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Bump under lip, white dots on lip, painless, no bleeding. Wear dentures, have anxiety

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Dentist, Pedodontics
Practicing since : 1981
Answered : 24 Questions
I should preface by stating I am a hypochondriac with severe anxiety, nevertheless I think I have a problem not sure! I am 36 M, Denture wearer in upper gum, non-smoker for 12 years.

4 months ago (maybe longer?), under my lip I noticed a very tiny (almost non colored but a little white) bump (that hasn't changed). Then in the same location, I noticed tiny 4 tiny white dots in the same location just recently. Today, I noticed there's a weird sorta white border in the same area, but the area inside of the isn't raised or discolored just looks normal besides the small white border--(everything is painless, no bleeding). This is really freaking me out!

The biggest problem is my health insurance doesn't kick in until march 1st so i dont want to get it checked out, then if it's something bad my h.s. might not pay for it. I cant sleep at night though and it's hard to function with doubt.
When viewing the photo--note the white border i was refering to is very faint, doesn't show up in the photo.
Posted Tue, 17 Apr 2012 in Dental Health
Answered by Dr. Amitabha Chakraborty 3 hours later

Thanks for posting your query.

Well, these lesions are not very clear in the photograph. But whatever is seen and from your history it seems that you are developing a mucosal lesion called Lichen Planus. There is nothing to worry about this lesion.

It is harmless, but takes long time treatment to get cured. First of all you have to confirm it by visiting to a local dentist, though there is no hurry in it. Don't be anxious, this is really nothing serious.

Above answer was peer-reviewed by
Follow-up: Bump under lip, white dots on lip, painless, no bleeding. Wear dentures, have anxiety 2 hours later
That's a relief to a certain extent, but I read that Lichen Planus can but caused by having Hepatitis C. Should I be concerned about this? I never used drugs, so i imagine I don't have it. But again, i have high anxiety about my health, which hopefully I'll treat soon.
I am reading that it it can be caused by liver disease, if not a medication (I am not taking any medications). Please follow up; I know I'm acting irrational but I haven't had anxiety therapy since I lost my insurance.
I'm not sure at all why you said this isn't serious!?!?!? It's pre-cancerous if that is the case!!!! Or it can be triggered from liver disease. Please follow up--this is very bad.

Oral Lichen Planus

The prevalence of oral lichen planus in Sweden is 1.9 per cent [3]. It is more frequent in women (2.2 %) than in men (1.6 %). The oral lichen planus lesions exhibit a varied pattern from which six main types can be discerned. Three of these are white and designated papular, reticular, and plaque, respectively; three are red and designated atrophic, ulcerous, and bullous, respectively [8,9]. More than one type can be found simultaneously in a patient. The skin disease lichen ruber planus can have intraoral manifestations in one and the same patient. However, it is more common for the intraoral lichen lesions to develop from immunological mechanisms connected to local factors [10].

Oral lichen is considered to be a precancerous condition. In investigations incorporating large patient groups the malignancy incidence varies between 0.4 to 12.3 per cent. The differences can in some studies be attributed to uncertainty regarding the original diagnosis and variations in the follow-up time span. In all, a couple of hundred cases have been reported in the literature about cancer evolving from lichen lesions of chiefly the atrophic, ulcerous or plaque varieties.
I am really worried. I read that it can turn into cancer only if it's ulcerous (which apparently isn't my problem).

However, it's very common with liver disease. I know it might be 5 pct chance, but even that is too high for my liking. I'm really concerned. I read it could be diabetes as well. Can you check with your colleagues. I literally cannot sleep, and don't think i will.
Answered by Dr. Amitabha Chakraborty 5 hours later
Hi again,

I apologize for the delay to respond to you.

The picture sent to us is not suggestive of anything serious. The possibility of ‘lichen planus’ is entirely based on your symptoms reported. Since I do not have a clear picture of the lesion, a direct examination by your dentist is needed to confirm the possibility.

Information on the web is often not entirely true. Don't get panic reading them. Reconfirm it through a reliable source. And nothing is more reliable then a direct examination from your dentist.

Lichen planus (LP) is a fairly common disease with reason unknown; mostly it is an autoimmune disorder. There are increased incidences of LP reported among diabetes. I am not aware of any reliable clinical studies to prove a direct link between LP and liver disease/hepatitis C infection.

Though some school says the lesion is precancerous but till date scientific evidence does not support this claim. A few studies (1 in 0000 and 0.0004% in Europe) claim to report LP as precancerous, however other studies do not support this claim. So don't be panic. Visit your local dentist whenever you find time. It does not warrant an urgent visit though.

Hope my answer is reassuring and convincing. Let me know if I have missed out on any concerns.
Do accept the answer if you do not have any further queries.

Thanks again for your query and wish you good health.

Above answer was peer-reviewed by
Follow-up: Bump under lip, white dots on lip, painless, no bleeding. Wear dentures, have anxiety 1 hour later

I had an examination back in 2009 and it was reported that my bilirubin count was a little high. Then they gave me a liver enzyme test and I was reported as normal. I had 2 follow up tests--all came back normal. However, I am sure that I have a liver issue of some kind.

My examination last year showed a normal blood test, but I imagine it can change fast. I cant help but think one of the two instances are occurring in me. The odds are just too great something is wrong. I read about 10 different studies--I think Im in a lot of trouble. I cant sleep and my life is in complete disorder. Can you forward this to a liver specialist or something? I can say there's a 100 pct chance I have LP.
Answered by Dr. Amitabha Chakraborty 2 hours later

Thanks for writing back.

I do not think that you need to be refer to a so called "liver specialist" for LP. I repeat, liver disease is nothing to do with LP. If you are suffering from LP ( that has to be confirmed from your local dentist) it will reduce by a simple but long term treatment.

It seems that you are unnecessary getting anxious with LP.LP is a common and non fearful disorder that can be managed by a little long time treatment.

If you still wish to consult a Liver specialist you may have to make a new payment typing in the question again.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: Bump under lip, white dots on lip, painless, no bleeding. Wear dentures, have anxiety 6 hours later
Dr. Amitabha,

Thank you for following up. I am scheduling a routine checkup on March 1st and they will check everything anyways. I'm less worried following your explanation. My anxiety and hypochondria has been terrible since I had to conclude therapy at the end of 2011. The anxiety has been further advanced by not having health insurance for 2 very long months. Your expertise is very appreciated. I hope to move on in the coming days. I will visit a dentist next week.

Thank you again.
Answered by Dr. Amitabha Chakraborty 2 hours later

I am glad to know that this discussion has been helpful to you. Don't get anxious by reading thing which are not reliable on the web. It is not good for health.

Do accept the answer if you do not have any further query.

If you wish me to answer in the future, do address your concern to my attention "Attn: Dr. Amitabha Chakraborty"

God bless.
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