I have the EXACT same thing as you- a small but well-defined red patch on my lower front gum, under and between several teeth. My dentist just referred me to get a biopsy done on mine. It's great to hear that yours wasn't cancer! What was it, though? I would love to hear what your red patch was in case mine is the same thing.

I have moved your post to its own thread. Where you posted previously, that member has not returned after making only a couple posts. Usually that leads us to believe there was nothing seriously wrong or they would have continued to ask questions.

Do you use tobacco products of any kind? If so, stop immediately and give your mouth a chance to heal itself. Tobacco, weather its chew or cigarettes is full of known cancer causing additives. If you drink alcohol of any form, stop drinking until you find out whats wrong. Alcohol will burn sensitive mouth tissue. Believe it or not, this includes strong mouthwash like Listerine so check the label for alcohol content.

It could be any number of things besides oral cancer. I hope its nothing serious! Get a biopsy and stay busy while you wait a week for the results.

Best wishes!!!

Hi Christine, no I have never tried a cigarette in my life, and drank only socially in the past and haven't had a drop in many years. Are you sure I should stop using Listerine? My dentist has always recommended I use it, and I've used it every day for about 10 years.

The small red patch sometimes bleeds a little when pressed. There is no pus or adjacent white areas, or any other symptoms to my knowledge. I'm just worried because it hasn't started healing at all. My dentist said if it hadn't been there for over a month he would have said it was probably just trauma. He recommends I have a biopsy. I'm very nervous and have been scouring the internet for what it could be.

I am positive you should avoid Listerine! Its full of alcohol. Listerine is ok if it is the kind that doesnt contain alcohol.

Any sore which has been in your mouth for 2 weeks or longer needs to be checked by a professional. That is an ENT or oral surgeon, they are more familiar than regular dentists with oral cancer and all the other things that are irregular. If this red patch has been in your mouth for over 2 weeks find yourself an ENT who specializes in oral cancer. Not saying thats what this is! Just that you dont want to end up with an ENT who specializes in putting tubes in kids ears.

Has your dentist or dental hygienist ever done an oral cancer screening on you? Thats where they pull your tongue out while holding it with a piece of gauze and they feel your neck. Every adult should have an oral cancer screening as part of every dental exam. If its not being done, ask for one. If your dental practice doesnt do them, then you are being short changed.

Try not to over google in these situations, all kinds of horror stories will come up. Im glad you found OCF, it have factual medical info and adheres to the Health on the Net Code which ensures correct medical info is given.

Try to stay busy, and keep your mind engaged in detail oriented tasks like reading to help you to avoid worrying.

Good luck!!!

Hi Christine,

I'll avoid the alcohol Listerine on your suggestion :-)
Connie from the other thread actually got back to me, and let me know that her diagnosis was actually a symptom of localized gum disease. I feel it's very likely that mine could be too, and that makes me feel somewhat relieved. I have an appointment for a biopsy in 4 weeks regardless, unless it happens to start healing on its own before then, which would be an excellent sign. My oral surgeon is highly rated, but no I've never actually had an oral cancer screening to my knowledge. I'll mention it to my dentist or ENT. I also have what I believe is an enlarged lymph node on my cheek, and another on my arm near the elbow, but both of those have been enlarged for over a year while this red patch only appeared a month ago. I will mention them to the ENT anyway. Thanks for your help, and I'll you updated!

Try rinsing your mouth at least 4 times per day with a mixture of 16 oz warm water, 2 tsp salt and 2 tsp baking soda. The salt in there could burn a little but still rinse for at least 20 seconds. This mixture will help to neutralize the ph balance in your mouth while the rinse is good at healing mouth sores.

Im very surprised and happy that the other member got back to you! Very nice of them!

Definitely mention the enlarged lymph nodes. They could be a sign of an infection or any number of other issues. Good luck with this, please keep us posted!

Ok, I've started rinsing with the mixture you specified. The salt doesn't burn at all- is that bad? Wouldn't it burn if it was just gum disease? Do you think I should try hydrogen peroxide?

