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Painless bumps in the mouth

Monday, August 3rd, 2009
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I’ve noticed for at least 3 months now that there are small bumps on the inside of my cheeks (one on each side). They have never really hurt, even when eating or when i push on them. About a month ago, I got these little white bumps on my tongue (two on each side near the front) which I let my mother look at and she said it was from having too much acid in my diet. Thinking back to what I had eaten or drank lately, the one thing that was a semi constant in my diet was V8 Splash. I found it very tasty and I finished a bottle (64 oz.) in about 1-2 days. I figured it was better than drinking soda, so besides water and the occasional soda, that is what I had. I had my oral hygienist look at them earlier this month, and after just feeling them and not looking, she said it was nothing to worry about. Ever since I got the white bumps on my tongue, i have not had any V8 Splash and have been very aware of keeping citric acid out of my diet. The bumps on my tongue have gone down and look normal color, but I can still tell where they were. The bumps on the side of my cheek are still there, not growing bigger, but I have not noticed them getting smaller. I intend to see my physician very soon, but I’d like some peace of mind now if possible.

Answered by: Maria/MD Health Forum.com Team

There are different kinds of lesions and bumps that may appear in the oral cavity. Some are harmless, but there are certain types may indicate serious diseases. One of the conditions that affect the lining of the mouth is a chronic autoimmune disease called oral lichen planus. In autoimmune disorders, the signs and symptoms occur because the body attacks its own cells.

Oral lichen planus commonly occurs on the inside of your cheeks but it can also affect other areas of the oral cavity such as the tongue, gums and lips. It may appear as white lacy streaks or small raised areas on the mucosa. Oral lichen may also present as fluid-filled vesicles. Sometimes the raised areas may turn into erosive lesions or ulcers which can be painful. A person with oral lichen planus may experience periods of flare ups, alternating with symptom-free periods.

The exact cause of oral lichen planus is unknown. Research suggest that it occurs when the body’s immune system activates a chronic inflammatory process in the mucous membranes- tissues that line body cavities such as the throat, nose, mouth, rectum and vagina. Chronic lichen planus has been linked to skin or mucous membrane cancer. To diagnose oral lichen planus, your doctor will ask you about your symptoms, take your medical history and carry out physical examination. Blood and allergy tests may be requested to rule out other conditions that may have similar symptoms. If the lesions are ulcerated, the doctor may consider biopsy.

Treatment for oral lichen planus largely depends on the severity of symptoms. If erosions or ulcerations are present, the doctor may prescribe corticosteroids. Immunosuppressive agents may be considered if the patient fails to respond to steroids. Non-drug measures such as practicing good oral hygiene, avoiding food items that are highly acidic or spicy, and abstaining from alcohol and tobacco are known to improve symptoms of oral lichen planus.

Another disorder of the mouth that may cause cause of painless bumps on the tongue or on the inside of the cheek is called leukoplakia. Although this condition is usually not dangerous, it is estimated that a small percentage of leukoplakia cases will develop mouth cancer later in life. The use of tobacco increases the cancer risk of people with a history of leukoplakia by up to 14%.

Leukoplakia is diagnosed by examining the patches in the mouth. It is also necessary to rule out other possible causes for signs and symptoms. Tests such as biopsy may be carried out to find out if there are changes that indicate oral cancer. Leukoplakia can be treated by surgery, some experts suggest that removing the patches can reduce the development of cancer. Taking beta carotene may also improve symptoms.

I can only put so much emphasis on the importance of your own physician’s evaluation.
Although you’ve been doing a good job on observing some measures such as avoiding acidic food items, you should still see your doctor to find out what has been causing the bumps in your mouth. Appropriate treatment can only be given once the underlying disorder is identified.

References:
http://www.nhs.uk/Conditions/Leukoplakia/Pages/Introduction.aspx
http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=22


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