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What causes numbness in center of the chin and tightness in lower gums?

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Neurologist
Practicing since : 1988
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Hello. About 3 months ago I started to have a weird sensation in the center of my chin, just on the line. I can not really describe it as numbness but at times I feel either tightness or some loss of sensitivity. I do feel the skin but it seems different from the right or left side. I also have a strange feeling in my lower lip. It is not constant, though.... Since a few days I feel tightness in my lower gums (4 front teeth, center). I have been to GP, neurologist and dentist. Dentist said that there is nothing wrong (I do have parodontitis, early stages) but he says it is not due to this. I had panoramic X ray which was normal (1 month ago) and MRI which was normal (2 months ago). I have a bit phobic and I am scared 24/7 that I have a tumour. I also have panic attacks due to this problem. Do you think I should have further tests? Thanks
Posted Sat, 16 Aug 2014 in Anxiety and Stress
 
 
Answered by Dr. Dariush Saghafi 2 hours later
Brief Answer:
Unlikely that any tumor exists causing symptoms

Detailed Answer:
Good morning. My name is Dr. Saghafi and I would like to respond to your concern regarding a sensation you are describing in the center of your chin which you is numb at times and other times feels like a tightness or loss of sensitivity. You note that the right side feels different from the left (I'm not sure which side is the normal feeling side).

You also are referring that as of a few days ago a tightness in the lower gum where the 4 front teeth are located began. You say that you are aware of having early stage periodontitis. You also state that you are a bit phobic and very concerned that you have a tumor and suffer panic attacks as a result of this uncertainty. You also state that you've seen a general practice doctor as well as a neurologist and dentist. None have found anything wrong from an organic point of view and both an MRI as well as Panorex have been done and shown to be normal.

I would have to say that certainly in the face of negative X-ray and MRI findings that there would be virtually no chance at all you could have a tumor in the region of this feeling in the chin. MRI technology is so exquisitely sensitive that lesions as small as 1 mm. are easily detected by both the scanner and radiologist reading the study. Therefore, I would say that is 1 important point in favor of supporting a NO TUMOR diagnosis.

Secondly, if both the GP as well as the neurologist and including a dentist agree that aside from early stage periodontitis there is nothing else of an organic nature that can explain your sensation that at least from a clinical perspective we have good reason to believe that you are clear.

You ask about whether or not you might benefit from more tests. My impression is that a full and solid workup has likely been performed to rule out the possibility of a tumor as well as other neurological and dental diseases so it is unlikely that repeat scans would show anything new at this time.

If you've had any laboratory work performed I would ask to see the results and if you are on any medication I would want to know this as well. In my practice I might suggest that such a problem be investigated with a few simple laboratory tests as well such as a CBC, basic chemistry panel, Vit. B12, D, and folate. I might also test for simple thyroid functioning using an FT4 and TSH screening set.

My guess is that either your GP or neurologist have ordered at least some of these tests. I'd be happy to look at the results if you have them to report or scan into the system.

Otherwise, I wish you the best and if this response has answered your question I would appreciate your feedback on the usefulness of my help this morning as well as your cooperation in CLOSING THE QUERY. This will indicate that we have satisfactorily addressed and completed answering your question.

This case review, research, and final draft compilation of the response required 27 minutes of physician specific time.

All the very best to you and please let me know if I can be of further assistance.
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