Mouth Diseases & Conditions

Mouth diseases are much more common than most people think they are and sometimes a person doesn't even realize what they have is a mouth disease. For example, any tooth problem is considered a mouth disease.

I have personally suffered with the same mouth disease more than one time in my life. It is the most common type of mouth disease, which is:

1. Gum Disease.

What is gum disease?

Gum disease is also known as periodontal (around the tooth) disease, which includes gingivitis and periodontitis. It is a chronic bacterial infection that affects the gums and bone supporting the teeth.

Did you know that gingivitis and periodontitus are serious infections, that if left untreated can lead to tooth loss? They certainly can. Both can affect one tooth, or many teeth.

What causes gum disease?

The main cause of gum disease is plaque, but other factors affect the health of gums.

What is plaque?

Plaque is a bacterial, sticky colorless film that constantly forms on teeth. It is hard for me to believe it starts off sticky and colorless, when I see it on my teeth as hard - impossible to remove myself, and white. After plaque forms on the teeth it causes the gums to become inflamed.

What is the difference between gingivitis and periodontitus?

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, tender, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. It is reversible with professional treatment and good oral care at home.

Untreated gingivitis can lead to periodontitis. Over time the plaque that forms on the teeth can spread and grow below the gum line. The bacteria in the plaque then irritates the gums. Too much plaque below the gum line can cause the tissues and bone that support the teeth to break down and become destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Although the symptoms may appear to be mild, eventually, teeth can become loose and may have to be removed.

The most common forms of periodontitis are:

A). Aggressive Periodontitis which occurs in patients who are otherwise healthy. The collection of plaque, tooth loss and bone destruction happens at a rapid pace.

B). Chronic Periodontitis causes the supporting tissues of the teeth to become inflamed and then bone and tooth loss occurs. This is the most common form of periodontitis and is prevalent in adults, but can occur at any age. Its progression can range from slow to rapid.

C). Periodontitis as a Manifestation of Systemic Diseases often begins at a young age. Heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.

D). Necrotizing Periodontal Disease is an advance stage of periodontal disease which appears as lesions in the mouth. These lesions are most common in people with HIV infection, malnutrition and immunity suppressed conditions.

What are the symptoms of gum disease?

The symptoms of gum disease are: persistent swollen, tender, red gums; bleeding gums while flossing, brushing, or eating hard food; tooth sensitivity; pain in the mouth; receding gums; loose or separating teeth; pus between the gums and teeth; bad breath; mouth sores; a change in your bite; a change in the way dentures fit in the mouth.

Of course a person can just have one, or two of these symptoms and still have mouth disease. The more symptoms, the more advanced the stage of mouth disease is.

By the time one or more of these symptoms appear, it's time to get the gum disease treated, to prevent tooth loss.

Who treats gum disease?

Gum disease is treated by a dentist or a periodontist.

As I said before, I have suffered with gum disease and when my gums look puffy and bleed a lot, I know it's time to go to the dentist.

Gum disease can be considered to be hereditary.

Mouth disease can also lead to other health problems such as heart problems. Since I am a heart patient, I have been told that mouth disease can cause heart disease. Supposedly the bacteria which is in the mouth is harmful to a person's heart, especially for people who are prone to heart problems.

2. Taste Changes are not uncommon and can have a large number and variety of causes, such as gum disease, vitamin deficiencies, a medication side-effect, or even from burning tongue syndrome.

Does taste changes need to be treated?

It is wise to first have a dentist or a dental specialist look in the mouth for any signs of gum disease or oral infection that might be causing this problem. Many patients inform their physicians of taste changes also.

3. Mucocele is a condition that damages one of the salivary glands which leads to the formation of a soft bump or a blister-like lesion in the mouth. This can occur on the lips, under the tongue, or less commonly on the roof of the mouth. It is common and harmless, but can be very annoying for the patient.

What causes Mucocele?

Mucocele is probably caused by minor injury to the little tube (duct) that carries saliva from the salivary gland to the surface of the mouth. The injury can be caused from biting. Instead of the saliva going back into the mouth it forms a clear or bluish bubble or blister. If the blister is poked at or injured more, bleeding can occur and then make it look red or purple. These lesions can be persistent and if left untreated, they will often swell, break (like a water balloon), and heal over, only to swell again and repeat all over again. This condition seldom goes away on its own.

Who treats Mucocele?

