Leukoplakia of the oral mucosa - diagnosis and treatment of the disease

Dry mouth ( xerostomia ) is a subjectively felt dryness of the oral mucosa. The formal cause of dry mouth is decreased saliva production, less than 0.1 ml per minute.

Saliva is secreted by special salivary glands, primarily the glands of the lower jaw (Glandula submandibularis). Saliva, or rather its components, performs important functions in the body, the main of which is protecting and cleansing the oral cavity. For example, it contains enzymes that suppress the proliferation of pathogenic bacteria, are involved in the primary digestion of food, contains inorganic components that provide remineralization of tooth enamel and protection against caries, etc. An important function of saliva is participation, through intermediary components, in the formation of the correct taste sensations.

Persistent dry mouth is not an entirely uncommon occurrence. The older a person is, the more often symptoms of xerostomia appear. According to statistics, 40% of people over 60 years old experience this symptom.

Mild but persistent or severe dry mouth can have unpleasant consequences. For example, with reduced saliva production (about 1.5 liters per day is produced in a healthy person), the enzymatic protection of the oral cavity is significantly reduced and inflammation of the mucous membrane is possible. Bad breath and dental caries may appear.

In most cases, dry mouth is a temporary and short-term phenomenon, and temporary xerostomia is eliminated by correcting the drinking regime. But if this does not help, or if additional symptoms appear (pain when chewing, swallowing, speaking), then to treat xerostomia you need to consult a specialist, since this symptom may have deep and specific causes.

Causes

There are many different reasons that can lead to the mucous membrane in the mouth beginning to peel off. Although most are considered harmless, the discomfort and pain caused as a result of this condition can be unbearable. Most often, the lining of the mouth will heal on its own, but if it doesn't, you'll need to see a dentist for effective treatment.

Reaction to toothpaste

Hypersensitivity reactions are abnormal reactions of the immune system that occur in response to exposure to harmless substances.
For example, components in toothpaste. Sometimes the mucous membrane begins to peel off after brushing your teeth. One reason for this is a mild allergic or irritant reaction to toothpaste. Most mouth rinses contain a small percentage of alcohol. It has been found that continuous use of such rinses can lead to infections such as ulcers and even oral cancer.

Listerine is the most popular alcohol mouthwash. Therefore, it should be used only as prescribed by a doctor, as it can improve gingivitis and even help heal gum disease. You must understand that this rinse is very strong and should not be used too often. Otherwise, the alcohol in it can cause a burn to the oral mucosa and lead to its detachment. To avoid this, you can dilute Listerine with water before use. The alcohol in Listerine has been found to have the following effects:

• dries out mouth and lips
• influences test results
• leads to tissue separation in the mouth

First of all, you should change the toothpaste that presumably causes your allergy. Try another one and notice if there is improvement or if the peeling persists.

If after a week the mucous membrane continues to peel even after changing toothpaste, you need to visit the dentist as soon as possible. Or you can use fluoride toothpaste to help strengthen your mouth.

Autoimmune disorder

Such serious diseases are most often accompanied by other symptoms on the skin of the body.
It often happens that detachment of the mucous membrane in the mouth occurs as a result of an autoimmune disorder. As a result of the body attacking healthy cells, ulcers form on the mucous membrane in the mouth. Examples of such autoimmune disorders are:

• Pemphigus is an unusual, sometimes fatal disease that causes blisters in the mouth.
• Bullous pemphigoid is a less dangerous disease in which the blisters are itchy, hard and dense. The skin between the blisters is red and possibly swollen.
• Dermatitis herpetiformis is a chronic inflammatory disease caused by sensitivity or allergy to gluten.

According to the American Autoimmune Disease Association, such disorders affect up to 15% of millions of people. These are chronic conditions for which there is no cure yet. However, therapy involves attempting to control and reduce severe symptoms. The following measures will help alleviate the disease:

• Balanced diet
• Regular exercise
• Enough time to rest
• Moderate amounts of vitamin supplements
• Reducing excessive sun exposure
• Drug therapy (often hormonal)

Stevens-Johnson syndrome

With Stevens-Johnson syndrome, the skin on the body also suffers greatly.
Stevens-Johnson syndrome is a rare but serious disease that affects the skin and mucous membranes. It is usually caused by an adverse reaction to certain medications. It is also possible that the syndrome is caused by an infection.

The disease begins with flu-like symptoms, accompanied by a red rash that spreads throughout the body and forms blisters. The damaged parts will eventually die and begin to peel off. You should consult a doctor as soon as possible, as this disease requires serious treatment. Therapy is mainly aimed at identifying the underlying cause, controlling symptoms and preventing future complications.

