Oral Ulcers: When to Seek Further Dental Evaluation

Oral ulceration

I have a wisdom tooth on one side that has only partially erupted and hasn't fully come out.
I haven't paid much attention to it, but recently I noticed a sore spot on the mucosa behind that tooth, which looks like a hole and has a whitish appearance.
It has not healed for about 8 days now, and I have taken antibiotics and steroids without improvement.
A few days ago, I visited an ENT specialist who suggested that the partially erupted wisdom tooth might be causing the oral ulcer due to pressure.
However, he also mentioned that if the medication does not improve the condition, a biopsy may be recommended.
I would like to ask how long the doctor suggests waiting before considering a biopsy? (I do not smoke or drink alcohol.) Can a wisdom tooth potentially cause poor healing of oral ulcers?

Ms. Chen, 20~29 year old female. Ask Date: 2015/12/13

Dr. Zeng Guanghui reply Dentistry

The above situation may be due to the wisdom tooth not fully erupting, causing some gum tissue to cover the tooth.
This can easily lead to cavities due to food particles or friction during chewing.
If the cavity does not heal, it is advisable to consult a dentist for further evaluation to determine if it is an impacted tooth and consider the extraction of the impacted tooth.

Reply Date: 2015/12/13

More Info

When it comes to oral ulcers, especially those that persist for an extended period, it is essential to approach the situation with caution and awareness. Based on your description, you have a persistent ulcer in the area behind your wisdom tooth that has not healed for about eight days, despite having taken antibiotics and steroids. This situation warrants careful consideration and possibly further evaluation.

Oral ulcers can arise from various causes, including trauma, infections, autoimmune conditions, or even malignancies. In your case, the ulcer's location near the partially erupted wisdom tooth suggests that it could be related to the tooth's position and the irritation it may be causing to the surrounding soft tissue. Partially erupted wisdom teeth can create a pocket where food particles and bacteria can accumulate, leading to inflammation and ulceration of the adjacent mucosa. This can result in a condition known as pericoronitis, which is an infection of the gum tissue surrounding a partially erupted tooth.

The fact that your ulcer has not improved after eight days of treatment is concerning. Generally, if an oral ulcer does not show signs of healing within two weeks, it is advisable to seek further evaluation. In your case, since you have already consulted with an ENT specialist who suggested a biopsy if the ulcer does not improve, it would be prudent to follow that advice. A biopsy can help rule out any serious conditions, including precancerous lesions or malignancies, especially if there are no other obvious causes for the ulcer.

Regarding your question about the wisdom tooth causing poor healing, it is indeed possible. The presence of a partially erupted tooth can lead to chronic irritation and inflammation in the surrounding tissues, which may impede the healing process. Additionally, if there is an underlying infection, it can further complicate healing and lead to the formation of ulcers.

In summary, if your oral ulcer persists beyond two weeks, or if you experience worsening symptoms such as increased pain, swelling, or discharge, it is crucial to seek further evaluation from a dental professional or an oral surgeon. They may recommend imaging studies, such as X-rays, to assess the position of the wisdom tooth and any potential underlying issues. If necessary, a biopsy can provide definitive answers regarding the nature of the ulcer.

In the meantime, maintaining good oral hygiene is essential. Rinse your mouth with warm salt water to help reduce inflammation and promote healing. Avoid irritating foods and beverages that may exacerbate the ulcer. If you experience significant discomfort, over-the-counter pain relievers may help manage your symptoms.

Ultimately, your health and peace of mind are paramount. If you feel uncertain or anxious about your condition, do not hesitate to seek a second opinion or further evaluation. Early intervention can often lead to better outcomes, especially when it comes to oral health issues.

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