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Dry mouth and irritation due to the use of oral rinses - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Dental Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1775 Questions
User :   Hi about 2 weeks ago i noticed some large bumps on the dorsal part of my tongue which i can only see if i stick my tongue out very far. I constantly feel like i have a dry mouth, i bought biotene toothpase and rinse, used chlohhexidine rinse , and nystatin. I guess my biggest worry is cancer. Iam nurse, and had two md at work look at it , which neither one of them seemed concernd. but iam. do you have any advice?
Doctor :   Hi
Doctor :   May I know your age and since when have you noticed these bumps?
User :   iam 46 and the bumps started about 2 weeks ago
Doctor :   How many such bumps do you see?
Doctor :   Do you have pain/discomfort associated with these bumps?
User :   7 or 8
User :   at first felt like my mouth had cottage cheese thats why i started nystatin, than for a day or two it burned, but i think this was caused by the chlorhexidine, and now it feels like sandpaper and dry. in the mornings my tongue has a white coat, and its like i can see the ridges of my teeth around my tongue. i started metropolol 25 mg on december 23rd due to severe migranes. could this maybe have something to do with it.
Doctor :   Do you still have the pain/burning sensation associated with these bumps?
Doctor :   Do you notice redness, mucous membrane peeling?
Doctor :   Is your tongue swollen?
User :   no not since i stopped the chlohexidine. no i havent noticed any redness or peeling. one of my md's at work thought the right side of my tongue was swollen , but stated it usually resolves itself. I have seen patients with reactions and having a swollen tongue and its not like this, but it does feel a little bigger.
Doctor :   Ok
User :   i have noticed a white layer where the red bumps are and i catch myself swallowing alot
Doctor :   Do you find any other visible changes both in colour and texture on the surface of these bumps?
Doctor :   How big are these bumps?
User :   they are just irritating and like with most things that are irriating i catch myself rubbing my tongue . no the bumps are white and raised and the area is whitish in color . pin size
Doctor :   Ok
Doctor :   Have you had similar problems in the past?
Doctor :   Do you have history of diabetes?
User :   this may be odd to ask could this be related to any bowel disorder? iam often constipated and unless i add fiber to my diet i have trouble with my bowels. no not any problems like this before. no history of DM. I did have a massive infection in my jaw bone last year that was fixed by an oral surgeon. it was due to a hair line crack in a crown which let bacteria in and caused my face to go numb. but once he did the root canal everything was fine.
Doctor :   Ok
Doctor :   Let me explain to you.
User :   oh and i should be honest and add that i recently started smoking again, after having migranes almost every day with vision loss it was the first thing i took up. but have quitt about 4 weeks ago again.
Doctor :   Sitting from this far without a physical examination of the tongue, it is a difficult task to predict the nature of the problem.
Doctor :   However based on your history, I can think of the following possibilities.
User :   let me ask you, should i consult my dentist or an ent
User :   prior to starting smoking again in november i was smoke free for 11 years
Doctor :   1. The whitish bumpy spots on the tongue could be due inflammation
Doctor :   an infection or irritation secondary to the oral rinses that you had may have triggered it.
Doctor :   2. Though metaprolol doesn't induce such changes, Nystatis is reported to cause mouth irritation and may have been the cause of the problem
Doctor :   3. Owing to the shortness duration history, absence of secondary changes, it is too early to suspect a cancerous transformation
Doctor :   Bowel problems are not known to cause these lumps too.
Doctor :   To simplify it,
Doctor :   I feel the symptoms are probably due to inflammatory/infection or due to nystatin which you had used.
Doctor :   Are you following?
User :   oh, yes... so do you think i should see an ent or my dentist. could it be treated with a abt
Doctor :   Consider consulting an ENT surgeon and yes it could be treated.
User :   and i will stop trying to treat it myself.... lol stop using nystatin. thanks for your help. I will call an ENT in the am
Doctor :   The treatment most probably could be just wait and watch with vitamin supplementation and change of medication.
User :   funny you said this, when i got the nystatin the NP said i should start using a good MVI
Doctor :   Yes, since nystatin are known to cause both mouth irritation and dryness, I suggest that you stop medicating yourself.
User :   ok i will, thanks again for your advice.... hope you have a great night
Doctor :   Consult and ENT surgeon who after physical examination will be able to suggest you alternate medications.
User :   bye
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