Oral Mucosa Inflammation: Causes, Symptoms, and Solutions

Oral mucosa

Hello Doctor, I would like to consult you.
I have been experiencing discomfort in my oral mucosa for a month and a half (since I had my upper left second molar extracted).
The symptoms are a burning and stabbing sensation localized to the left side of my cheek and the area of the gum towards the back.
I also feel swelling and numbness, and I have observed that the color on the left side is redder than the right.
Additionally, I have pain near the outside of my ear and mild tinnitus inside my ear.
I have already seen a dentist who said there was no significant issue and did not observe any swelling.
In my most recent visit, the doctor suggested that it might be due to decreased saliva secretion from the salivary glands, leading to bacterial growth in the mouth and subsequent inflammation of the oral mucosa.
I was advised to increase my fluid intake and take vitamin B complex and vitamin C, with the understanding that improvement would take time.
I am unsure if this is the cause, as I have been on antibiotics and anti-inflammatory medications without improvement.
I can only trust the doctor's advice to drink more water and take vitamin supplements.

Today, I went to a dental clinic recommended by a friend for a thorough check-up, where I had a full-mouth X-ray taken.
The dentist said there were no issues with the gums and did not find any swelling (although I feel there is some).
They also mentioned that my discomfort is not related to the extraction of my last remaining tooth.
The dentist examined the area near my ear, and when I mentioned the pain, they suggested it might be a temporomandibular joint (TMJ) issue.
I asked if the burning sensation in my mouth could also be related to this, and the doctor said it might be due to an immune system problem, or it could be a separate issue.
They wrote a referral for me to see an oral surgeon or an oral diagnostic specialist at a larger hospital.

I have previously seen an oral surgeon, but they could not identify the cause.
Now, I would like to ask you, is it true that oral mucosal inflammation cannot heal solely with medication? If the oral mucosa appears red, does that mean there is definitely no problem after being examined by a doctor? I read online that numbness, pain, and swelling in the mouth can be symptoms of precancerous lesions.
My symptoms have persisted for over a month and are quite similar, with no improvement, and I often feel very uncomfortable.
I am very worried that it might be something serious.
Are there any tests that can provide deeper insights to confirm that there are no issues in areas of the mouth or eyes that cannot be seen? Until my symptoms improve, I want to ensure that everything is okay.
I have seen many doctors over the past month and truly do not know what to do.
The stress has become overwhelming.
I sincerely apologize for the trouble and would greatly appreciate your help.
Thank you very much.

Ms. Chen, 40~49 year old female. Ask Date: 2019/03/19

Dr. Zeng Guanghui reply Dentistry

The above situation may indicate issues with the immune system or the temporomandibular joint (TMJ).
It may be advisable to consult an oral and maxillofacial surgeon for an evaluation of the TMJ and to see a rheumatologist to assess for any immune system disorders.

Reply Date: 2019/03/19

More Info

Understanding oral mucosa inflammation is crucial for addressing the discomfort and symptoms you are experiencing. Your situation, characterized by burning, tingling sensations, and swelling in the left cheek and jaw area following the extraction of a tooth, raises several important considerations.

First, it is essential to recognize that inflammation of the oral mucosa can occur for various reasons, including trauma from dental procedures, infections, or underlying systemic conditions. In your case, the extraction of the upper left second molar may have led to localized inflammation, particularly if there was any trauma to the surrounding tissues or if the extraction site became infected. The symptoms you describe, such as redness and swelling, are consistent with inflammation.

The involvement of your ear and the sensation of tinnitus (ear ringing) can be indicative of a few possibilities. One common cause is temporomandibular joint (TMJ) dysfunction, which can occur due to changes in jaw alignment or muscle tension following dental work. TMJ issues can lead to referred pain in the ear and surrounding areas, which may explain your symptoms.
Your dentist's suggestion that decreased saliva production could contribute to your symptoms is also valid. Saliva plays a crucial role in maintaining oral health by washing away food particles and bacteria, and a decrease in saliva can lead to an increase in bacterial growth, potentially causing further irritation and inflammation of the mucosa. Staying hydrated and taking vitamin B and C supplements can support your immune system and overall oral health, but it may take time to see improvement.

Regarding your concerns about oral cancer, it is understandable to feel anxious, especially when experiencing persistent symptoms. While some symptoms of oral cancer can overlap with those of mucosal inflammation, such as pain and swelling, the presence of a clear diagnosis from multiple healthcare professionals is reassuring. Oral cancer typically presents with more specific signs, such as non-healing ulcers, lumps, or persistent pain that does not improve over time.
To further investigate your symptoms, consider the following steps:
1. Follow-Up with Specialists: Since you have already seen a dentist and an oral surgeon, it may be beneficial to consult an ear, nose, and throat (ENT) specialist. They can evaluate any potential TMJ issues and assess the ear pain and tinnitus.

2. Diagnostic Imaging: If you have not already done so, ask for imaging studies such as a CT scan or MRI, which can provide a more detailed view of the jaw, TMJ, and surrounding structures. This can help rule out any underlying issues that may not be visible on X-rays.

3. Biopsy: If there are any suspicious lesions or persistent areas of concern in the oral cavity, a biopsy may be warranted to rule out any malignancy or pre-cancerous changes.

4. Oral Hygiene and Care: Maintain excellent oral hygiene to minimize irritation. Use a mild mouthwash and avoid irritants like spicy or acidic foods that could exacerbate your symptoms.

5. Stress Management: Given the anxiety and stress you are experiencing, consider stress-reduction techniques such as mindfulness, meditation, or counseling. Stress can exacerbate symptoms of TMJ dysfunction and oral discomfort.

In conclusion, while your symptoms are concerning, they are not necessarily indicative of a severe condition like oral cancer, especially with the reassurance from healthcare professionals. Continue to advocate for your health by seeking further evaluations and maintaining open communication with your healthcare providers. It is essential to address both the physical and emotional aspects of your condition to find relief and regain your peace of mind.

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