People with Stevens-Johnson syndrome often experience symptoms such as:

• General malaise
• Severe headaches
• Joint pain
• Fever
• Cough

Some time after the first symptoms appear, a rash may appear inside the mouth, which can lead to the death of tissue in the mucous membrane and cause it to peel off. The rash usually looks like a target - darker in the center and lighter on the outside. If you brush your teeth at this stage of the disease, it can cause blisters and ulcers to develop, which, when ruptured, leave painful sores. The lining of your mouth may blister, making it painful to swallow, or you may develop a more serious problem such as dehydration.

Early treatment of this condition is recommended. Otherwise, symptoms may worsen and lead to a life-threatening infection. Your doctor will refer you to the intensive care unit or burn unit for close monitoring and treatment.

Treatment will include:

• Strong analgesics to relieve pain in moist areas of the skin and mucous membranes.
• Skin moisturizing. This can be an air filter or using a liquid.
• Replacement of fluid loss. These are liquid and tablet preparations containing nutrients that help repair damaged mucous membranes in the mouth.
• A general antibiotic if an infection is detected during a blood test.
• Mouth rinses containing an anesthetic may be prescribed to numb the mouth and make swallowing easier.

Overzealous or careless brushing of teeth

If you apply a lot of force while brushing your teeth, there is a possibility that the bristles of the toothpaste will damage the mucous membrane of the mouth and lead to its peeling.

If you stop brushing for a while or are as careful as possible, the flaking may stop, but if it doesn't, you need to see your dentist as soon as possible. You should also avoid eating acidic foods as they can aggravate the situation.

Stomatitis

Herpetic stomatitis (left) and allergic contact stomatitis, which occurs as a reaction to some substance (in this case acrylic)
Stomatitis is an inflammation of the oral mucosa. This is a painful condition that is accompanied by redness, swelling and sometimes bleeding. When swelling occurs, the expansion and contraction of the mucosa causes it to peel off. Typically inflammation is the result of:

• Poor oral hygiene
• Burns from hot foods and drinks
• A medical condition that affects the entire body.
• Allergic reaction

Most often, stomatitis occurs in children. If you notice that your child has inflammation in the mouth, you need to visit a pediatrician who will examine him, determine the real cause of the inflammation and prescribe treatment in a timely manner, which will help avoid the spread of the inflammatory process to other parts of the body.

Depending on what causes canker sores, it may or may not be contagious. Herpetic stomatitis in children is considered contagious. Infection can occur through kissing or playing in close contact with each other.

Treatment of stomatitis is based on treating the underlying cause of the infection. The fundamental factor in the treatment of stomatitis is avoidance of the causative factor. You also need to do the following:

• Maintain good oral hygiene by brushing your teeth regularly
• Avoid spicy foods (especially for children)
• You should choose your toothpaste carefully to avoid an allergic reaction.

Psoriasis on the oral mucosa

Geographical language.
Its exact cause is not known, but some studies have linked it to psoriasis. Psoriasis mainly affects the trunk and limbs, but can also develop on the lining of the mouth, including the tongue, lips, and cause peeling. The Journal of Dermatological Case Reports reports that the condition most often appears as red patches and peeling on the lips and then spreads to other areas of the body.

If you find that the mucous membrane in your mouth is peeling, contact your dentist, who will conduct a qualified diagnosis and determine the actual cause of the damage. It must be determined that the lesions are due to psoriasis and not other health problems for treatment to be effective.

According to the European Journal of General Dentistry, oral psoriasis can appear as widespread lesions on the tongue, yellow or red spots, a whitish area or translucent plaques. With this form of psoriasis, sores may appear on the roof of the mouth (the top of the mouth), the inside of the cheek, or the lips. Often the disease affects the gums. Visit your dentist to avoid spreading the infection to other parts of the body.

If you notice the following symptoms, psoriasis is most likely the cause of the flaking of the mucous membrane in your mouth:

• Red spots with white borders
• Redness of the mucous membrane in the mouth
• Detachment of mucous membrane on the gums
• Mouth ulcers

Once your doctor performs a biopsy to make a definitive diagnosis, he or she will be able to prescribe treatment, which may include topical corticosteroids or oral medications to control your body's autoimmune response.

Oral cancer

Oral cancer
Oral cancer occurs when a tumor develops in the lining of your mouth, which is the tissue that covers your mouth and digestive organs. The disease can also appear on the surface of the tongue, inside the cheeks and palate, down to the throat, gums and lips.

Oral cancer occurs when cells in the lips or mouth undergo changes in their DNA. It is this mutation that allows cancer cells to grow and divide, causing healthy cells to die, which usually causes the lining in the mouth to die and begin to peel off. It mainly starts in the flat, thin cells that line the lips and the inside of the mouth.

