White patches on the gums?

[cherylglistner]

Hi everyone...

I'm trying to help someone on About Dentistry who discovered tiny white patches on his gums. Here is his forum post. So, of course, I immediately figured he might have had Leukoplakia or, at the most extreme, Candidiasis of the mouth. I don't think either of these are it though. His symptoms don't match up - in particular, the patches don't hurt, itch, or burn. I wonder if it may be an orthodontic issue. Anyone out there have a clue?

~CherylGlistner~

 

[pmantz]

Go see a dentist.

 

[JavadiCavity]

Strictly speaking, SDN is not a place for medical/dental advice. Your friends best option is to go see a dentist. But, I'm curious about what the differential diagnosis could be. If I find anything, I'll let you know.

 

[DrTacoElf]

my guess is fordyce granules

 

[cherylglistner]

my guess is fordyce granules

Hm, that's an interesting guess - I had not considered that.

But, yeah, I am curious about this as well. I told my friend to go see a dentist, no matter what I might say. I was just curious about you alls' opinion on the matter - though, of course, I realize it is not the best place for medical advice.

Thanks anyway though guys

~CherylGlistner~

 

[psiyung]

I'm waiting for a big dick to come and close this thread

 

[armorshell]

Given all the evidence presented I'm forced to conclude the white patches are advanced invasive squamous cell carcinoma. Or alginate. Could go either way.

They should probably see a dentist, not ask students.

 

[Sprgrover]

my guess is fordyce granules

From the post on About it sounds like the sites in question are on the alveolar mucosa, which would rule out fordyce granules. Alginate would wash out very quickly and it doesn't stick to oral surfaces (plus, patients are very aware of any remaining bits in their mouth and are keen to get that stuff out), and while it's not out of the realm of possibilities, I'd place squamous cell carcinoma at the bottom of my differential (site, color, etc.). My hunch is that, for the first time, this person lifted up his/her lip to expose the labial alveolar mucosa on the maxilla and noticed that in some areas the soft tissue is very thin and appears blanched due to the underlying bony structure, which is often scalloped around the roots of the anterior teeth. It's a variation of normal anatomy and I have the same findings in my mouth. Regardless, the person should make an appointment with his/her dentist. Speculation over the internet is no substitution for a thorough physical exam by a professional.

 

[pmantz]

I can't believe Supergrover didn't shut this thing down. Oh well

 

[Sprgrover]

I can't believe Supergrover didn't shut this thing down. Oh well

Well, in this particular instance it's a gray area. Since the person that started the thread isn't directly seeking medical advice for an ailment she has, and elsewhere on SDN threads along the lines of "I have a patient/case/etc. with 'X' - any thoughts?" are allowed and are even encouraged by Lee for discussion amongst students and residents, I've decided to leave this one open for the time being as it falls under the above.

 

[aphistis]

While it's impossible to diagnose anything without better information than this, I'll point out that a squamous cell carcinoma arising from the gingiva of an otherwise healthy 26-year-old is something you could probably get published by virtue of its rarity alone.

 

[KOM]

Well, in this particular instance it's a gray area. Since the person that started the thread isn't directly seeking medical advice for an ailment she has, and elsewhere on SDN threads along the lines of "I have a patient/case/etc. with 'X' - any thoughts?" are allowed and are even encouraged by Lee for discussion amongst students and residents, I've decided to leave this one open for the time being as it falls under the above.

Thanks. As an upcoming student I really enjoy reading about various clinical cases and get some different perspectives. I think it's a bit of an injustice to current students in their final years of education to presume any opinion or insight they may have is naive or not worthy of discussion.

I wish you could just put a disclaimer up and say...all opinions/posts on this site are exactly that "opinions" and should should in no way constitute any professional advice...go see a real etc etc. I'm not a lawyer, but in today's society and with everyone trying to make the ez buck I guess such a disclaimer might not hold up too well in court. Correct me if I'm wrong.

 

[cherylglistner]

Hi everyone

Phew boy - didn't realize this would be such a lively thread! I'm glad though - that's what these forums are all about. Plus, I was hoping this would spark some discussion. I heard back from my friend with the white patches and it turns out that they are his teeth poking out of his gums. He is apparently suffering from severe gum disease and his dentist (thankfully he took my advice and sought out professional help instead of internet help) discovered the tops of his gums were inflamed. The man later explained to me that he had a history of bad teeth and had to have many of them extracted except the front teeth. He had better be careful, or he'll get those pull as well. If you guys want to read through our thread, here's the link. He also had some white discoloration on his inner cheek which I had believed to be from either biting his cheek or having his teeth scraping the cheek - however, this was before he explained that his back teeth were all gone. Ay yi yi - the best advice you can give to people like this is see a professional - it's waaaay too difficult even try and diagnose a problem like this.

~CherylGlistner~