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Red and white patches in gums
For nearly 2 years I am suffering from this, what started as a small white patch in one gum area has now slowly grown to white patch which then turn to red to for gum areas. No burning or pain while eating normally. But a tingling sensation when I eat something hot or spicy. I have tried few oral doctors who did deep cleaning, gave me oxidant medicines, gave me turbocot to apply as oral cream steroid. I even lost weight in between for update my lifestyle, proper brushing. But all in vain. It is now spreading to 1 gum at a time and now I am frustrated. I need someone who could help me get rid of this. Please can someone guide me on exactly what is this and how can I resolve this.
Answers (2)
Thank you for the detailed history. A white patch on the gums that has slowly spread over 2 years and now has red areas, without pain, needs a tissue diagnosis rather than more empirical treatment. The main possibilities are:
• Oral lichen planus (gingival form). This is common, chronic, and often causes tingling or sensitivity to spicy or hot food. It can look white, red, or both.
• Leukoplakia or erythroleukoplakia. Red-and-white patches are the pattern that needs a biopsy, because a small proportion can show dysplastic change. This is especially important if there is any tobacco, areca nut/gutka, or alcohol use.
• Less likely: a lichenoid reaction (to medication or dental materials), candidiasis, or an autoimmune blistering condition such as mucous membrane pemphigoid, which can cause "desquamative" red gums.
Deep cleaning and antioxidants would not be expected to help with any of these, and a steroid cream only helps if the diagnosis is right.
Next Steps
1. See an oral medicine specialist or oral and maxillofacial surgeon, not a general dentist.
2. Ask for an incisional biopsy of the most representative area, ideally including a red portion. If your gums are peeling or blistering, ask for a second sample for direct immunofluorescence.
3. Ask for basic bloods: CBC, iron studies, B12/folate, and fasting glucose. Hepatitis C screening is reasonable if lichen planus is confirmed.
4. Bring a list of all medicines and any recent dental work, such as fillings or crowns.
5. Take clear, well-lit photos monthly to track changes.
Health Tips
• Stop all tobacco, areca nut, and alcohol now if you use them.
• Avoid very spicy, acidic, or hot foods, and use a soft brush and alcohol-free mouthwash.
• Don't keep using the steroid cream long-term without a confirmed diagnosis.
• Seek review sooner if you notice a non-healing ulcer, a lump or thickening, bleeding, numbness, or a swollen neck gland.
• Most of these conditions are manageable once correctly identified, so a biopsy is the key next step.
Answered
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