I have an ulcer behind the wisdom tooth. Please help.

Patient's Query

Hello doctor,

From the last three months, I have a constant pain on the right side of my mouth. I believe the pain was similar to when someone has an erupting wisdom tooth, but I am not 100 % sure. When I looked in the mirror with a flashlight, I found a tiny white spot in the area between my right upper and lower wisdom teeth. I had this spot for at least 4 or 5 days, and then gradually it subsided within a week or so. After a week, when I took a look, that white spot was gone but the little surrounding area had become white. This white area got bigger with time. I visited a dental surgeon in a top hospital, who visually examined the area and asked me to get an OPG done. The OPG report suggested impacted wisdom tooth. The doctor said the white area was caused by trauma from the friction of the two wisdom teeth on that side with the skin.

I was not very convinced and visited another dental surgeon, who also said more or less the same thing, after examining and going through the OPG. As per his advice, I got both wisdom teeth extracted. The white area has remained till this date, not the initial white dot which had disappeared within 5 to 6 days as mentioned above. I could not open my mouth properly for few days after the extraction, but when I finally did, everything appeared normal. Since then, I have not had any oral or dental issues. It is to be noted that neither doctor had seen the first tiny white dot or spot since I had met them after it was gone and when the surrounding area was white.

I have attached some photos here, and the photos marked 1 and 2 show the first white dot. While the remaining show the condition after this spot disappeared. I request your thoughts and opinion about the issue detailed above. Could the original white spot be an ulcer or canker sore? If yes, what could have been the possible cause? Is a single canker sore cause of worry? Can it indicate some very serious underlying condition? I have read on the internet that mouth ulcers normally occur on the inside of cheeks, tongue, and lips. Can it occur in the area where the spot appeared? If it had been a mouth ulcer, is it possible that the ulcer affected the area in a way which caused a trauma resulting in the white area? I request a detailed response to the above at the earliest, please.

Answer

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist

Hi,

Welcome to icliniq.com.

Thank you for your query. I have seen all the attached photos (attachment removed to protect patient identity).

There is nothing to worry. It is a healing traumatic keratitis. As per the given picture, your lower wisdom tooth was not in the correct position. The normal eruption period of wisdom tooth is 17 to 25 years of age. If there is enough space behind the second molar and the tooth position is normal, it will erupt in the normal period.

The pain you had is due the pressure applied by the wisdom tooth on the adjacent molar in its attempt to erupt. Finally, a part of tooth came out. Since rest of the tooth is inside the gum and bone, the gums behind the wisdom tooth grew over the tooth.

When you chew, the upper wisdom tooth hits on the gum over the lower tooth, which leads to traumatic keratitis. The white spot you noticed initially is the point where the irritation by upper tooth happened.

As the irritation started, the gums over the lower tooth got swollen, and more area comes between the upper and lower last tooth. That is why the white spot increased in size.

The treatment is to extract the upper and lower wisdom tooth. Traumatic keratosis will subside after removal of the cause. The white color which is persisting will disappear by 6 to 8 months from the tooth extraction.

If you have a habit of smoking, tobacco, or pan chewing, then it will take more time for tissue remodeling. Then there may be a chance of transforming to any pathology in future. It is a very rare.

In your case, it is not a mouth ulcer. Traumatic mouth ulcers will subside by removal of the cause. Mouth ulcers can occur in any part of the mouth. Usually, all mouth ulcers will subside within 7 to 10 days. If painless ulcer persists beyond six months, then you need histopathological examination.

For more information consult a maxillofacial prosthodontist online --> https://www.icliniq.com/ask-a-doctor-online/maxillofacial-prosthodontist

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