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Have tooth decay, white patches with red spots and lump on gums. Oral cancer?

DOCTOR OF THE MONTH - Aug 2013
Aug 2013
User rating for this question
Very Good
Answered by

ENT Specialist
Practicing since : 1996
Answered : 1025 Questions
Question
what are the signs of oral cancer? i have no pain in my mouth at all but suffer from tooth decay and white patches with red spots. also a lump on my gums where my wisdom tooth nevet came in. there are also pimple looking things under my tongue
Posted Wed, 9 Oct 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sriram Nathan 31 minutes later
Brief Answer:
Many signs and Symptoms

Detailed Answer:
Hello and welcome to XXXXXXX

I am Dr Sriram Nathan an ENT surgeon who has treated many patients with malignancy or cancer of the head and neck region.

First let me try to assess what you have and then give you other general instructions.

The white patches with red spots are common in the oral cavity and should not be a bother unless they are increasing in number and are becoming large. In this case you may go for a simple test called the biopsy and get the reports so that you can be relieved.

The lump on the gum where wisdom tooth never erupted can be due to the non erupted tooth itself and also can be due to a gum infection. You may start a course of antibiotic in consultation with your doctor and get the site examined by the dentist to be on the safer side.

The pimple looking things under your tongue are the follicles which are normal structures and do not need any treatment unless they are inflamed in which case you may start a course of good antibiotic in consultation with your doctor.

These are your present problems. Specifically for oral cancers you need to consider these:

- Any lump on any part of the tongue or oral cavity should be immediately inspected and examined by the ENT
-Any feeling of voice change and difficulty must be examined
- Avoid spicy food stuffs and take lots of green leafy vegetables. This is the best way to prevent cancer.
- Any jagged or projecting tooth can cause frequent trauma which is a risk factor and this should be addressed by the dentist
-Avoid tobacco and other related products

Hope your doubts are addressed and I will be happy to answer any more

Regards

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 1 hour later
the tooth decay has happened so quickly and i take and took great care of my teeth. my gums have multiple white patches on them. my tongue has sore/cut looking things on the sides from the tip and all in the back. also my lymph node in my neck has been enlarged so big you can visibly see it for over 2 years now. i have already tried antibiotics a few times when i had insurance. they didnt change anything at all. also i have the feeling of sonehing stuck in my throat all the time
 
 
Answered by Dr. Sriram Nathan 19 minutes later
Brief Answer:
Need more test reports

Detailed Answer:
Hello again,

There are a few things which have come to light after our discussion. Let us try to take them one by one:

- The patches on the gum need further evaluation by an oral surgeon and you may even ask for a gum biopsy since it is there for a long time i believe and is definitely bothering you.

-The cut looking things are called serrations on the surface of the tongue which is perfectly normal. You need to hydrate yourself and take less stress and these will become better and go away.

-If the nodes in the neck have been enlarged and you are feeling the lump in throat feeling then it is imperative that you get an Upper GI endoscopy, an cytological aspiration study of the node and also a CT scan of the neck and get back to me with the reports. These have to be done as soon as possible. If not then at least get an lesser priced test like the ultrasound of the neck and get back to either me or an ENT consultant with the reports.

At the end of it all, you may find that everything is fine but we need to confirm to be on the safer side.

Hope you get well soon and I Would be happy to clear any more doubts

Regards

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 28 minutes later
it does worry me! the things on the side of my tongue look like little growths almost. it feels swolleb but not painful. also im unsure if this is related but i went ten days(am going) without passing a bowl movement, during this time my belly button area became extremely painful and red with discharge. when i was passing bowls there would be blood on rhe toilet paper on the stool and in the toilet
 
 
Answered by Dr. Sriram Nathan 16 minutes later
Brief Answer:
definitely related

Detailed Answer:
Hello again,

Like i mentioned before, stress can cause any of the problems which you have mentioned!

If you have not passed bowel in ten days that would definitely characterize as stress and that can cause the swellings on the tongue.

You need to immediately XXXXXXX a gastroenterologist or general surgeon in the background of non passing bowel and blood in the stool which may indicate either an obstructed bowel or a fissure which has to be treated as soon as possible.

You may start on a mild laxative and also take lots of fibre and fruits so that your bowel movements may be regularized. Your doctor may know about these.

Finally if the swellings in your tongue do worry you so much then get it examined by an oral surgeon.

hope you get better

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 17 hours later
those are highly expensive options. i dont have insurance and none of them do payment plans
 
 
Answered by Dr. Sriram Nathan 7 minutes later
Brief Answer:
consult a general surgeon

Detailed Answer:
Hello again,

Since your problems are severe I had suggested the measures.

Anyway you may try the stress relieving measures I explained earlier

You can also just visit a general surgeon who can advice non expensive treatment options

Get well soon

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 1 hour later
seriously?!!! thats medical advice? you say they are severe which i know they are but then say im stressed? i know what stress is, i have 3 children. im not stressed in my life right now i feel like im going to die.....thats how serious. this is to me
 
 
Answered by Dr. Sriram Nathan 11 minutes later
hello again,

I can understand how frustrated you are feeling right now and that is increasing your stress further.

