Greetings to all. I am a 39 year old male who never smoked cigarettes. I tried smokeless tobacco twice, once with snuff and once with chewing tobacco, in my teens. Hated it and never did it again. I do occasionally (7-8 times a year) smoke a cigar, although I tend to hold it more than smoke it. I drink approximately 5-6 beers a month.

In regard to oral health history, I have suffered from cold and canker sores for years. Also, I have been told by every dentist I have been to that the inside of my mandible juts into my mouth cavity below my teeth much more than on most people and could cause pain eventually. (They always want to grind it down.) Finally, I did not have my wisdom teeth out until 2002, when I was 36. I had very long roots and still suffer from some very slight numbness to my right cheek area due to nerve damage caused when the right lower wisdom tooth's root brushed against a nerve. Very minor, however.


About five weeks ago (beginning of June), I noticed what I though was a canker sore on the inside of my lower right jaw, in the area of my molars. It developed they way canker sores usually do for a week, including a painful ulcer forming. But then it swelled up and became very painful and tender when touched. I would describe it as blister like. It also developed a white "pimple" behind it, in the area of my most rearward molar. The white area was very small and at the top of a triangular projection of gum, although it was at most a 1 mm high. (It really looked just like a small pimple with a whitehead.)

About two weeks after I first noticed something, I went to my dentist on June 16, 2005 because of the swelling and pain. He thought it was an infection and prescribed an antibiotic. It seemed to improve, but then, regressed over the Fourth of July weekend. The pain and swelling were much worse after I ate or brushed my teeth, i.e., after something was scraped against the area at issue. When it swelled the most and was most painful, it also would cause my teeth to hurt.

I went back to my dentist on July 5, 2005 and he set me up with an oral surgeon. However, the day after seeing my dentist, the ulcer started to heal and is now much less painful, although not quite pain free. In addition, the swelling started to get smaller, although it is still present and tender. Color wise, it went from a red, inflamed color to a more pinkish color, except where the ulcer is which is white/yellow. Curiously, the swelling and pain are at their least in the mornings when I wake up. I assume because my toungue and food are not rubbing against it as I sleep.

Having visited this web site, I decided to see the oral surgeon anyway as a precaution. I went yesterday, July 7, 2005. He took x-rays and manipulated the swelling, which he described as squishy and soft. He also manipulated my glands and said he felt nothing unusual. Finally, he said he believes it is an infection and again prescribed an antibiotic, as well as a mouth rinse. He indicated that if it is not healed completely by next week, he will do a biopsy on Friday. If it has healed, he said the next step is to figure out what caused the infection.

When I arrived home from the oral surgeon last night, I brushed my teeth. Afterward, I felt something in the area of my farthest molar back protruding from my gum. I looked with a flashlight and the top had come off the white pimple like area and a very hard, very sharp, projection was sticking out! Eventually as I manipulated it with my finger, it came completely out. It is approximately 2-3 mms long and shaped like a triangle, very sharp and very hard. It looks just like bone. (I kept it in a plastic bag for the oral surgeon.)

I have a few questions:

1) Could the "bone like" structure actually be bone, if not, what could it be?

2) If it could be bone, has anyone ever heard of pieces of bone working their way out of a gum? (The surgeon who removed my wisdom teeth told me that small fragments of my wisdom tooth from this area had remained in my jaw because they were to deep to get.)

3) Is it possible the bone fragment(s) are the cause of the swelling?

4) I am curious as to whether anyone thinks I also should see an ENT cancer/medical doctor in addition to the oral surgeon? (Fortunately, the city I live in has one of the finest cancer centers in the country.)

5) Regardless of whether the ulcer and swelling finally resolve, should I still have the biopsy done on Friday?

Thanks to all who respond.

It sure doesn't sound like cancer in any case. Sounds like a piece of a root from a wisdom tooth removal that got left behind. That's pretty much what it would do - eventually become infected and work its way to the surface. The antibiotics should clear it up and if not, your doctor already has the plan to biopsy. My gut feeling is that you are going to be fine.

Kudos for you and your doctor for doing the right thing.

Thanks for the reply Gary. It will help me sleep tonight!

Timothy, after having my wisdom teeth and a few others, I had bone chips coming up and out for several months. John had all but 5 teeth removed during cancer surgery, and he is having some problems with chips working their way to the surface also. It sounds like your oral surgeon is being thorough. Amy

Timothy,

I am a dental hygienist and an oral cancer survivor. It probably is a piece of bone that has worked its way out following your difficult third molar extraction. Follow up with the oral surgeon but I bet you feel better and better every day, unless there are more pieces working their way out too.

Good luck -- let us know how the story ends.

Barb

Timothy,

I am a dentist. Odds are pretty good that you had a bone spicule come out. This is a pretty common thing to happen after extractions. Yes, it can even happen several years after the extraction.

I am sure that the surgeon will not want to do the biopsy as you will probably be fully healed by next Friday.

Rest easy.

