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Ask Dr. Behere Your Own Question
Dr. Behere
Dr. Behere, Dentist
Category: Dental
Satisfied Customers: 2775
Experience:  Masters degree, years of experience with all kinds of dental problems.
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I have developed rough patches on my gums behind the teeth

Customer Question

I have developed rough white patches on my gums behind the teeth in the middle, over the last two days. It started out as a smooth red bump while eating, and has now turned into a rough white patch.
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Behere replied 1 year ago.

Hello,

To help me make a better diagnosis, can you upload a photo of that area here?

You can refer to these step-by-step instructions to upload your photo: http://ww2.justanswer.com/how-do-i-send-photo-or-file-expert

Alternatively, you can just use an external photo sharing site like www.imgur.com and copy-paste the URL of the image here.

Regards,
Dr. Behere

Customer: replied 1 year ago.
Here is the best I can get. Hard to get a good pic.It is a white patch that runs straight back from the teeth, feels rough to my tongue. As I said, it started out as a smooth-feeling bump while eating moderately spicy food 2 days ago, and changed to a flat rough patch the next day, perhaps a bit bigger than the bump.By way of background, I have never smmoked, have about 2 drinks a week. I was exposed to high risk HPV orallyu aboout 9 years ago, and have a historyu of 3 non-melanoma skin cancers.
Customer: replied 1 year ago.
also this pic
Customer: replied 1 year ago.
should also add that it has been mostly asymptomatic, but was mildly aching for a while yesterday.
Expert:  Dr. Behere replied 1 year ago.
Hello,
I've seen both your photos, I wish they were better focused though :-(
From what I can see, the white patches are quite harmless. At best they are simply excess keratin deposits. This occurs at places where the mucosa is tightly attached to the underlying bone, that is the gums and the palate.
It needs no intervention.
At best, this is a candidial infection. I suggest you start swishing with a mouthwash like Listerine. That should have an effect is reducing the white patches within a weeks time.
If they are painting, get a local anesthetic gel from the pharmacy and apply it to the sore areas.
This is nothing dangerous and does not need a biopsy.
Hope this answers your question. Feel free to contact me again for more information.
Please leave a positive rating if my answer has helped you. I do not get credit for it otherwise!
Regards, *****
Customer: replied 1 year ago.
what makes you say that it is one of these things, rather than leukoplakia? Aren't keratin deposits like tough plaque? - it is nothing like that, not hard at all.How does your diagnosis relate to the flat, rough white patch starting out as a smooth bump?
Customer: replied 1 year ago.
tooth plaque, I mean.
Customer: replied 1 year ago.
BTW, it does not wipe away, as oral thrush is supposed to.
Expert:  Dr. Behere replied 1 year ago.
Hello,
Since you do not chew smokeless tobacco, leukoplakia is ruled out.
No, keratin deposits are not like tooth plaque.
The smooth bump was more a change in texture that you felt with your tongue.
Not oral thrush gets wiped away. A variety called as Chronic Hyperplastic Candidiasis does not get wiped away.
Hope this answers your question. Feel free to contact me again for more information.
Please leave a positive rating if my answer has helped you. I do not get credit for it otherwise!
Regards, *****
Customer: replied 1 year ago.
I'm unable to find anything online indicating that a rough white patch on the gums can be caused by keratin deposits. Can you point me to something? All the articles seem to say leukoplakia. Tobacco is said to be a major risk factor, but cause is unkown. Can you point me to anything saying all cases result from tobacco?Chronic Hyperplastic Candidiasis is said to be primarily on the tongue, also associated with smoking, and pre-cancerous.
Customer: replied 1 year ago.
This says that keratin deposits and leukoplakia (which is possibly pre-cancerous) are the same thing:Excessive keratin deposition in mouth epithelium often appears as white plaque, a characteristic feature of typical oral leukoplakia patch which is markedly different from the surrounding red oral mucosa.
Expert:  Dr. Behere replied 1 year ago.
Hello,
Please dont take this personally, but I feel we aren't on the same page. This seems to be developing into a debate between my knowledge and experience, versus information you are finding on the net.
No matter what someone tells you, you can always find the complete opposite information on the Internet.
While I like your attitude of backing everything up with evidence, I feel it is in both our best interests if I do not work on this question any more.
Therefore, I will opt out and open this question to the other dental experts on this site.
I wish you well!
Regards, *****
Customer: replied 1 year ago.
Thank you.
Customer: replied 1 year ago.
Don't bother. I went to see my dentist. She said the white patch is healing from an abrasian, aggravated by spicy food.
Customer: replied 1 year ago.
that is leukoplakia, which means any oral white patch that doesn't have another diagnosis.