Persistent Gum Issues After Herpes and Inflammation

After gingivitis (gingival herpes), it is suspected that there has not been a complete recovery?

Hello Dr.
Tseng,
Attached is Image 1 (when I had gingival herpes in April): https://i.imgur.com/E2pGaes.jpg and Image 2 (after recovery, it turned dark red): https://i.imgur.com/4HGpqSh.jpg.
In April, I visited the doctor because I suspected an ulcer on the gum of my lower right molar (as shown in Image 1).
At that time, the doctor diagnosed it as gingival herpes, and later said it developed into gingivitis.
The treatment continued until June, when the doctor said it had healed.
However, every time I take a picture of that tooth, I still see a dark red ring around it (as shown in Image 2).

I would like to ask Dr.
Tseng a few questions:
1.
Is there still gingivitis present now, or could that be a periodontal pocket?
2.
If it is not gingivitis, is it possible that the gum was so severely injured that it can only heal to this extent?
3.
It has been almost four months since April, and if it hasn't fully healed (it seems to have improved slightly), could it be gum cancer? Does it currently appear to be gum cancer?
4.
If it were gum cancer, would it have worsened significantly in four months, such as developing more severe ulcers?
I apologize for taking up Dr.
Tseng's time with my questions, and I hope you can answer them.
I worry every day about whether it is gum cancer, but when I see doctors, they all tell me it is impossible, yet they haven't explained what the dark red ring is.

Thank you very much for taking the time to read and respond to my questions.

Miss Wang, 30~39 year old female. Ask Date: 2021/07/31

Dr. Zeng Guanghui reply Dentistry

If it is herpetic gingivostomatitis, although the inflammation of the gums may improve, the herpes virus can sometimes remain latent and reactivate.
It is recommended that if there are recurrent episodes of gum inflammation, one should consult an oral surgeon or an oral pathologist for further evaluation.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/07/31

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your persistent gum issues following your herpes diagnosis and subsequent inflammation. I understand that this situation can be quite distressing, and I appreciate your detailed description and the images you provided. Let’s address your questions one by one.

1. Current Status of Your Gum Condition: Based on your description and the images, it seems that you may still be experiencing some form of gingivitis or periodontal disease. The dark red and black discoloration around your tooth could indicate inflammation or a possible periodontal pocket, which is a space that can form between the gum and tooth due to gum disease. It’s essential to have a dental professional evaluate this area to determine if there is an active infection or if it is healing tissue.

2. Healing Process: After significant trauma to the gums, such as from herpes or severe inflammation, it is possible for the gums to heal in a way that may not return to their original state. The appearance of the gums can change due to scarring or residual inflammation. If the tissue is healing but not completely normal, it may be due to the extent of the initial injury. Regular dental check-ups can help monitor the healing process and ensure that any underlying issues are addressed.

3. Concerns About Gum Cancer: It is understandable to worry about the possibility of gum cancer, especially with persistent symptoms. However, the characteristics of gum cancer (oral squamous cell carcinoma) typically include non-healing ulcers, lumps, or thickened areas that do not improve over time. The discoloration you describe could be due to inflammation rather than cancer. Nevertheless, if you have concerns, it is crucial to have a thorough examination by a dentist or an oral surgeon who can perform a biopsy if necessary to rule out malignancy.

4. Progression of Gum Cancer: If it were to be gum cancer, it could potentially worsen over time, leading to more severe symptoms. However, the timeline for cancer progression varies significantly among individuals. The fact that your dentist has reassured you that it is unlikely to be cancer is a positive sign. Regular follow-ups are essential to monitor any changes.

In summary, while your symptoms are concerning, they do not necessarily indicate cancer. The best course of action is to continue working closely with your dental care provider. They can provide you with the most accurate diagnosis and treatment options based on a thorough examination. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another dental professional or an oral specialist may provide you with additional peace of mind.

Please remember that maintaining good oral hygiene, including regular brushing, flossing, and dental visits, is crucial for your gum health. If you have any further questions or need clarification, do not hesitate to reach out.

Wishing you the best in your recovery and health.

Sincerely,
Doctor Q&A Teams

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