NO!!!!! That is not good to put in your mouth.

Dan,

My stage 1 cancer started as a well defined red spot on my soft palet. I would skip forward if I where you and schedule a punch biopsy ASAP with an ENT. I went the dentist - oral surgeon -ENT rout myself and just ended up where you are going anyway. If this is over two weeks old (and I think it is) I would advise you to ask the ENT for a faster visit if you can get one.

I agree with Kelly that you really need to find yourself an ENT who specializes in oral cancer and get a biopsy done. It could be any number of things but its better to be safe than sorry by waiting a month. Call tomorrow!

How can I find an ENT who specializes in cancer? I guess an ENT is different than an oral surgeon?

Hi Dan,

Check out this link http://health.usnews.com/best-hospitals/rankings/cancer. There's bound to be a Comprehensive Cancer Center near you (or within reason). They'll have an entire "Team" of oncologists looking you over. If you get a Dx, make sure you get a 2nd opinion at a CCC.

Once you find a hospital, you can check out the staff and find details on the doctor, ratings etc....

"T"

Thanks fishmanpa. I'll call tomorrow to see if the Fox Chase Cancer Center or Hospital of the University of Pennsylvania has an opening in the next week or two for a biopsy.

Kelly, is a punch biopsy the most reliable? If it's not cancer, I don't want them to have to take a huge chunk out of my gum in the front of my mouth. Is a scalpel biopsy or brush biopsy less reliable?

A biopsy is taking only a very small amount of tissue. Just avoid doing the fine needle biopsy as it may need to be redone. Talk all the options over with the doc and have them do what you are most comfortable with.

Good Luck!!!


PS....Since you must be near Philly, there is the annual Philadelphia Oral Cancer Awareness Walk on April 6th. Come on out and help support this small non profit. Last year I was their speaker and this year I know they have a great speaker. Im not that far from Philly but I cant make it as I will be the speaker for the Scottsdale AZ walk.
OCF Events

Sure, I'll have to check that out

Dan,

I think a punch biopsy is about 3/16 in. diameter. Its fairly small and should only bother you for about a day. They do not go that deep and it takes less than a minute. its not big enough for a stitch.

Correction,

I think the punch is less than 1/8 in. Di.

Biopsy punches actually come in millimeters and there are two standards sizes, 3mm and 5 mm. Taking a small core with what is essentially a round razor blade is very quick and not painful. They press the little cookie cutter circle against the tissue and it cuts down a few millimeters. They remove the punch and grab the center of the tissue plug with a hemostat, pull on it a little tug, and snip it off with a pair of surgical scissors. Done. A couple of minutes tops. Depending on location they will use a conventional dental anesthetic like lidocaine to numb the area up first. Most are not even stitched up afterwards, or take one stitch only.

Brush biopsies are very unreliable, and do not provide the pathologist with the information that he needs. A punch or incision leaves all the layers of cells intact in their proper relationship ( basal cells on the bottom, upper epithelium cells on top. A brush biopsy gives the pathologist "scrambled eggs" of cells and some of the information is lost.

Hi everyone,

I talked to Fox Chase Cancer Center and they said that they were out of network with my insurance. I then called the Hospital at the University of Pennsylvania to schedule a visit. In the meantime, I went to another dentist for a second opinion on what the patch could be. This second dentist was in fact very adamant that it was not cancer! He said that cancer which begins on the "free gingival margin" is very rare, and that in his opinion I shouldn't even get a biopsy. I still felt I should get one, however on his advice (and technically against the advice on this forum to not use harsh treatment) I began "brushing the hell out of it" (his words) and also bought a water pick. Since then I have actually seen marked improvement! The patch has shrunk considerably, which means (I believe) that it was not cancer after all!

Dan,

I know you are anxious about this and the only way to determine if if is cancer is through a biopsy.

