Unidentified Oral Lesion After Seafood Meal: Causes and Solutions

Unidentified foreign body in the oral cavity?

Hello, Dr.
Tseng.
Last week, I traveled to Singapore for four days.
On the first night, I had dinner at a Chinese restaurant, and I may have eaten some contaminated seafood.
Within three minutes, a lump about the size of a peanut appeared on the inside of my right cheek (near the lower canine area).
It quickly grew to the size of a larger peanut.
I rushed to the restroom to squeeze it out, but it bled profusely.
I then kept rinsing my mouth with ice water and spitting it out, which helped a bit.
For the next four days, eating was really difficult, and even brushing my teeth caused bleeding and pain when the bristles touched my gums.
After returning home, there was no improvement, so I quickly went to an ENT specialist (since I wasn't sure which department to visit).
The doctor applied some medication, prescribed three days' worth of medication, and gave me an anti-inflammatory injection.
Initially, there was no improvement, and it seemed to get worse, but by the second and third days, I started to feel a bit better.
Today, I finally feel somewhat improved.
Could you please explain what might have caused this? Thank you.

yung, 30~39 year old female. Ask Date: 2006/08/13

Dr. Zeng Guanghui reply Dentistry

During eating, a sudden blister forms in the mouth, which gradually becomes engorged and then ruptures, resulting in a mouthful of blood.
The bleeding improves after applying ice, but a painful ulcer develops at the site of the ruptured blister, affecting future eating and tooth brushing.
This condition is known as idiopathic oral blood blisters (large blisters in the pharynx or oral mucosa), commonly referred to in Traditional Chinese Medicine as "flying throat." The causes may be related to the consumption of spicy foods or coarse, hard foods that cause trauma to the vascular tissues in the mouth.
It may also be due to inherently fragile oral blood vessels that rupture after injury, leading to the formation of blisters.
Once a blister ruptures and an ulcer forms, it is important to maintain oral hygiene to prevent secondary infections, and the use of topical oral ointments for protection may be considered.

Reply Date: 2006/08/13

More Info

Based on your description, it appears that you experienced an acute oral lesion following a meal that may have involved contaminated seafood. The sudden appearance of a swelling or blister-like lesion inside your cheek, which subsequently ruptured and caused bleeding, is indicative of a few potential conditions.

Possible Causes
1. Traumatic Ulcer: The rapid swelling you experienced could be a traumatic ulcer, which can occur due to physical irritation or injury to the oral mucosa. This might have been exacerbated by the consumption of hot or spicy food, or even by the act of biting down on something hard or sharp.

2. Vesicular Stomatitis: The description of a blister-like swelling could also suggest a viral infection, such as herpes simplex virus (HSV) or other viral stomatitis. These conditions can cause painful vesicles that may rupture, leading to ulcers and bleeding.

3. Allergic Reaction: If the seafood you consumed was contaminated or if you had an allergic reaction to it, this could lead to localized swelling and inflammation in the oral cavity.

4. Infection: Bacterial infections can also lead to the formation of abscesses or localized swelling in the mouth. If the lesion was infected, it could explain the persistent pain and bleeding.

5. Angioedema: This is a condition characterized by rapid swelling of the deeper layers of the skin, often triggered by an allergic reaction. If you have a history of allergies, this could be a possibility.

Recommended Solutions
1. Oral Hygiene: Maintaining good oral hygiene is crucial. Rinse your mouth with a saline solution or an antiseptic mouthwash to help keep the area clean and reduce the risk of secondary infection.

2. Avoid Irritants: Steer clear of spicy, acidic, or hot foods that could further irritate the lesion. Soft foods that are easy to chew and swallow may be more comfortable.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. Always follow the recommended dosage.

4. Topical Treatments: Your doctor may have prescribed topical anesthetics or corticosteroids to reduce pain and inflammation. Follow their instructions carefully.

5. Follow-Up Care: Since you mentioned that your symptoms improved after a few days, it’s essential to continue monitoring the lesion. If it does not heal within a week or if you notice any worsening symptoms, such as increased swelling, fever, or spreading redness, you should seek further medical evaluation.

6. Consult a Specialist: If the lesion persists or recurs, consider consulting an oral surgeon or a specialist in oral medicine. They may perform a biopsy or other diagnostic tests to determine the exact cause of the lesion.

Conclusion
The oral lesion you experienced is likely a result of trauma, infection, or an allergic reaction, possibly related to the seafood you consumed. While initial treatment has provided some relief, it is essential to continue monitoring your symptoms and maintain good oral hygiene. If the lesion does not heal or worsens, further evaluation by a specialist may be necessary to rule out more serious conditions. Always prioritize your health and do not hesitate to seek medical advice when in doubt.

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