large masses, but small tumors or early-stage cancers may not be visible. If there is a suspicion of a more serious condition, additional imaging techniques, such as a CT scan or MRI, may be recommended for a more comprehensive evaluation.

If you are experiencing persistent symptoms, it would be prudent to seek a second opinion from a specialist. An oral and maxillofacial surgeon or an oral pathologist would be well-equipped to assess your situation further. They can perform a thorough examination, possibly including a biopsy if warranted, to rule out any serious conditions. Given your recent experience with a benign ulcer, it is understandable to be concerned about the adequacy of the biopsy. If you feel that the biopsy may not have been deep enough, discussing this with a specialist could provide clarity and peace of mind.

In terms of your ongoing discomfort and the white area remaining after the biopsy, it is not uncommon for healing tissue to appear different from surrounding areas. However, if the area continues to cause concern or does not heal, further evaluation is warranted.

As for finding a reputable oral specialist in Taipei, I recommend looking for a dental clinic or hospital that specializes in oral and maxillofacial surgery. Many hospitals have departments dedicated to oral health that can provide comprehensive care. It may also be helpful to ask for recommendations from your primary care physician or local dental associations.

In summary, while your symptoms may not definitively indicate gum cancer, it is crucial to remain vigilant and proactive in seeking further evaluation. Early detection and treatment of any oral health issue are key to ensuring the best possible outcomes. Don't hesitate to advocate for your health and seek the care you need.

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