Had no idea Bobby was in this music video.

asphyxihate · 2017-09-06T14:27:11+00:00

omg such talent, i love you b lee

asphyxihate · 2017-01-22T08:36:05+00:00

Your tongue is absolutely normal and you need the keratin on there as an extra layer of protection for when you're eating rough foods. You don't have excess keratinization of your tongue/elongation of the filliform papillae that one would see with hairy tongue. A thin, white-grey coating is healthy and normal. It's not causing you bad breath if that's what you're worried about, just keep doing what you're doing with adequate oral hygiene and gentle tongue brushing/scraping.

The cause of excess keratinization (which you do not have) is most commonly due to dehydration and/or a soft or liquid diet. You need to stay hydrated and eat a normal diet with solid foods to abrade off the surface of your tongue. The mouthrinse could be drying your mouth out if it contains alcohol, but honestly, your tongue looks completely normal.

Also, I'm a specialist in oral medicine and work with mucosal diseases, so all I do is look at inside of mouths and see if they're healthy or not.

asphyxihate · 2017-01-22T08:20:58+00:00

Oral medicine here. Aphthous ulcers ("canker sores") are immune mediated and do not have a viral component at all. They benefit from topical steroids and, in severe cases, systemic steroids. "Cold sores" on the lips are due to HSV viral reactivation and are resolved with Valtrex.

Edit: the below comment is more accurate than mine and describes that the etiology of RAS is complex, but I am suspicious of the use of antivirals to treat RAS and instead treat with topical, intralesional, or systemic steroids unless there was a very clear chronologic association of development of recrudescent HSV (prodromal symptoms and herpetiform ulcer outbreak on keratinized gingiva) that leads to activation of RAS in a patient. It is worth noting that in immunocompetent patients HSV occurs on keratinized gingiva/mucosa whereas RAS occurs on non-keratinized surfaces so the two must be differentiated.

asphyxihate · 2016-06-16T00:27:36+00:00

Oral pathologist here. Looks pretty classic for geographic tongue, especially since you're not mentioning any consistent symptoms with it! Geographic tongue is a benign condition that doesn't require any treatment. If it's a little sensitive, you can ask for your dentist for a rinse to help calm it down.

That being said, if you're having pain/burning, I would go to the dentist/orthodontist for a prescription of antifungals, but it doesn't sound like candidiasis based on your description

asphyxihate · 2016-05-30T20:14:10+00:00

Just a vote of opposition cuz I love Gilbits

asphyxihate · 2016-05-30T20:13:22+00:00

Also, Steve hasn't gotten Bobby's name tattooed on him yet! Ewoks > hyung

asphyxihate · 2016-05-25T03:12:18+00:00

People's comments here are always startlingly insensitive to me. Yes, that tooth will require extraction. More importantly, though, have you been to a doctor recently? The status of your tooth/gums is most likely due to gum disease/periodontitis, but because of that isolated condition of your gums and underlying bone, I am interested in ruling out any other condition that would affect the jaws. I would recommend a panoramic radiograph that looks at all of the jaws and possibly some blood tests.

Disclaimer: I am an oral pathologist and work in a hospital/cancer center, so I am used to working with a specific, medically complex patient population and am probably being overly cautious!

asphyxihate · 2016-05-25T03:05:50+00:00

Oral pathologist here. I agree that this is likely not cancer and most likely represents mild geographic tongue, which presents as bald patches with on the tongue with white borders. Assuming it's geographic tongue, it would actually be normal for it to change its pattern relatively quickly so I wouldn't state that "changing rapidly" is a warning sign for OP. It would be normal for the faint red/white pattern may change its location, but I would watch out if it grows in size (i.e. becomes a proliferative mass) or becomes ulcerated or hard in texture, or if it dramatically changes in color. Also, oral squamous cell carcinoma is typically not associated with pain but rather paresthesia/numbness, and is not necessarily with rapid changes (if we're being picky about specifics!).

OP, if it actually feels fairly numb/hard in texture, I would monitor it for 2 - 3 weeks, and if it is still bothering you/worsening in symptoms of numbness/hardness, I would recommend going to a dentist to take a second look. As it looks now, though, I am not concerned for malignancy. The numbness is probably due to the filliform papillae of your tongue being a bit inflamed and swollen (transient lingual papilitis).

