Oral Mucosal Changes: Common Concerns and Symptoms

Q: Oral Mucosal Changes: Common Concerns and Symptoms

Hello： <br>1. <br>There is a reddish area approximately 0.5 cm in size on the mucosa adjacent to the right upper lip molar, but the surface is smooth without any wounds, and there are no protrusions or depressions. <br>Occasionally, some white material can be removed by hand, whi

The mucosa between the upper lip and the upper molars?

I am 32 years old, with no habits of smoking, drinking, or betel nut chewing.
Recently, I discovered a section of mucosa on my upper lip adjacent to the right molar that has a reddish area about 0.5 cm in size, which appears to have more prominent microvessels.
The surface feels smooth, with no wounds, and it is neither raised nor depressed (clearly different from images of precancerous lesions associated with oral cancer).
Sometimes, I notice a small white substance (about 2 mm) that can be wiped away easily.
I would like to ask the doctor what this could be?
2.
Upon lifting my upper lip, I noticed blood streaks on the gum of my upper left wisdom tooth (also with prominent microvessels), but there is no bleeding or swelling, nor any other symptoms.
What could this indicate, doctor?
3.
My tongue tends to be on the larger side, and I recently observed some indentations along the edges, which is referred to as "tooth-marked tongue" in traditional Chinese medicine.
How would this symptom be interpreted in Western medicine?
4.
Previously, I had an ulcer on the left side of my tongue (about 0.3 mm) that healed, but now I notice that the area has a darker color (a deeper red).
What could this mean, doctor?
5.
The lower sides of my tongue show prominent microvessels that appear purplish and have a net-like pattern.
What could this indicate, doctor?

Yīzhí dānxīn zìjǐ zěnme le, 30~39 year old female. Ask Date: 2012/12/20

Dr. Zeng Guanghui reply Dentistry

Hello:
1.
There is a reddish area approximately 0.5 cm in size on the mucosa adjacent to the right upper lip molar, but the surface is smooth without any wounds, and there are no protrusions or depressions.
Occasionally, some white material can be removed by hand, which may be dental plaque.
If there is inflammation of the oral mucosal epithelium, it could lead to changes in the color of the oral mucosa.
It is recommended to use a cotton swab during oral hygiene to remove the plaque.
If the color change persists for more than a week, it is advisable to consult a dentist for further examination.
2.
There are blood streaks in the gums of the upper wisdom tooth, which may indicate gingival inflammation, but there are currently no acute symptoms.
It is recommended to eliminate dental plaque, and once the gingival inflammation subsides, the blood streaks should naturally resolve.
3.
If the tongue is enlarged, it may rub against the lingual side of the lower teeth over time.
Additionally, if there is poor salivary function leading to xerostomia, the lingual mucosa may become irritated, resulting in dental impressions.
4.
There is an ulcer (0.3 mm) on the left lateral aspect of the tongue, which appears darker after healing.
If there are no protrusions or hard lumps, it is advisable to monitor the situation.
5.
There are many superficial veins on the underside of both sides of the tongue.
If venous blood circulation is poor, the vessels may become prominently visible.
It is recommended to consult an oral specialist for a detailed examination.
Wishing you peace.

Reply Date: 2012/12/20

More Info

Understanding oral mucosal changes can be a complex process, especially when various symptoms arise that may cause concern. Based on your description, let's address each of your concerns systematically.

1. Red Area on Oral Mucosa: The red area you described, measuring about 0.5 cm, could be indicative of several conditions. The fact that it feels smooth and lacks any ulceration or significant elevation suggests that it may not be an immediate cause for alarm. It could be a localized inflammatory response, possibly due to irritation from dental appliances or food. The presence of white debris that disappears when wiped away could be related to keratinized tissue or remnants of food or bacteria. However, if this persists or changes in appearance, a follow-up with a dental professional is advisable to rule out any potential lesions.

2. Gingival Blood Vessels Near Wisdom Tooth: The appearance of blood vessels in the gum area near your wisdom tooth, along with the presence of blood streaks, suggests possible gingivitis or localized inflammation. This could be due to plaque accumulation or irritation from the wisdom tooth itself, especially if it is partially erupted. Maintaining good oral hygiene is crucial, and if the condition does not improve, a dental examination may be necessary to assess for periodontal disease or other underlying issues.

3. Fissured or Indented Tongue (Scalloped Tongue): A scalloped tongue, often referred to as "齒痕舌" in traditional Chinese medicine, can indicate several factors in Western medicine. It may be associated with bruxism (teeth grinding), which can cause the tongue to adapt to the pressure of the teeth. It can also be a sign of dehydration or nutritional deficiencies, particularly in B vitamins. If this is a new development, consider evaluating your hydration and dietary habits. If the condition persists, consulting a healthcare provider for further evaluation may be beneficial.

4. Darkened Area Post-Ulcer: The area on your tongue that appears darker following a previous ulcer is not uncommon. After an ulcer heals, the tissue may take on a different coloration due to changes in blood flow or healing processes. This darker area could be a result of increased vascularity or pigmentation changes in the mucosa. If the color change is accompanied by pain or other symptoms, further evaluation would be warranted.

5. Visible Blood Vessels on the Tongue: The appearance of prominent blood vessels on the sides of your tongue, especially if they appear purple or net-like, can be a normal anatomical variation. However, it can also indicate underlying conditions such as vascular malformations or systemic issues like hypertension. If this is a new symptom or if you experience any discomfort, it would be wise to consult a healthcare provider for a thorough examination.

In summary, while many of the symptoms you describe may not indicate serious conditions, they warrant careful monitoring and possibly further evaluation by a dental or medical professional. Regular dental check-ups are essential, especially if you notice changes in your oral health. If symptoms persist or worsen, do not hesitate to seek professional advice to ensure your oral health remains optimal.

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