Now I'm not a doctor or a medical professional, but I'm an nearly 8 year OC survivor and have been to many doctors including ones at Fox Chase, Hospital at the University of PA (HUP) and Johns Hopkins plus my local ENT/surgeon and none of these doctors ever suggested that I "brush the hell out of it"!! Most dentists are trained to detect signs of oral cancer, but they will refer you to an oral surgeon or ENT for a biopsy. You are probably seeing "marked improvement" because you are removing the suspect cells because of the rough brushing. Please stop this!

When is your appointment at HUP? When you go there and want the ENT to examine this red spot you've basically destroyed it, what is he/she going to look at? They will likely not recommend a biopsy because of what you've done.

Using a water pick is OK provided you are not blasting the red area with the water. I use a water pick based on a recommendation of one of my doctors and was advised to use the lowest water pressure when you first start using it.

I truly hope it is not cancer, but please be patient until you see the doctor at HUP.

Dan, as I previously advised you need to see an ENT or oral surgeon. Not all dentists check for oral cancer let alone diagnose it. Unfortunately many are not up with current medical findings that oral cancer can be found in younger seemingly health patients. Brushing the heck out of it is like ripping off a scab, it makes it appear that the sore is gone but its really still there underneath that top layer. Please avoid shooting that spot with a waterpik. I know you are anxious and want to know whats going on but it takes time. Even if you see a qualified ENT or oral surgeon tomorrow and they do a biopsy it will take another week for the results to come back.

How about attending the OCF's Philadelphia OC Awareness Walk on Saturday? Its at a dental school and they will have specialists on hand doing oral cancer screenings. They may be able to fast track any unusual findings to a qualified professional. Hurry, registration closes 4/5/13 at noon. You can still attend if you miss the deadline but may not get a tshirt and registration will be $30 instead of $25.

OCF Awareness Events (OC screenings at events)

Hi everyone,

I think maybe I should explain a little better. When my dentist told me to "brush the hell out of it" I'm sure he did not mean to grind away at it. That is only detrimental to gum health. What he meant was brush directly on that area very often (3x a day or more), but to brushly lightly as I normally would, not to abrase it or press on with the brush. I use an electric toothbrush at a 45 degree angle to the gumline as my primary dentist has always taught me. I have to politely disagree with your advice not to use the waterpik directly on it, as I have definitely seen clear improvement since I've begun. I've also been rinsing with warm water with a little salt and baking soda as you recommended. I'm definitely not abrasing the surface or removing a layer of tissue when cleaning it, just following the dentist's advice and in result I'm seeing a return to normal pale pink tissue color in the area. The patch has began shrinking from the borders inward.

I also have to politely disagree that a reduction in red area can be caused by unknowingly removing the top layer. According to the medical journals I've read online, the redness of erythroplakia is the color of the underlying blood, which is seen more clearly through that tissue than in normal tissue because of a localized inflammatory response to foreign "eothelial cells", or due to thinness of the epithelium. In any case, since the redness is from the blood underneath the surface, it should not be possible to reduce redness by bringing the blood even closer to the surface by reducing the surface layers; this would only make it redder.

I definitely still want to get a biopsy if the patch does not totally disappear on its own as a result of this treatment, however at this point it seems that it really will. I could just get one anyway, but I would rather not scar my gum if there is an almost 100% chance of it not being cancer. I don't believe that according to anything I've read dental care can cure erythroplakia; therefore if it does, then it simply was not erythroplakia. I hope that you take my word for how well the red patch is responding to the new treatment, because my own descriptions were all you had to begin with, only my dentists and I have actually seen the patch. I truly appreciate all of your help and I know that your diligent warnings to get a biopsy are from personal experience and from a wish to spare me the suffering that you and your loved ones have gone through by waiting too long. But please give me a little more time to see how the patch continues to improve.

Christine I don't think I can make the walk tomorrow, but instead I've already made a donation through https://donate.oralcancer.org.

Thank you all so much for your advice, and although it's possible that not getting an immediate biopsy is a wrong decision, for right now at least I feel I am pursuing the right avenue by watching it improve and keeping the option open for one if it does not completely clear

Ok, Dan! I am wishing you all the best with this. Please take care of yourself and watch your sore closely.

Thank you very much for your donation! That was very kind of you