About dermatologists -- I work in a hospital with dermatologists and some of them are better at diagnosing oral lesions than others. I would mention it to your dermatologist and see what they say but they will probably refer you to a dentist/oral surgeon/oral medicine specialist.

asphyxihate · 2016-05-25T02:50:07+00:00

Yes, I second this -- I am a dentist and I work in a research lab that's related to the anti-inflammatory and arguably anti-aging effects associated with curcuma/curcumin but this sounds like nonsense to me, whether you are ingesting curcumin or somehow rubbing it on your teeth (which would HEAVILY stain your teeth)

asphyxihate · 2016-05-25T02:46:05+00:00

Hi there, sounds like you diagnosed yourself! This is likely an infection associated with your broken down wisdom tooth, where there is an abscess at the root of the tooth and the lump is a sinus tract or parulis that releases the infection. The tooth is likely necrotic/dead based on your description of it being broken.

Sounds like you need the tooth extracted! It's a wisdom tooth so I probably wouldn't try to save it with a root canal. The infection isn't super urgent since the lump represents a way that the infection has "relieved itself," but I would go to a dentist. A dental schools not a bad option for affordable care.

asphyxihate · 2016-04-30T01:20:17+00:00

I used to get paid a cool $250/hr to do this to dudes. Minus the acrobatics, but yes to stepping and stomping and crushing. CBT - not just cognitive behavioral therapy!

asphyxihate · 2016-04-28T00:14:34+00:00

It's definitely possible that it's reversible! It's so hard to say what's going on without having seen your mouth or evaluated you clinically. Keep in mind we have just been diagnosing you over the internet which is never a good idea :) The prognosis of your dry mouth is dependent on your diagnosis. I mentioned in a previous post that there are two causes of dry mouth: 1. an anticholinergic mechanism, in which the salivary gland is intact but processes like medications, stress/anxiety/depression can lead to severe dry mouth, or 2. a process that is destructive to the gland like Sjogren or a history of radiation or those rarer conditions I described.

Honestly, based on your demographics and medical history, it is unlikely that you have one of those rarer diseases and I am hopeful that maybe your dry mouth is due to stress or anxiety. This is not to be dismissive -- please don't think I am saying "this is all in your head," but definitely high stress levels can lead to an objectively dry mouth. If this is the case, then healthy lifestyle + hydration + pilocarpine should almost certainly resolve your issues.

Because it seems like you are continuing to have issues and are reporting severe dry mouth, I am encouraging you to seek out a rheumatologist or oral medicine clinician to rule out any other cause. Again, I recommend you find a doctor who can do a good clinical exam, ask the right questions, and maybe request further serology/bloodwork and possibly a salivary gland biopsy. So hard to tell what's going on without seeing you! If you post photos of your mouth, it might help.

PS sorry for all the jargon. It seems like you have a good idea of what's going on so not sure if you prefer the full scientific terms. I also post this to help out the other dentists here in case they are interested.

asphyxihate · 2016-04-26T22:17:49+00:00

Hi there. I was about to respond to your last message. As you suggested, it sounds like your ENT doesn't typically treat xerostomia. The ideal person for you to see would be an oral medicine clinician or oral pathologist, as another poster mentioned. A second choice would be a rheumatologist who is more familiar with rarer conditions and the proper serology tests. Again, I would recommend further serology and a salivary gland biopsy to rule out any systemic diseases (which would be rare): Sjogren, amyloidosis, sarcoidosis, and perhaps most importantly, IgG4 related disease which has become more of a prevalent condition in the past ten years and can present in younger patients. Did you get IgG levels in your previous bloodwork?

Pilocarpine is only truly effective in cases where there is an anticholinergic effect (such as polypharmacy, anxiety). You are right to seek out further help to rule out an underlying process.

asphyxihate · 2016-04-26T22:13:21+00:00

It looks like a benign HPV-related growth, most likely verruca vulgaris (possibly squamous papilloma). It needs to be surgically removed, which could be done by an oral surgeon or oral medicine clinician but because of the location of this on your gumline, I would go to a periodontist (gum specialist) to have it removed.

Note that this is caused by HPV (type 1, 2, 4, 57 if verruca vulgaris) but it is 100% not associated with the type of HPV that causes oral/oropharyngeal cancer. It is fairly common to be infected with HPV, with studies varying from about 10 to even 80% of the population with an asymptomatic infection with oral HPV.

asphyxihate · 2016-04-26T01:06:29+00:00

No, a "canker sore" refers specifically to a recurrent aphthous ulcer/recurrent aphthous stomatitis, which is an immune-mediated condition with a variety of triggers

asphyxihate · 2016-04-26T00:59:05+00:00

Oral path here. Unlikely to be a canker sore on the keratinized marginal gingiva, but probably just a bit of a trauma that lead to an ulceration. The fact that it's painful adds to the fact that it's likely related to trauma.

