Common mouth lesions

YOUR DENTIST

AND YOU

Dr. Charlene Reid

At one point in your life you will have had some type of lesion in or near your mouth. There a many lesions that affect the mouth. The following are a few that are most commonly found.

Oral Candidasis

This is commonly called yeast infection, thrush or a local Bahamian term "trash." This is a fungal infection that affects the oral cavity. As many as 60 percent of healthy adults carry the species of fungus as a component of their normal oral flora. However, certain local and systemic factors may favour overgrowth. These include use of dentures, use of a steroid inhaler, dry mouth, hormonal disorders, HIV infection, certain cancers malnutrition, age, radiation therapy, use of certain antibiotics or corticosteroids.

It appears in the mouth as white patches that can be wiped off. It can also appear as red burning spots or as scaling fissures at the corners of the mouth. Oral candidiasis is common in infants, affecting one to 37 percent of newborns. Candidiasis in otherwise healthy infants manifests as a minor infection of the oral cavity

Treatment involves antifungal medication. Commonly used topical regimens include nystatin, clotrimazolend systemic fluconazole (Diflucan).

Herpes Labialis

It is a primary oral infection with the herpes simplex virus (HSV). It occurs at a young age without symptoms. A minority of persons develop a symptomatic primary infection, presenting with an acute outbreak of oral vesicles that rapidly collapse to form zones of red painful ulcerations. In all cases, the gums are involved as well as other oral sites and the skin may be affected.

After primary oral infection, HSV may persist in a latent state in the body and later reactivate as the more common herpes labialis, or "cold sores," "night fever." Common triggers for reactivation are well-known and include ultraviolet light, trauma, fatigue, stress, and menstruation. These lesions affect approximately 15 to 45 percent of the population. They classically appear as a well-localized cluster of small vesicles along the border of the lip or adjacent skin. The vesicles subsequently rupture, ulcerate, and crust within 24 to 48 hours. Spontaneous healing occurs over seven to 10 days.

Pain, swelling, and cosmetic concerns may prompt physician consultation. Orally administered antiviral agents, such as acyclovir (Zovirax) or valacyclovir (Valtrex), have a modest clinical benefit.

Hairy Tongue

Hairy tongue, also known as black tongue, is a benign condition of elongation and staining of the fingerlike projections (papillae) on the tongue surface. This condition may be caused by overgrowth of a bacteria or yeast that produces a coloured substance (pigment). Anything that reduces the flow of saliva in the mouth, such as dehydration or illness, or if the person is not eating a normal diet, can lead to the condition, which typically develops over a few weeks. Medications that commonly cause hairy tongue include antibiotics, anti-psychotics, anti-depressants, and anti-cholinergic agents. Other causes include smoking, alcohol, the use of mouthwashes, and exposure to radiation therapy.

Although often called "black" hairy tongue, the condition may cause black, brown, or yellow discolouration depending on the foods ingested, tobacco use, and the amount of coffee or tea consumed. Rarely, patients may complain of gagging or of a metallic taste. Debris between elongated papillae can result in bad breathe. Most cases improve with regular tongue brushing using a soft toothbrush or tongue scraper.

© 2009 The Freeport News