What Causes White Spots on Gums?

The most common sites of white spots are the oral mucosa of the cheeks, back of tongue, abdomen of tongue, lips, palate, floor of mouth, gums, etc., but they can also occur in other parts. Some types have more specific parts: granular white spots are more common in the buccal mucosa of the corner of the mouth; wrinkled white spots are more common at the bottom of the mouth and tongue and abdomen; warty white spots are more common in the gums. The location of white spot is different from that of keratosis, and there is nothing in common in morphology and texture.

Mucosal leukoplakia

Mucosal leukoplakia are white patches that occur on the mucosa, but as a disease, it mainly refers to those leukoplakia that are characterized by hyperkeratosis and epithelial hyperplasia. For example, vitiligo can also occur on the mucosa, but its histological changes are mainly loss of pigment, and generally do not have excessive keratosis and other manifestations, so it does not belong to mucosal white spot disease. The leukoplakia of the dermatology includes lesions of the oral cavity and vulva. Many medical scientists have regarded leukoplakia as a precancerous lesion in the past, but after a large number of observations and studies, it has been proved that most of the leukoplakia are benign.

Overview of mucosal leukoplakia

In addition to microabscess and abnormal epithelial hyperplasia, candida albicans can also be identified by periodic acid Schiff staining or culture to identify pathogens in the tissue. From the location of the disease, the texture of the lesion, and the sharpness of the border, it can distinguish white spots from white angle Chemical disease, histological examination is more clear.

Causes of mucosal leukoplakia

The true cause of mucosal leukoplakia is unknown, but it is generally believed to be related to the following factors. 1. Mechanical stimulation. The patient's teeth are not aligned or the dentures are installed irregularly. The protruding teeth or dentures rub the mucous membranes for a long time and form white spots over time.

Mucosal leukoplakia

2. Too much alcohol and tobacco. The patient has a long history of smoking or drinking (hard alcohol), or he likes to eat fried and spicy foods, which will cause some irritation to the oral mucosa.

3 bad habit. Patients often do not brush their teeth and gargle, making the mouth dirty, or not cleaning the vulva, so that vulvar secretions remain, and eventually cause the disease.

4 Chronic inflammation. Chronic diseases of the oral cavity, such as gingivitis, periodontitis, etc., and chronic diseases of the vagina, such as vaginitis, cervicitis, etc.

5. Other factors. Some patients are genetically related, or are associated with vaginal atrophy in the elderly.

TCM believes that the occurrence of this disease is caused by over-consideration, unhappy mood, stagnation of liver qi, or ordinary indulgence in spicy and hot taste, heart-fire, liver-fire, pathological inflammation, accumulation of heat and humidity, meridian emptiness, and damp-heat betting. This leads to oral and genital diseases.

Clinical manifestations of leukoplakia

The disease occurs in the lower lip, gums, cheeks, and dorsal mucosa of the oral cavity, and in the vulva or vagina of women, occasionally on both sides of the glans or foreskin of men.

The early damage is that the affected area is pale white dots or thin strips without any conscious symptoms. Later, the affected area is gradually sensitive to hot diet or salty and spicy food. After a few months, patches of uneven milky skin-like flat ridges appeared on the mucous membrane, or they merged into a large piece. The surface tends to be shiny, and it will become thicker and harder in the future. It will stick to the mucous membranes, and strong scraping will cause bleeding. At this time, itching and tenderness, congestion, swelling, redness, and minor trauma caused by scratching the affected part caused bleeding, and severe cases had cleft palate or ulcers. Buccal leukoplakia can be mistaken for buccal lichen planus or candidiasis. Vulvar mucosa leukoplakia should be distinguished from genital dryness, vitiligo, atrophic sclerosing moss, and candidiasis, and some should be distinguished from discoid lupus erythematosus.

Leukoplakia diagnosis

Because a variety of diseases and factors can cause white damage on the oral mucosa, the differential diagnosis of white spots is mainly distinguished from other keratotic white lesions on the oral mucosa. For long-term unhealed white spot disease, histopathological examination should be performed to rule out canceration.

