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Doctors' Answers to "Frequently Asked Questions" - Mouth Problems

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Lasting Jaw Problem [posted 1/6/99]
Question: As a child my orthodontist gave me a number of experimental Retainers, which were supposed to somehow rearrange my jaw along with closing up the spaces between my teeth. At that time I began to "crack" my jaw by opening and moving it from side to side. It was painful and aggravating but something I had to do. This continued through adolescence. Today my top and bottom teeth do not fit together in a comfortable bite, and when they do fit together my bottom jaw is slightly back and to one side. In my early 20s I got a retainer to close up small spaces where my teeth had floated apart, and this was later replaced by a mouth guard. I feel that the guard is causing my teeth to clench together in the uncomfortable bite mentioned above. I got a lower mouth guard, but this didn't help. Each morning when I wake up my jaw muscles feel tense and ache, and I have started to crack my jaw again. (I also hear air-pops when I swallow). A chiropractor told me my jaw is mis-aligned. That is, one side opens differently than the other. He adjusted my jaw, and suddenly my top and bottom teeth were lined up, but because they still bite together the same way all night long the situation soon reverted back. What is a bite adjustment? Is there any way to file my teeth so that they would fit together comfortably without my lower jaw being swung back and to the side? Also, why do I feel the need to crack my jaw, and can this constant manipulation be harmful?

Answer: Sorry, I'm not a dentist. You need to see a orthodontist.

Jaw Pain [posted 1/6/99]
Question: I've been suffering from pains in my right jaw for the past few days. It is very difficult to open my mouth and eat. I can't chew on that side anymore. The pain is emanating from my gums and I have noticed some swelling in that right back area. At first I thought that it might be my wisdom tooth coming out, but it's not, as I can see some infection, redness, and swelling. Tonight, a blood clot appeared. It is not flat or ensconced in the gums. Rather it is like a little bump protruding. The pain is still there. It is bearable, but nevertheless painful. Do you have any ideas as to what this might be? Also, I feel a fever coming on.

Answer: Something that needs a dentist, probably an infection.

Persistent Mouth Ulcers [posted 12/04/98]
Question: I have had reoccurring apthous ulcers for most of my life. Even though I have tried many treatments over the last 20 years, I can only find relief by taking Prednisone. Without the prednisone  I constantly have from 10 to 20 ulcers at one time on my gums, tongue, throat and side of my mouth. I have been tested for everything under the  sun. I have tried antibiotics, cancer drugs, acne drugs, vitamins, herbs, topical treatments, allergy treatments, herpes treatments, etc. I have seen dentists, dermatologists, infectious disease doctors, general doctors, ear, nose and throat doctors and even a chiropractor. I am losing hope. As a last resort I recently tried Thalomide and it knocked them out. But after a week I broke out in a rash and had some numbness in my leg so I stopped taking it. Please give me any suggestions that you have.

 Answer: L-Tryphophan is touted by some as a help. Zinc oxide lozenges are used in common colds and might be worth a try.

  Bad Taste in Mouth [posted 11/24/98]
Question: I have a bad taste in the back of my mouth. gargling does not help much.I feel like there is phlem in the throat that I cannot expel by coughing, hacking etc., my tongue is coated on the backspeech is fine. No detectable wheezing or breathing difficulty. I do a lot of carpentry work and am exposed to wood dust often. I've had allergy problems this spring (sinuses), but their fine now.

Answer: Several possibilities. First a bacterial infection of the tongue or stomach. This can be treated by using prilosec/an antibiotic and pepto-bismol. Second, reflux acid which is affecting the tongue-treated by zantac, prilosec etc. I doubt your work has much to do with it.

Burning Mouth [posted 11/5/98]
Question: We have consulted every specialist known to find out why my mother has constant burning in her mouth, lips and stomach. The worst all the time is mouth. She is on many medications, they have been researched and burning is not a side affect of one or any combination of these. She is a vibrant, great, with it 90 year old lady. She has been suffering for many years with this. She takes vicodin for relief but that doesn't help much anymore. Please please help, thank you.

Answer: Sometimes very high doses of vitamin b complex will help this problem. It will take about 8 weeks and needs very high doses of vit b6 as well as the other vit bs.