An oral surgeon usually has to remove the leaked saliva and affected gland in order to completely stop the process. This is a minor procedure. Most likely the tissue will be examined under a microscope to check for some form of growth or tumor.

4. Hairy-Coated Tongue is when keratin (the product on top of the tongue) accumulates too much. This condition is harmless but can be very annoying. Hair-like projections are formed on top of the tongue.

I had this condition once and it was very annoying. I kept brushing my tongue under my top teeth to ease the discomfort.

Black hairy tongue is a formation of too much bacteria which gives the tongue a dark color. Black tongue can be caused by smoking, poor oral hygiene, use of certain antibiotics, or the chronic use of antacids and some types of mouthwash. Most of these causes can directly change the bacteria that is normally in the mouth.

What is the treatment for Hairy-Coated Tongue?

The discoloration can be removed by: using a tongue scraper; brushing the tongue with a toothbrush twice a day; rinsing the mouth with diluted hydrogen peroxide - one part peroxide and five parts water and thoroughly rinsing with plain water afterwards; and brushing the tongue with diluted hydrogen peroxide - one part peroxide and five parts water and thoroughly rinsing with plain water afterwards.

5. Fissured or Plicated Tongue is the presence of cracks, clefts, or fissures on the top of the tongue. This is a very common mouth problem and is known to be hereditary. It becomes more noticeable with age and it affects males more often than females. Fissured or Plicated Tongue rarely causes any problems.

6. Geographic Tongue is often seen together with fissured tongue. It is a benign (not serious) condition that usually involves the top and sides of the tongue, although it can occur in other areas of the mouth also. It usually affects middle-aged and older adults.

What are the symptoms of Geographic Tongue?

Soreness or mild pain may occur when the person eats acidic or spicy foods. Sometimes folds or ridges and red spots appear on the top of the tongue and the red spots may move around. The red spots which feel slightly raised and tender usually appear white or yellow-white with raised line around their edges.

Symptoms are mild, they are not an infection and can't be transmitted from one person to another.

What is the treatment for Geographic Tongue?

Using a topical corticosteroid rinse 2-3 times a day often eases the soreness and mild pain.

7. Burning Mouth Syndrome (BMS) is a common and harmless problem that affects peri- and post-menopausal women primarily and very little men. It is an annoying condition that affects the sensory nerves in the mouth. It is not progressive and can't be transmitted to anyone else.

What are the symptoms of Burning Mouth Syndrome?

The symptoms are: pain such as a burning or scalding feeling which are more noticeable as the day goes on; loss of taste or strange tastes such as tasting salt, bitter, sweet or sour even when nothing is in the mouth; and a sensation of swelling, sliminess, dryness or roughness in the texture of the mouth.

A person can have one, or more than one of these symptoms and the duration of the syndrome varies from person to another. The discomfort does go away by itself.

What is the treatment for Burning Mouth Syndrome?

If the pain is unbearable a person can see their physician for a prescription.

Some people dilute Tabasco sauce, hot sauce, or hot pepper sauce and swish it in their mouth to relieve the discomfort. It is best to do this after meals and right before going to bed. Usually the painful sensations lessen in about 2 weeks.

There is no cure for the syndrome and it will disappear after a period of time, which varies from person to person.

8. Hand, Foot and Mouth Disease (HFMD) is a common viral illness of infants and children under 10 years of age, but can also occur in adults.

Please note this is NOT foot-and-mouth (also called hoof-and-mouth) disease, a disease of cattle, sheep, and swine. The two diseases are not related and are caused by different viruses. Humans don't get the animal disease, and animals don't get the human disease.

What are the symptoms of Hand, Foot and Mouth Disease (HFMD)?

The disease usually begins with a fever, poor appetite, a sick feeling, and often with a sore throat. One or 2 days after the fever starts, painful sores usually develop in the mouth on the tongue, gums and inside of the cheeks. They begin as small red spots that blister and then often become ulcers. A non-itchy skin rash develops over 1-2 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually located on the palms of the hands and soles of the feet and may also appear on the rear end and/or genitalia area.

A person who has HFMD may just have the rash, or the mouth sores, or may not have any symptoms.

This disease CAN spread from one person to another by direct contact with the nose and throat secretions, saliva, blister fluid, and stool of the infected person. The virus is most often spread by people with unwashed, virus-contaminated hands and by contact with virus-contaminated surfaces. The infected person is most contagious during the first week of the illness.