(1) Oral Candida infections are difficult to identify clinically, but there is no atypical hyperplasia in histology. Candida pseudohyphae can be found.

(2) No abnormal proliferation of oral lichen planus epithelial cells, liquefaction and degeneration of basal cells, and dense band infiltration of lymphocytes in the upper part of the lamina propria.

(3) White sponge nevus is a hereditary disease and is relatively rare. Occurs frequently in babies and a few occur in adolescence. The lesions affected the entire oral mucosa, and the white lesions were thick and spongy. If it occurs in a patient over 40 years of age, the lesion is limited to part of the oral mucosa.

Mucosal white spot prevention measures

1. Protect your teeth. Irregular teeth, especially those with abrasion of the oral mucosa, should be corrected as soon as possible, and damaged or residual teeth should be referred to a doctor and

Mucosal leukoplakia When repairing, the installation of dentures should be regular, not too large or crooked, so as to avoid bruising to the mucous membranes.

2. Develop good hygiene habits. Pay attention to oral hygiene, develop a habit of brushing and rinsing your teeth sooner or later, keep the vulva clean, clean the vulva regularly, and change underwear and underwear frequently.

3 Pay attention to diet hygiene. Quit smoking and alcohol, and eat less or spicy foods, such as spicy food, should not overheat.

4 Treatment of chronic inflammation. Chronic infections of the oral cavity and inflammation of the genitals should be detected and treated in time to avoid jeopardizing the disease.

Treatment of mucosal leukoplakia

1. Anti-infective treatment. When there is a large amount of purulent secretions in leukoplakia infection, antibiotics can be used. For example, amikacin 2.5 g is added to 250 ml of 5% dextrose saline intravenously, twice a day; 0.5 ml of metronidazole 100 ml is administered intravenously. Once a day, the two drugs can be used continuously for 5 to 6 days. 2. Topical drugs. For severe itching of genital leukoplakia, you can use 1: 5000 potassium permanganate solution for external washing, or use traditional Chinese medicine ground skin 30g, snake bed 30g, white moss skin 30g, flavescens 30g, alum 15g, dandelion 30 G, moonstone 15 g decoction fumigation, twice a day for 7 days; oral mucous membrane white spots, can be used Qingfan mouth to loosen .

3 Surgery. Electrocautery and liquid nitrogen condensation therapy can be used to treat leukoplakia. If there is papillary proliferation, surgical resection should be performed, and leukoplakia should be performed for those with suspected cancer.

4 TCM syndrome differentiation and treatment. Occurs in white spots in the oral cavity, accompanied by irritable temperament, disturbed sleep at night, dry mouth, red tongue, and carditis of heart, spleen, liver, and fire. It is recommended to nourish yin and clear heat and detoxify plaques. 12 g of raw land, 12 g of black ginseng, wheat Winter 15g, Zhimu 10g, Cork 10g, Salvia 15g, Baiziren 10g, Jujube Kernel 10g, Trichosanthin 15g, Gypsum 30g (first frying), Coptis 6g decoction for oral administration; white spots on the vulva, Accompanied by erosion, exudate, pruritus, the syndrome belongs to liver and spleen dampness and heat betting, and the spleen and spleen should be cleared, heat and dampness should be selected. Codonopsis 12 grams, 10 grams each of Pale Atractylodes, 20 grams of Chinese yam, 10 grams of Zhimu, and 10 grams of cork , 10 grams of gentian, 10 grams of comfrey, 12 grams of cordyceps, 10 grams of ginseng, 10 grams of tincture, 6 grams of raw licorice.

Mucosal white spot disease population

The disease mostly occurs in adults over 40 years of age.

Oral leukoplakia is more common in male patients and can occur on the palate, cheeks, gums, tongue or sides, and lips. Localized angle visible on mucosa

Mucosal leukoplakia Excessive hypertrophy, hypertrophy, whitening, can be single or multiple, different sizes and shapes, point-like, flaky, plaque-like or diffuse into a diffuse lesion, shallow clefts and small ulcers can occur over time. Generally asymptomatic or with mild pain.

