I attended a hospital OP appointment at Maxillofacial dept yesterday as my Dentist had referred me. I have been having trouble with my gums for a long time now, following extra hygiene procedures & 4 monthly hygeinist appointments but sadly no real improvement. Gums flare & become very sore, Lychen Planus suspected, which is auto immune so all linked to my Hypothyroid. Hospital want to do a biopsy on 20th June, they have ruled out anything nasty like cancer. As it's autoimmune was wondering if I should actually have it done ?
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retrieverk9
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I have had lichen planus for about ten years. During all that time I've only had two bad flare ups though if I deliberately press my tongue down onto the floor of my mouth there is generally some tenderness.
I too was referred to the maxillofacial dept of the Queen's Medical Centre by my dentist. I was told they were confident it was not sinister but said a punch biopsy was perhaps a good idea though not essential as the consultant was confident it was not malignant.
I decided to go with the biopsy and the result was as expected: lichen planus. I was told that it was "burning itself out" but I still have it after all this time though it causes me little trouble. I have a check up at the dentist's every six to nine months, just to make sure there are no undesirable changes though I was assured at the hospital that there is not much risk of anything sinister developing from lichen planus.
I have hypothyroidism too. As you say it's another autoimmune disease.
As you are asking if you should have the biopsy, I take it you have been told the same as I was, that you can have a biopsy if you want but that it is not essential as the hospital is confident of their diagnosis. I went with the biopsy for my peace of mind.
I hope the above is helpful and that all goes well whatever you decide to do.
Thanks so much for the reply, our cases sound identical. Had exactly the same feed back from the consultant yesterday. I'm really grateful for your reply, has put my mind at rest & I will go ahead with the biopsy.
I have problems with my gums from time to time. They swell up, bleed, and get very sore, despite being extremely careful with my dental hygiene.
I've found one thing that helps and that is vitamin C. I probably spend quite a bit of my life on the edge of having scurvy, but unfortunately I have issues tolerating vitamin C, so I only take it when I absolutely cannot avoid it. My gums clear up for a while and then gradually get worse again, and so the cycle repeats. But for normal people with no issues with vitamin C it is a very safe experiment to try. It might not help, but it will do you no harm either, so it might be worth a try.
Thank you for that advice. Since being diagnosed autoimmune thyroid I have taken on board the vitamin supplement advice given on this forum, so I do now take a slow release Vit c supplement daily along with a few others
I can also sympathise with this, having been in a similar situation. I had quite bad erosive LP on the inside of my cheeks and tongue which was really sore and stopping me eating properly. My dentist could only prescribe Difflam, which helped a bit, but not enough. To get stronger medication I had to be referred to the hospital, who refused to prescribe anything without doing a biopsy first. I pleaded with them, but they wouldn't budge, and in the end I agreed because I was desperate for something to heal it. The biopsy wasn't too bad, although it took about 2 weeks to fully heal. The main surprise for me was that, as they removed a lot of the sore tissue, it actually got rid of most of the problem! It still comes back a little bit from time to time, but nothing like it was, and I never needed the steroid mouth rinse for it in the end.
It's a tricky one to decide, but if you need stronger medication for it, I expect you'll have to have a biopsy. Things that helped me before that were the Difflam rinse, which numbs things, not eating raw tomato or onion, and avoiding sugar free gum, which really aggravated it.
The hospital have prescribed 2 weeks of Steroid mouthwash, although I can't help but think that surely that will affect the true picture of the biopsy.... but we never understand Dr's thinking
Gosh, I’m going to the dental department of my local hospital on Thursday. I’ve been getting what feels like cold sores on the roof of my mouth for a long time - I feel what feels like a cornflakes uptick on the roof of my mouth - always in the same place, I feel like I’ve got flu, really poorly and miserable then it all settles down until the next time and the outbreaks are totally unpredictable.
In March the ‘cold sore’ was followed up with what seems like burning mouth syndrome. I felt lousy, my tongue was agony, it felt like it was twice the size it should have been, tingled, the glands at the base of my tongue we’re painful and my glands on my chin felt like little cushions.
It seems to build up, be really painful and debilitating for a while then go away but it always seems to come back again and everything about my mouth hurts. I asked and my dentist seemed sure that it wasn’t anything ‘sinister’ but he decided to refer me anyway.
I use a really gentle toothpaste with no additives, I rinse with Gengigel mouthwash or a salt water rinse. I use Teepee interdental brushes, a sonic toothbrush at gentle setting and a Waterpik between teeth after cleaning. I also get painful teeth and regular sinus infections- doctor says ‘it’s your teeth’ dentist x rays, whacks and puffs air int all my teeth and says it isn’t my teeth.
When I was treated for Graves my sinusitis went away altogether but it seems to be coming back now, my TSH is creeping up from what it was when I finished my block and replace treatment.
What is it with the thyroid and oral problems? There has to be a link. In view of what you both have found. I’ll be very interested to see what the doctor / dentist has to say to me on Thursday.
Fruitandnutcase, I seem to have something similar going on. It started after I had a broken tooth repaired so I was almost certain it was dental in origin - but the dentist says no, all teeth are fine.
I’ve been to the dentist over a dozen times since Christmas (not all with the same tooth - I had issues with another one which ended with needing a root canal). And at the moment, I can’t even work out exactly where it hurts (I’ve had mouth ulcers galore though).
I hope you get some answers. You’ve made me think though - maybe this *is* thyroid hormone related. Probably about time I did a test...
I've had similar painful problems lately but haven't yet investigated. (I tend to wait a long time before seeking help because I'm housebound, live a long way from services, and after 40 years of illness I'm very cynical.) I hadn't considered this disorder in my own case. I'm not sure whether I would agree to a biopsy. If your consultant is sure of the diagnosis, then a biopsy may be diagnostic overkill, and from my own experience of having other kinds of biopsy while in a poor state of health, healing could be prolonged.
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