The viruses that cause HFMD can remain in the body for weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though he or she appears well.

A person can get HFMD more than once in their lifetime.

How is HFMD diagnosed?

Usually a physician knows the difference between HFMD mouth sores and other mouth sores. A physician will also take a throat or stool sample for laboratory testing to see if the specific virus is present.

What is the treatment for HFMD?

There is no specific treatment for HFMD.

Symptoms can be relieved by using over-the-counter medications for the fever and pain and by using mouthwashes or sprays that numb pain to lessen the mouth pain.

It's important to drink a lot of fluids to prevent dehydration.

HFMD can be prevented by having good hygiene habits, such as washing hands frequently, cleaning dirty areas thoroughly and avoiding close contact with others who have HFMD.

Can HFMD lead to other illnesses?

Yes, such as viral or aseptic Meningitis, Encephalitis (swelling of the brain) which can be fatal, or a polio-like paralysis.

There have been unsubstantiated reports of fingernail and toenail loss in mostly children within 4 weeks of their having hand, foot, and mouth disease (HFMD). The nails did grow back though.

9. Oral Cancer can form in any part of the mouth or throat. Most oral cancers begin in the tongue and in the bottom of the mouth. Anyone can get oral cancer, but the risk is higher if you are male, over age 40, use tobacco or alcohol or have a history of head or neck cancer. Frequent sun exposure is also a risk for lip cancer.

What are the symptoms of Oral Cancer?

Symptoms of oral cancer include: white, red or speckled patches in the mouth; a mouth sore that won't heal; swellings/thickenings, lumps, bumps, rough spots, crusts or eroded areas on the lips, gums or inside the mouth; bleeding in the mouth; loose teeth; problems or pain with swallowing; unexplained numbness, loss of feeling, or pain and tenderness in any area of the face, mouth, or neck; persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks; a lump in the neck; a soreness or feeling that something is caught in the back of the throat; difficulty chewing or swallowing, speaking, or moving the jaw or tongue; an earache; hoarseness, chronic sore throat, or change in voice; a change in the way the teeth or dentures fit together; and/or dramatic weight loss.

Who Gets Oral Cancer?

According to the American Cancer Society, men face twice the risk of developing oral cancer as women, and men who are over age 50 face the greatest risk. It's estimated that over 35,000 people in the U.S. received a diagnosis of oral cancer in 2008.

Risk factors are: smoking cigarettes, cigars, or pipes; smokeless tobacco users; excessive alcohol consumption; family history of cancer; and excessive sun exposure especially at a young age.

Although, over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.

Who diagnoses Oral Cancer?

As part of a routine dental exam, a dentist will do an oral cancer screening exam. My dentist has me stick out my tongue and he holds it with a gauze pad as he looks for any obvious signs of oral cancer. A dentist will perform a biopsy if needed. These tests are necessary to detect oral cancer early, before it has had a chance to progress and spread.

What is the treatment for Oral Cancer?

Oral cancer treatments may include surgery to remove the cancerous growth followed by radiation therapy or chemotherapy to destroy any remaining cancer cells. Some patients have a combination of treatments.

Can Oral Cancer be prevented?

Yes. Don't smoke, or use tobacco products and drink alcohol in moderation, if at all. Eat a well balanced diet and limit sun exposure.

A person can do a self-exam once a month by examining the entire inside of the mouth thoroughly and feel for lumps on both sides of the neck and under the jaw. If you notice any changes or signs on your own, contact your dentist or health care professional immediately.

Also, see a dentist regularly.

The only way to be sure if any of the symptoms above are any of the diseases or conditions I described is to be evaluated by a dentist or oral specialist, such as an oral pathologist. They can give a definite diagnosis.

Resources:

1. Perio.org (2010, May) http://www.perio.org/consumer/gum-disease.htm
2,4,5,6. Net Wellness (2010, May) http://www.netwellness.org/healthtopics/mouthdiseases/mouthconditions.cfm
3. Net Wellness (2010, May) http://www.netwellness.org/healthtopics/mouthdiseases/mucocele.cfm
7. Net Wellness (2010, May)
http://www.netwellness.org/healthtopics/mouthdiseases/burningmouth.cfm
8. CDC.gov (2010, February) http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm
9. WebMD (2010, May) http://www.webmd.com/oral-health/guide/oral-cancer
Medline Plus (2010, May) http://www.nlm.nih.gov/medlineplus/oralcancer.html