The cause of the mutation is unknown, but doctors cite factors that may increase the risk of developing oral cancer. These include:

• Regular use of tobacco products
• Consumption of strong alcohol
• Prolonged sun exposure
• Weakened immune system
• Sexually transmitted virus - human papillomavirus (HPV)

Visit your doctor as soon as possible to determine the best treatment options. Symptoms to watch out for:

• Mouth ulcers that do not heal within a week
• Numbness and loss of taste
• White spots on the oral mucosa
• Unexplained lumps in the mouth
• Lumps on the neck

Oral leukoplakia

Leukoplakia
Leukoplakia is a condition in which areas of keratosis (induration, keratinization) appear as firmly attached white spots on the mucous membranes of the oral cavity. Oral leukoplakia is defined as "a predominantly white, persistent lesion of the oral mucosa that cannot be characterized like any other identifiable lesion"

Oral leukoplakia is usually not dangerous, but sometimes it can be a precancerous condition. If you begin to experience severe itching, you should see a doctor as soon as possible. Although most of the growths are not cancerous, some may show early signs of cancer. The cause of this type of condition is unknown, so it is advisable to visit your dentist if you experience unusual, persistent changes in your mouth.

Oral leukoplakia varies in appearance, with changes occurring mainly on the gums, the inside of the cheeks and sometimes on the tongue. Manifestations of leukoplakia generally look like this:

• White or gray spots
• Uneven, flat texture
• Some area of ​​the mouth may be hard
• Your mouth may develop red lesions that may show precancerous changes

People with a weak immune system (due to medications and diseases, mainly HIV/AIDS) may experience another type of this condition called hairy leukoplakia. This condition causes fuzzy white patches that resemble ridges on the tongue, which can easily be mistaken for an oral rash. This may cause the mucous membrane in the mouth to peel off.

Diseases of the oral mucosa

October 5, 2011 - Wednesday

For many years, the Sverdlovsk Regional Dental Clinic has been providing consultation and treatment for diseases of the oral mucosa. This type of service is provided with the aim of early detection and timely prevention of such a terrible disease as cancer of the oral mucosa and red border of the lips.

In recent years, the following diseases have been most common:

Traumatic lesions of the oral mucosa

Trauma is distinguished: mechanical; physical; chemical; acute and chronic. In chronic trauma, timely identification of these factors is extremely important to reduce the risk of malignancy.

Leukoplakia is a keratinization of the mucous membranes or the red border of the lips, which usually occurs in response to chronic external (sharp edges of teeth, failed dentures, damaged tooth crowns, bad habits (biting cheeks, lips), passion for spices, alcohol, smoking, hot food, hot air) or internal factors (diseases of the gastrointestinal tract, such as chronic gastritis, colitis, enteritis).

Typical complaints are:

• roughness of individual areas of the oral mucosa
• burning sensation, rawness
• sometimes pain when eating, talking

Candidiasis is a disease caused by yeast-like fungi, which, when the immune system is weakened, can turn into pathogenic microorganisms. Predisposing factors are: long courses of antibiotic therapy, tartar, chemical burns, metabolic disorders, endocrine diseases, hypovitaminosis, diseases of the female genital organs, acute and chronic infectious and non-infectious diseases, pregnancy, old age and childhood. Typical complaints are:

• dry mouth
• pain when eating and talking
• burning
• perversion of taste

Herpetic lesions of the oral mucosa

In acute herpetic stomatitis, the picture of the disease is as follows:

• heat
• general condition disorder
• burning sensation, tingling, itching, numbness in areas where the rash appears on the skin and mucous membrane
• the formation of blisters that later merge into painful erosions.

In chronic herpetic stomatitis, characteristic symptoms are:

• complaints of pain in the mouth, burning when eating, talking
• single rashes of blisters on the red border and skin of the lips, on the wings of the nose, and on the hard palate

Lichen planus (LP) is a nodular chronic disease that occurs on the skin and visible areas of the mucous membranes. Several mechanisms for the occurrence of LP are suggested, such as: 1) neurogenic, 2) toxic-allergic, 3) viral. Complaints for CLP are:

• sensitivity to spicy foods and spices, itching
• the appearance of white stripes on the mucous membrane
• dryness, roughness in the mouth
• pain when eating

If the clinical picture and complaints are not in doubt, then after the initial examination the doctor makes a diagnosis and draws up a treatment plan. In cases where the final diagnosis requires additional examination, the patient is referred to auxiliary medical institutions to clarify the diagnosis.

We remind you that only a doctor can make an accurate diagnosis during a personal examination!