Jerry

Tim, the same thing happened to me following wisdom tooth removal, many years before I ever heard about oral cancer. What you describe sounds so much like what I remember, that I cannot imagine it would be anything worrying.

An update. The swelling and tenderness I had did not go away so the surgeon performed a biopsy a week ago. I am still waiting on my results. The size and tenderness of the swelling appear to vary depending on if I eat or talk. Also, when it is at its most tender, it is bright red. It gets pinker when it calms down. Finally, the area bleeds when I brush my teeth.

Now, a few more questions.

1) Does a biopsy usually take a full week?

2) This swelling appeared within a week or so from nothing. Is that typical or atypical of cancer?

3) The tenderness is similar to after you eat something too hot. Not a sharp or dull pain, but, a feeling as if tender skin was exposed to something rough or hot. Also, it worsens greatly if brushed against by my tongue or food. Again, is that typical or atypical of a cancerous lesion?

Thanks.

Tim,

From the replies of various members Id say youve got a pretty good chance this all has to do with the wisdom tooth that came out, and its very well possible that the infection might take a little more time to heal in this case.

Good luck,
Ian.

Just to TRY to answer some of your questions. My biopsy took more than a week. However, I had the unfortunate timeline of having the biopsy right before the Christmas holidays and they told me that the lab and quite a bit of the medical staff will probably be slowing down. Therefore, my waiting was several weeks.

As for the swelling. My lymph nodes seemingly swelled up overnight. In fact, I did not even notice that I had a swelling on my neck until my husband saw me bending over to clean a bathtub and noticed a lump on my neck. Of course, I immediately went into the local clinic to have it checked out. During the waiting time from biopsy to diagnosis, the lymph nodes continued to expand which was pretty scary.

I really didn't have any sort of pain to indicate that I had cancer at all. Just the swollen lymph nodes and a weird looking growth the local ENT spotted on my supraglottis that looked suspiciously like cancer to him.

I've also experienced bone shards coming through my gums. A year ago I had a molar that would once in a while make my face swell and come down with an infection. The dentist who must have been a bit over confident in his skills had to spend three hours removing it under local. In the end he had to crack some of the socket around it. Within a month I was back in his office and he was having to dig some of the splinters out of the gums that began poking through.

For your sake and my best guess is that you have something going on that isn't cancer. I'm crossing my fingers for you that it is only a minor problem and you will not have to join our ranks.

Jen

Thanks Jen, and to all the others who have replied since my initial post. My swelling hurts like crazy and has since it was small, although as I said, it hurts like I have something stuck in it or like it was burned, more than a dull or sharp pain. Regardless, nothing to do but wait for the biopsy results.

Hi Tim. My biopsy took exactly 7 days. Then I had to have another one unfortunately. Please keep us posted on your results. I have my fingers crossed for you that its not cancer.

Blessings,
Barb~

Well the obvious question here is did you have an x-ray or MRI to determine whether it was a root left behind of a tooth. The biopsy would not remove it - it would need oral surgery for that. Cancer typically does cause pain, although there are exceptions. Infections always cause pain.

Another thing that could cause this is a crack in the root of a tooth. It will cause a fistula to form in the bottom of the root area through the gum (which starts as a pimple - when it ruptures it will drain and the pain will stop). Antibiotics will only be a stopgap measure if this is what you have The solution will require removal of the tooth by an oral surgeon.

Cold sores are yet another thing - they are a form of Herpes and can get inside the mouth as well, especially if you are under a lot of stress. You could practically get herpes just reading some of these posts - lol! Acyclovir is one possible treatment here.

Take a chill pill - I still wouldn't be looking for cancer but you are wise to rule it out early.

It could be osteomyelitis in mandible, just my guess

Tim,
unfortunately you will need to wait for the biopsy to be able to put this to rest. There is NO way you should try to compare what is going on in your mouth with our symptoms. Other than telling you that you did the right thing by following this, it is impossible for anyone to "know" what this is or isn't just by your symptoms. Some of us had pain some did not.

I can tell you that the "sharp boney" thing that broke off does indeed sound like a spicule as Jerry suggested. I had several of these bastards appear during the first year after radiation. Apparently they are caused by a number of things including bone that is undergoing some healing process nearby. They in themselves are not a health problem but they can lead to infections in the gum due to the wound they cause. They go away exactly as yours did, they break off when the underlying tissue has healed.

Don't be afraid to call and urge speed about your biopsy report. Many times the Pathologist has done the job and the delay is in the Dr's office. Go ahead and tell them this is driving you crazy. They sometimes fail to see the stress they cause by being slow.

My biopsy report came back negative. Whew! However, it did disclose that my jaw bone is dead in the area of the swelling so I will be having surgery to clean out the swollen area and scrape away the dead bone so it can heal. It does not sound like fun, but, I am breathing easier tonight. My sincere thanks to all who replied. Your words of wisdom and comfort were greatly appreciated. Best of luck to all.

Best of luck to you too, Timothy. Stay healthy. Amy

Great news about no cancer!