Oral Infection? [posted 8/11/98]
Question: I have had a bad taste, sort of musty or moldy, in my mouth for about 4 days. I also noticed the back of my tongue is partially coated with a whitish paste, and there are several red lumps on the back-most edge of my tongue that I had not noticed before. I have always brushed at least twice daily, but since I became aware of this foul taste, neither vigorous teeth and tongue brushing nor mouthwash have helped. I have recently started dating a woman, and performed oral sex on her for the first time about a month ago, and the last time was about 5 days ago. I was wondering if maybe this was related to her and what I can do about it, it's really causing me to worry.

Answer: Probably candida, but unrelated to oral sex. You can transmit herpes by oral sex, but this is usually painful small blisters. See a doctor for further evaluation.

Bad Taste in Mouth
Question: I have had this pretty severe bad taste in my mouth for a while now. It tends to come and go. The last time I had it, it lasted about a week and then I did not get it again for about two months. Now, I have it again and it has already lasted about four days. I feels like I constantly have a copper taste in my mouth. What I was wondering is if it could be a result of a post nasal drip. If you have ever heard of such a problem, could you please let me know if there is something that I could do to get rid of this problem.

Answer: There are several possibilities. First, ensure your teeth are flossed twice a day and brushed 2-3 times a day. Gum disease is the leading cause of this problem. Second, a post nasal infection or sinus infection could cause this symptom complex-not just a drip. Thirdly, occasionally systemic problems like hepatitis or medications you are taking will produce this metallic taste. If it persists after the dental care, see your physician.

Mouth cracks; redness
Question: What causes the cracks or red areas on the outside area of the mouth? In the area between the upper and lower lip in the corners.

Answer: This is called cheliosis. Vitamin B deficiency, dry skin, and use of anti-acne treatments are all associated with this problem.

Ulcers in the mouth
Question: I frequently get ulcers in the mouth. Whenever they occur, it becomes very inconvenient for me to eat and also talking to others. Please subscribe me some medicines that would help.

Answer: First, what is the cause? If it is herpes, then acylovir or equivalent would help. If it is lupus or a connective tissue disorder, then that problem would have to be addressed, so work on the causal diagnosis first. There are topical medications that help the pain. Liquid benadryl swish and spit can help and there are topical gels available at your pharmacy that help. Dentists sometimes can help with topical covering to decrease the pain.

Oral rash
Question: In the rural area where I live, visiting my Primary Care Physician is nearly a half day adventure. I have something on the floor of my mouth (under my tongue). The area appears unusually red in color, has no appearance of a rash or other changes in surface appearance. However, I can feel a slight texture with my tongue that I can best describe as fuzzy or rough. The best comparison I can make is that of rubbing one's finger across coarse sandpaper. I've thoroughly researched such topics as "oral candidiasis," "thrush," and "trench mouth" on the Web. My symptoms are dissimilar to those associated with these conditions (as the symptoms were described by various Websites. Any ideas?

Answer: Most of the infective causes are painful, which you are not describing. I don't know if you smoke or how old you are. The risk of oral cancer rises with each. Off hand, I don't have any great ideas-- looks like someone needs to see this one.

Question: I'm a 48 year old male who's very healthy with one notable exception. Within the past 30 days I've developed a very strange and unpleasant taste in my mouth that won't go away. I haven't changed my diet, and have had a dentist check for fillings that may be leaking, but was told that it's not the cause. It's virtually constant (24 hours a day) and goes away only for a moment while I'm eating. It can be best described as metallic tasting. The smell of my breath hasn't changed and my girlfriend says she can't taste it when she kisses me. It's very unpleasant and I don't know why it's occurring or how to get rid of it.

Answer: Several possibilities here. First have your physician check your liver enzymes and other tests to ensure that you haven't had sub-clinical hepatitis or any liver inflammation. Occasional people have a diverticuli which is located about the Adams Apple. This is called a Zenker's Diverticuli (sack) and can be surgically repaired. They tend to have food collect here which causes the bad taste and odor. Some patients have an infection in their stomach caused by Helicobacter Pylori. This can be treated by your physician and is a fairly common cause of this complaint.

Sore Mouth
Question: The roof of my mouth has been sore, red, and a little swollen for some time now. I thought it would go away but it's not. What is wrong and do I need to see a doctor? I'm starting to get a little worried.

Answer: Agree, see a doctor.

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