How can I differentiate a red spot as oral cancer versus an ulcer?

Question

Hello doctor,

I noticed a red spot near my wisdom tooth two days ago. I am worried about erythroplakia or oral cancer. I do not know how long the spot has been present; it seems to rest over the lower wisdom tooth when the mouth closes.

I have attached the pictures below.

Please review and suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through the attached pictures(attachments removed to protect the patient's identity), and they are not so clear.

If you have only observed the spot recently, then do not worry, it is nothing chronic and looks more like an ulcer due to pericoronitis or wisdom tooth infection, or cheek bite.

You need to ensure that the ulcer does not increase; you should take appropriate steps, such as:

Saltwater rinsing several times a day.
Apply a Lidocaine or Benzocaine gel (anesthetic gel).
Dentogel or Dologel (Choline salicylate and Lidocaine) can be applied for pain relief and to prevent it from getting bigger.

If it is a self-limiting lesion, it will eventually decrease and fade away.

Also, follow a regular nighttime mouthwashing regimen for 15 to 30 days with preferably Chlorhexidine mouthwash, unless the ulcer or this lesion has persisted for the past two weeks.

I would not recommend a biopsy. A physical examination at the dentist is preferable.

I hope this helps.

Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

No, it is just a red lesion of the oral cavity, but the important thing to bear in mind is that it should not persist past two weeks.

I have seen the pictures attached (attachments removed to protect the patient's identity), which is clear now, and you need not take much tension. If you have any detrimental habits, just in case, please quit smoking or alcoholism.

It is neither oral cancer nor erythroplakia, as both are chronic conditions, so stay assured.

Make sure you follow the rinsing and mouth washing with Chlorhexidine mouthwash, and gel protocol I suggested. If you have more doubts, I can help you during subsequent follow-ups.

If the red lesion is still present for a month, then you can consult me anytime, and I can put you on antibiotic prophylaxis. It is not needed right now if you do not have any pain.

You can also start Omega-3 or 6 supplements thrice a week to reduce the risk of frequent oral ulcerations.

Regards.