Make an appointment

The mucous membrane in the mouth peels and hurts

Sometimes the ulcers can be very painful. This is in addition to the fact that the mucous membrane begins to peel off because of them. If you experience severe pain and the detachment does not go away after a week or so, you need to see a dentist for diagnosis and prompt treatment.

Psoriasis in the mouth can have similar symptoms, which is also believed to cause a condition called geographic tongue. Psoriasis often affects the trunk and extremities, and most likely causes lesions on the mucous membranes, including the tongue, lips, and inside the mouth. According to the Journal of Dermatological Case Reports, in rare cases, the lesions may appear as red spots and areas of peeling mucous on the lips before spreading to other places on the body.

Although psoriasis in the mouth is quite rare. If you have it and are experiencing injuries in your mouth, you need to talk to your dentist to make sure your symptoms are due to psoriasis and not some other infection. A more serious cause of mucosal detachment and pain in the mouth is Stevens-Johnson syndrome, but it is usually accompanied by a number of more serious symptoms, including damage to the skin, eyes, all mucous membranes, fever, etc.

Additional symptoms to watch for before you visit your doctor include the following:

• White sores inside the mouth that won't go away
• Bumps or small pimples in the mouth
• Dryness and cracking of lips
• The mucous membrane on the gums peels off
• Ulcers

Treatment

There is no perfect medicine for treating oral mucosal sloughs. It is important to treat the underlying cause as soon as you are diagnosed. The dentist will analyze the symptoms and compare them with one of the reasons mentioned above. He will then be able to prescribe medication to treat the detachment of the mucous membrane in your mouth.

The dentist may prescribe a local anesthetic or tablets to help relieve the pain. These medications include aspirin, acetaminophen, and ibuprofen.

Usually, mucosal detachment goes away within a few days, but if it lasts longer for you, then you need to see a dentist as soon as possible. Treating the underlying cause is the key to solving the problem.

Prevention of xerostomia

In the absence of common diseases, prevention comes down to removing the causes of severe dry mouth. Preventive measures include: maintaining the correct water balance in the body, oral hygiene, stopping smoking and frequent consumption of strong alcoholic beverages, using special rinses (containing ingredients such as lactoferrin, which increase moisture in the oral cavity) and preparations that imitate the natural component composition of saliva (for example , based on carboxymethylcellulose or hydroxyethylcellulose).

Request a consultation

Folk remedies

Apart from hospital treatment, there are a few simple home remedies that can help you stop the mucous membrane from peeling off and reduce pain at home. You should note that these remedies are not a full-fledged treatment, but will temporarily soothe the pain before you finally see a dentist.

Also, some foods can irritate blisters and sores caused by detachment of mucous membranes in the mouth, tongue and throat. The following remedies will help relieve pain and irritation. You can try one of them or combine several products.

Coconut oil

Coconut oil has strong anti-inflammatory and antimicrobial properties, and, in general, improves the health of the body. This is the best remedy to get rid of peptic ulcers that cause white bumps on the tongue. All you need to prepare this remedy is fresh coconut. It’s easy to find instructions on the Internet on what to do with it to obtain oil. Or you can buy edible coke oil, although this will cost more.

To apply the tool, do the following:

• Apply a small amount of coconut oil using a swab to the sores.
• Alternatively, you can put a small amount of coconut oil in your mouth and leave it for 10 minutes before spitting it out.
• Repeat this twice a day until the peeling and white bumps on the tongue disappear.

Aloe rinses

Aloe vera is considered one of the best, if not the best, calming plant of all. The gel has many anti-inflammatory, antibacterial properties, which are very important in the healing process of white bumps on the tongue and exfoliation of the mucous membrane in the mouth.

Take the gel-like aloe pulp, half a cup of water and mix gently. Apply this mixture to wounds three times a day to relieve pain and speed up the healing of ulcers.

Wax tray

For wounds that rub against teeth or are irritated by dentures, applying a small “cap” will help. This can really reduce annoying friction significantly. You must make the mouth guard as thick as possible so that it fits around the teeth and locks into place.

Do it like this;

1. Melt beeswax and coconut oil and stir
2. Let the mixture cool
3. Gently press the piece onto the edge of your teeth to prevent friction from causing wounds.

Rubbing with honey

Honey has antibacterial and potential anti-inflammatory properties. Raw organic honey thus forms an excellent soothing layer for mouth sores and ulcers. Placing honey on the white bumps on the tongue can help relieve pain and speed up the healing process.

All you need to do is rinse your mouth with warm water and then apply a thick layer of fresh natural honey. You can do this with your fingers or a spoon. Leave the mask/compress on for about 10 minutes before rinsing off. For optimal results, do this twice daily.