Other common mouth conditions

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Luke manages all types of common and not so common oral conditions.

The many functions the mouth performs make it a vital part of the body. Any problem that impacts on your oral health is likely to have a big effect on your lifestyle and general wellbeing. Most mouth disorders are relatively benign, and treatment will vary according to the condition, but good oral hygiene and a good general level of health can go a long way to preventing many of these diseases.

Here are four of the most common mouth conditions:

Fibro-epithelial polyps (FEP)

Fibro- epithelial polyps or FEPs are small, firm, pink or red knob-like swellings that can occur anywhere in the mouth, but normally appear on the lips, cheeks or tongue. Generally painless, they can affect people of all ages and are caused by the irritation or minor trauma, commonly as a result of an accidental bite. Once established, they do not usually continue to grow. The norm is for the them to occur singly, but occasionally multiple FEPs can appear. FEPs only need removing if they are irritated by biting or for cosmetic reasons, should they become visible. Removal is performed using local anaesthetic to numb the area before cutting out the FEP.

Mucoceles

Mucoceles, or mucous cysts, are clear or bluish soft dome-shaped swellings found on the lips, within the oral cavity or tongue. Those found on the floor of the mouth, under the tongue, are larger and are called ranulas. Although harmless, mucoceles and especially ranulas, can impede swallowing, chewing, speaking and occasionally, breathing. Typically, these cysts are not painful, and they normally measure no more than a centimetre in diameter.

Mucoceles occur when one of the tiny tubes that deliver saliva from the salivary gland to the mouth becomes damaged or blocked, most commonly through repeated biting or sucking on the cheek or lower lip; a harsh impact to the face is another cause. Mucus escapes from the damaged tube and becomes sealed off, which creates the mucocele. A similar swelling arises from a blocked tube.

Frequently mucoceles will disappear by themselves and will not require treatment, however they can also enlarge. If they do not resolve by themselves, they can be effectively treated by the fluid being released either naturally or by a medical procedure, such as endoscopic drainage, to drain the fluid.

If this proves ineffective, the salivary gland may be removed under local anaesthetic or a procedure called marsupialization may be performed to create a new tube to help saliva leave the salivary gland. Other treatments that may reduce swelling or be used instead of surgery are steroid injections or the application of medication to the mucocele’s surface.

Follow-up appointments will be required to check that mucoceles do not reappear, and once the mucocele has been removed, it is essential to maintain good mouth hygiene with an antibacterial mouth rinse.

Thrush

For adults, thrush in the mouth is normally a harmless, non-contagious condition, which is often found in older people using dentures. It manifests itself by a reddening of the inside of the mouth, accompanied by white patches. If the white patches are wiped off, the red spots exposed may bleed.

Other symptoms include being unable to taste or eat and drink normally; cracks at the edge of the mouth; and an unpleasant taste and pain, such as sore gums or tongue.

Oral thrush can be effectively treated by applying a mouth gel available from chemists over a minimum of a week. However, if untreated, the infection can spread around the body, and you should consult a medical professional if the condition does not improve.

Frictional keratosis

Oral frictional hyperkeratosis is a benign abnormality of mucous membrane lining the inside of the mouth, which generally occurs in adults. Typical symptoms are a white patch in the mouth, normally in the gums or cheeks, often accompanied by a thickening of the skin in the affected area. This white patch can also take the form of a horizontal white line.

This white discoloration indicates an overproduction of the fibrous protein, keratin. This is caused by friction as two surfaces in the mouth rub against each other. The symptoms arise in the same way that calluses form on the skin of hands and feet. The body reacts to the irritation by producing more cells, in this case, keratin, giving the skin a different thickness and colour.

Common causes of friction are: excessive tooth-brushing; repeated rubbing of the tongue against the teeth; constant cheek or lip biting; broken or poorly fitted dentures and substandard fillings or caps or jagged teeth.

The most effective way of treating oral frictional hyperkeratosis is to remove the cause of the friction by correcting dentures, fillings, crowns, jagged teeth and any other sources of irritation.

Geographic tongue

Geographic tongue is a common condition which can cause burning or soreness it has no propensity to cause cancer. It typically doesn’t require any medical treatment. Although geographic tongue can sometimes cause tongue discomfort, it’s otherwise a harmless condition.

To manage discomfort or sensitivity, over-the-counter pain relief, mouth washes and in some cases vitamin B supplements may help.