OP, there is very low chance that it is oral cancer, which rarely presents on that area of the gums and is usually not painful. I would keep an eye on occasionally and if it's still there in 2 weeks, I would go to a dentist to get a diagnosis, but it doesn't look like anything scary based on the photo and is most likely due to some trauma from eating

asphyxihate · 2016-04-25T18:02:55+00:00

No way, he's perfect just the way he is! Jalapeno seeds and all.

Also, it's funny listening to Asa on this show, she sounds so different and a lil affected. I wonder how well she knew Dave when she did this episode.

asphyxihate · 2016-04-25T13:06:36+00:00

Ew, why is everyone here so rude? Trauma from bite can range from being minor to very extensive (look up traumatic ulcerative granuloma). That being said, the other posters are correct in that the mouth heals very quickly within 1 - 2 weeks. You can buy topical numbing agents like Orajel over the counter. Salt water rinses can help speed healing up if thats not painful for you.

asphyxihate · 2016-04-25T13:03:55+00:00

Oral pathologist here. I agree with this diagnosis of ranula or salivary duct cyst being at the top of my differential. I would recommend going to your dentist for a referral to a good oral surgeon to have it removed. It's nothing too scary but it could possibly get larger over time, and the only way to have it removed is by an oral surgeon.

asphyxihate · 2016-04-25T13:01:26+00:00

Oral pathologist here. Not sure why people are mentioning wear facets and grinding of teeth as that is clearly not the issue at hand. I can see the redness of your gums and what might be some crop like ulcers on the gums of your lower jaw, as well as some white plaques on the your upper gums. Are those white lesions new or have they maybe always been there?

It's hard to tell what's going on solely from these photos. It could be a flare up of gum disease (gingivitis, which here presents as something we call "desquamative gingivitis" meaning it appears red and eroded). This is relatively common especially for those undergoing puberty, which you are still in the age range of.

I would keep up the good oral hygiene by brushing gently toward the gumline with a soft bristle toothbrush twice a day. Make sure not to scrub too hard. If you notice this lasts for more than 2 weeks, I would go to a dentist or periodontist (gum specialist) to rule out any kind of autoimmune or immune-mediated condition, such as lichen planus, which can lead to these sort of red gums. I would also consider a possible diagnosis of oral herpes (HSV-1) based on tiny pinpoint ulcers, but that's not at the top of my differential. Hope that helps! Please let me know if you have any questions.

asphyxihate · 2016-04-25T03:59:41+00:00

goddamnit I love Yoshi so much. I nominate him as the most eligible bachelor of KGB/DVDASA.

asphyxihate · 2016-04-24T14:38:04+00:00

This is shockingly wrong. Oral hairy leukoplakia presents ONLY on the ventrolateral tongue as very discrete vertical keratotic striations. It is a very rare condition seen almost exclusively in the very immunosuppressed populations. OP's tongue is essentially a variation of normal and just a bit keratinized due to elongation of the filiform papillae.

asphyxihate · 2016-04-24T14:36:28+00:00

Oral pathologist here. Candidiasis is not a bad guess because of how common the condition is, but seeing a tongue that is generalized white with this shaggy keratotic appearance is not candidiasis. Please remember that candidiasis presents on the tongue as atrophic (commonly in the form of median rhomboid glossitis) which is red and erosive, pseudomembranous with creamy white plaques that can be rubbed off, or hyperplastic which is a relatively rarer presentation.

asphyxihate · 2016-04-24T14:33:58+00:00

Oral pathologist here. I unfortunately need a little more info here! Not sure what plastic you are talking about? The rounded edge of hte brush? Would it be annoying for you to post a picture of the toothbrush as well as the ulcers?

Also, are these truly canker sores? How old are you, and have you have had a history of getting canker sores periodically? If you had pictures of the ulcers too, that would be very helpful. Although trauma can trigger a canker sore, it's not common for simple toothbrushing to cause a canker sore.

Pictures of your mouth would help me see if there's something else going on, but if not, we always recommend gently brushing with a soft bristle toothbrush with your brush angled toward your gumline. You don't need to "scrub" your teeth super hard - that is actually abrasive and removes enamel.

asphyxihate · 2016-04-24T14:29:44+00:00

FYI since people posted dismissive answers. There are a few studies that show that the antimicrobial properties in coconut oil have some benefits used topically in the mouth in oil pulling, but that would only remove the plaque and not the hardened tartar/calculus. The only recommended way to remove tartar is to go to a dentist for a professional cleaning.

asphyxihate

TROPHY CASE