Vulvar leukoplakia is more common in women after amenorrhea, and mainly occurs on the inside of the clitoris, labia minora, and labia majora. Sometimes it occurs in the vestibule, vagina, and urethral opening. Partially, it is usually white keratinizing damage, and it can also be gray-white, gray-blue, or purple-red. Early hyperkeratosis and hypertrophy. Atrophic lesions can occur at later stages, causing vulvar stenosis. Patients are often accompanied by local itching, which can be followed by infection, ulceration, or eczema.

Mucosal leukoplakia

More common in middle-aged men and older, mainly in the cheeks, lips and tongue mucosa, followed by hard palate, gums, etc. The lesions were white patches, single or multiple, the realm was unclear, and the edges were slightly raised. In the later stage, the leukoplakia thickens, which can produce superficial fissures and small ulcers. It is usually without symptoms and may also have a tingling sensation or mild pain.

Mucous membrane leukoplakia

We know that leukoplakia includes lesions in the oral cavity and vulva. The leukoplakia mainly occurs in women, so it is also called genital leukoplakia.

The genital leukoplakia has been used in the clinic since 1885. At first it only referred to the white keratosis of the female perineum, and more in-depth observation and research was later. Dermatologists have long considered leukoplakia as precancerous lesions for a long time, and believe that 20% to 30% will eventually develop into cancer. In fact, to this day, the medical community has not formed a unified understanding of the definition, scope, diagnostic criteria and whether it is a precancerous lesion. Many studies have proven that the overwhelming majority of leukoplakia are not precancerous lesions.

However, the necessary tests and monitoring are still needed because the possibility of cancer still exists. At the same time, systemic diseases should be actively treated, and the vulva should be washed frequently to keep it dry and clean. If the local pruritus is obvious or accompanied by infection, it can be treated with Chinese and Western medicine under the guidance of a doctor. Surgical resection should not be performed blindly.

Leukoplakia

Oralcukoplakia is an internationally recognized precancerous lesion. Oralcukoplakia is closely related to smoking. Smoking is an oral mucosa

Mucosal leukoplakia The direct cause of white spots. Because tobacco contains phenols, aldehydes, organic acids and other substances. Long-term smoking, the toxic substances in tobacco can stimulate the oral mucosa and directly attack the oral mucosal epithelial cells to change them. From a clinical perspective, the mucous membranes of the gums and cheeks of the smoker are red with blue-purple and edema This is oral mucositis caused by smoking. In the long-term, it can also cause abnormal hyperplasia to form white spots. In addition, high temperatures can cause burns in the mouth's mucous membranes when smoking. Kwon and other researchers believe that the oral mucosa is stimulated by smoke for a long time, which can cause excessive keratinization of the mucosal epithelium. The abnormal mucosal hyperkeratosis caused by this kind of tobacco can promote the occurrence of white spots in the oral mucosa. The risk of leukoplakia is significantly higher than that of non-smokers, which is related to smoking style, length of smoking, and amount of smoking. Dry smoking, the longer the smoking time, the greater the amount of smoking, the higher the possibility of suffering from white spots. In a case-control study, Shah et al. found that long-term smoking and oral submucosal fibrosis have a direct correlation. Andresson [11] and other studies have shown that different levels of nicotine in tobacco have different degrees of damage to oral mucosa. The higher the total daily nicotine exposure, the more severe the damage.

Fang Xiangzhong reported that China's Oral Mucosal Disease Collaborative Group conducted an epidemiological survey of leukoplakia caused by smoking and related factors in 134.942 different people in Beijing, Shanghai, Xi'an, Wuhan, Guangzhou and other regions, and found that there were 14.076 people with leukoplakia in the oral mucosa. The rate is 1.47%, of which the prevalence of males is 14.78% and that of females is 2.11%. Among them, 15 cases of suspicious cancerous patients accounted for 0.11%. The survey showed that among those who had smoking habits, the prevalence of white spots was 25.25%. 19.49% of women, and 3.5% of white spot prevalence among men without smoking habits, and 1.38% of women, and the prevalence of white spot among dry smokers was higher than that of paper smokers. To be high, the difference is very significant. ^[1]