What you need to understand is that you have impacted bowel for ten days and counting, you have blood in your tissue and you have lump in your throat.
Now much as I would like to help you out there is no conservative or over the counter treatment for any of these. They are pretty serious symptoms and I must insist you to seek medical help immediately.

However you may try measures such as high fibre diet and more fruits and vegetables. But these will help you once we can be sure that the symptoms which you have are not due to anything serious and that can be done only on direct examination by a general surgeon and ENT. Am sure there will be some practitioner in your area who can examine you at a reduced rate and later you can share with me the findings afte which I can help you out better.

With just a list of symptoms and also when they are certainly serious my hands are tied, you must understand that. I would most definitely need to do some tests to get to the root of the problem.

hope you do understand

take care

Dr Sriram Nathan

Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 50 minutes later
hnmmm ive been to county health clinics and they cost too much.
 
 
Answered by Dr. Sriram Nathan 23 minutes later
hello again,

As far as you throat problems are concerned let me tell you that in all probability you have nothing to worry about. Since you have already taken a course of antibiotics you may try anti reflux medication such as Pantoprazole and it will become better. Your doctor will know about this.

Regarding the swelling in the neck, Since the swelling is in the same state and size for two years you have no emergent concern regarding the same. You will definitely require further tests in the future for proper diagnosis and treatment but it does not seem to be an emergency so do not worry about that too.

Regarding you bowle which is stopped for ten days you may try home remedies such as warming of stomach with a sponge soaked in warm water, taking lots fruits like banana and papaya. You may also try the over the counter stool softeners available.

Finally if these conservative measures do not work then you must consult a general surgeon so that a proper treatment can be initiated

regards

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 1 hour later
sometimes i cant even breathe and feel like my windpipe is completely constricted. other times i am barely able to swallow water. and when i look at the back of my throat it looks smaller and has what looks to be sores but they dont hurt and dont go away. on my gums i have the same type of marks that are increasing in number. also as stated my tongue looks gross and unnatural
 
 
Answered by Dr. Sriram Nathan 11 minutes later
hello again,

You had not specified your complaints like choking which you are experiencing occasionally and along with the lesions of the tongue I would assume that you have reflux problem which is very common and nothing to worry about. Also since you have so much stress, this problem will be aggravated in your case.

You may take the medication which I had mentioned earlier and you can follow the anti reflux measures which I will mention a few:

-avoid anything spicy or oily or high flavoured
- never skip a meal and instead of having big spaced out large meals have frequent smaller meals
- do not strain when you speak and do not scream or whisper
- after a meal do not immediately lie down
- take lots of salads and green leafs
- while you sleep do not wear tight clothing and do not lie on your left side
- maintain an ideal weight and exercise regimen to control the same
- avoid citrus drinks, caffeine and spirits

These are a few simple measures which will definitely help you in a long way along with the anti reflux medications.

Finally as I have said before if the symptoms do not improve then you must definetely consult an ENT specialist

take care

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 3 minutes later
i tried those already with my dr about 9 months ago. i took them for 3 consecutive months
 
 
Answered by Dr. Sriram Nathan 28 minutes later
hello,

You must understand that anti reflux measures and treatment is lifelong and should be followed for as much.

A three month treatment may make you feel better but does not cure the problem. You must continue the anti reflux treatments for as long as your symptoms keep recurring and only then you will have good control.

Furthermore, if the anti reflux treatment is not working then you must get an upper GI endoscopy done as I mentioned before. In any case whenever a treatment is not working and/ or not giving relief then it must be investigated further as I have already mentioned before.

Start these anti reflux measures and medications again for minimum three month and later on continue the anti reflux measures for as long as possible with tapering of the medications in consultation with your doctor.

regards

Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 5 hours later
it showed absolutely no improvement. we only used them as a trial for 3 months and also antibiotics which didnt change anything.
 
 
Answered by Dr. Sriram Nathan 1 hour later
Brief Answer:
stop antibiotics but continue anti reflux

Detailed Answer:
Hello again,

I see that you have not much relief with anti reflux measures and also antibiotics.

You should not take antibiotics for a long time as they increase the reflux

Anti reflux measures if done properly will definitely help. If it is not helping then either it is not being followed properly or there may be other problem which like I mentioned several times before has to be investigated further.

You may try anti reflux measures more religiously and strictly for one month and then if it does not improve then you must get an upper GI ENDOSCOPY and get back to me.


Regards


Dr Sriram Nathan
Above answer was peer-reviewed by
 
Follow-up: Have tooth decay, white patches with red spots and lump on gums. Oral cancer? 2 hours later
i was on them as perscribed daily for 3 months. what are the other possibilities
 
 
Answered by Dr. Sriram Nathan 9 minutes later
Brief Answer:
take less antibiotics

Detailed Answer:
Hello and welcome again,

Take antibiotics only for a short duration and if they do not work then you must go for a throat swab. Taking for three months is not advisable and it will actually increase the reflux.

Apart from reflux it can be many things ranging from
Apthous
Stomatitis
Mucositis
Pappiloma
Folliculitis
Or other tumours, mostly benign and rarely malignant... as mentioned earlier these can be diagnosed by a combination of examination and endoscopy

Regards

Dr Sriram Nathan
Above answer was peer-reviewed by
 
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