Hi,

I'm 19, but I think I've made a fatal mistake in not having a dental check up for 2 or 3 years...

I have white patches in my mouth - inner cheeks, my tongue is totally white, and one of my tonsils is swollen, and has an indentation near it. My lips have also been peeling, I have swollen glands in my cheeks and also have tinnitus. I never checked for changes in my mouth as I didn't know about oral cancer, and certainly didn't think anything of the sort could strike someone of my age who's never drank or smoked.

I've also been getting short of breath recently, and suffering from acid reflux. No swollen nodes in my neck, but everything else seems so ominous...If it's cancer, it sounds late stage, doesn't it?

Does anyone have any thoughts?

First I want to preface this with this statement, no one on the web is going to be able to diagnose your condition. We can't see your mouth, can't feel the tissues, and most of the people you communicate with are not doctors. While some are highly informed about particular topics (like me) most are not doctors, as I am not. So given what you have said in your email, I am going to try to answer your questions, but this is no substitute for a visit to a doctor and a proper medical/dental examination.

Having said that, given your numerous symptoms and complaints, you should see a dentist, perhaps a periodontist or an oral surgeon, and visit and ENT/otolaryngologist who specializes in some of the areas that are giving you problems. The longer you wait the longer things are a problem and may even get worse.

White patches in your mouth fall in to two main categories, ones you can rub off with your fingernail, and those that you cannot. If your tongue is all white, my guess is this is a Candida infection. This is a fungus and it is common in people under stress, or who have compromised immune systems from other diseases, or even radiation treatments. Candida can be cleared up easily with several anti fungal drugs in a matter of a couple of weeks. The most common drug for this is Diflucan. Candida may be in the sulcus (the pouch between your lips and jawbones) as well. You can scrape it off with your finger nail or a brisk tooth brushing, but it will come back, until it is treated with an antifungal drug. It is not life threatening or associated with beginning oral cancers. The second kind of white patches in your mouth are leukoplakia. They cannot be rubbed off. These are common in smokers, which you say you are not, and in people who chew tobacco, (again in the sulcus areas of the mouth where they keep their chew). Leukoplakia can later develop into oral cancer, but they do not always do this. There are some other white areas that might develop but they are less common, such as lichen planus. A long white line along your cheeks where your teeth meet, is most likely a linia alba (white line) this is from contact with the teeth during clenching and other mouth actions that you may engage in unconsciously or at night in your sleep. It is harmless and common. I have this myself. At your age a swollen tonsil is more likely and infection than a cancer. I had a cancer which started in my tonsil, but that happened when I was 48. While it is not impossible for someone your age to get cancer there, it is highly unlikely, and not commonly reported in the literature. It is true that some ear and TMJ problems (the jaw hinge joint) can be related to oral cancer as can swellings in the tissues of your mouth. But again, at your age this is unlikely. If you haven't seen a dentist in a long time, you may have a tooth abscess that is causing an infection that is causing swelling. This can display symptoms similar to what you are describing. If you haven't seen a dentist in a long time, and maybe your oral health isn't that good, these are all likely scenarios.

You say you saw docs in Jan and Feb, and they were not concerned. Your correspondence leads me to believe these were general MD's. Certainly even they, would recognize a Candida infection, sometimes called thrush, and treat you for it. If they didn't make this diagnosis or offer you an alternative explanation, get a new doctor. MD's are not as good at diagnosing oral problems as dentists, and dentists see things like abcesses, Candida, TMJ problems, infected salivary glands, etc. all the time. They will be able to get you the right diagnosis.

As for worrying about your life.......... If your are that worried, take action. See a dentist. Get a definitive diagnosis. Don't wander around message boards looking for an answer that none of us out here can give you. Let someone who is qualified to do so, look in your mouth. Do this and relax. If you are not a tobacco user, your odds of having oral cancer, while not "0," are very small. As for your syptoms being "late stage" my gut reaction is that many of them are stress related........Get someone to take a look, information is empowering, and you will be able to relax about things and what is going on in your mouth, and perhaps your life.