Mouth Problems

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Mouth problems, such as sores, are very common. Follow this chart for more information about mouth problems in adults.

SYMPTOMS DIAGNOSIS SELF-CARE
Begin Here

1. Is the person an infant or child?


Yes

See "Mouth Problems in Infants and Children."

No

2. Do you have pain in your mouth?


Yes

Go to Question 6.*

No

3. Do you have painless white or gray sores that may have a hard, raised coating on the tongue or the inside of the cheeks?


Yes

This lesion may be a precancerous LEUKOPLAKIA, more common in those who use tobacco.

See your doctor. Stop smoking or using other tobacco products to help prevent oral cancers. See your dentist if sharp or rough teeth or dental work are causing irritation.

No

4. Do you have a painless lesion, growth or lump on the lip or face?


Yes

This may be SQUAMOUS CELL SKIN CANCER.

See your doctor. When there is any change in the color, size, texture or appearance of the skin, or if there is pain, itching or bleeding from a lesion, lump or mole, see your doctor.

No

5. Do you have a painless, fluid-filled sac that may be bluish in color on the inner lips, gums, palate or under the tongue?


Yes

This may be a MUCOCELE, a harmless cyst that may be caused by sucking mouth tissue between the teeth.

These cysts usually go away on their own. To avoid infection, only a doctor should open these cysts.

No

*6. Do you have pain or swelling under your tongue or in your cheek, especially while eating or drinking?


Yes

This may be a blockage in a salivary duct, possibly caused by a SALIVARY DUCT STONE.

See your doctor.

No

7. Do you have small open and painful sores that are white or yellowish with a red border on the inner lips or cheek, gums or tongue?


Yes

These may be CANKER SORES. They may be caused by viral infections.

Canker sores usually heal on their own. To relieve discomfort, rinse with salt water or diluted hydrogen peroxide, or apply an over-the-counter oral gel. You may also use an analgesic such as acetaminophen or ibuprofen to relieve pain. See your doctor if your symptoms don't improve.

No

8. Do you have a sore that is red and crusted on your lip or on the outer edge of your lips?


Yes

This may be a COLD SORE, caused by a type of HERPES VIRUS.

Cold sores usually go away on their own. Analgesics, such as acetaminophen, and cold sore ointments can help relieve the discomfort.

No

9. Do you have a red, swollen tongue or lips?


Yes

This may be an ALLERGIC REACTION to a medicine or another ALLERGEN.

URGENT
See your doctor or go to the nearest emergency room right away if you have any trouble breathing. An antihistamine may help relieve other allergy symptoms.

No

10. Do you wear dentures that seem to rub your gums or irritate your mouth?


Yes

MISFITTING DENTURES can cause mouth pain.

See your dentist.

No

11. Do you have red and swollen gums that may bleed when you brush or floss?


Yes

You may have GUM DISEASE such as GINGIVITIS or PERIODONTITIS, or a CAVITY, usually caused by poor ORAL HYGIENE.

See your dentist. Good oral hygiene, such as regular brushing, flossing and dental checkups, and eating a healthy diet can help prevent gum diseases.

No

12. Do you have small, painful bumps on your tongue?


Yes

These bumps are probably INFLAMED PAPILLAE (where the taste buds are) due to an injury from a burn caused by hot food or drink, or a self-inflicted bite.

The inflammation and bump will usually go away on its own. Avoid hot, spicy and acidic foods. Use an analgesic, such acetaminophen or ibuprofen, to relieve pain.

No

13. Do you have creamy white patches on the tongue, inner cheek or gums that are painful when scraped?


Yes

This may be CANDIDIASIS (ORAL THRUSH) caused by a fungus growing out of control.

This condition usually goes away on its own. Eat unsweetened yogurt with live cultures to restore the natural balance of bacteria in your body. Gargle with salt water or use analgesics, such as acetaminophen, to relieve discomfort. If your symptoms get worse or don't improve, see your doctor. He or she may prescribe an antifungal medicine.

No

14. Do you have raised patches of white lines or bumps that may also include red open sores on the inside of your cheeks or sides of the tongue?


Yes

You may have ORAL LICHEN PLANUS, an inflammatory condition that may have many causes.

This condition may go away without treatment. Practice good oral hygiene, such as regular brushing and flossing, don't eat foods that irritate your mouth, limit alcohol consumption, and stop smoking. See your doctor if your symptoms get worse or don't improve.

No

15. Do you have a burning sensation in your mouth that may involve several areas?


Yes

You may have BURNING MOUTH SYNDROME (BMS).

See your doctor. Treatment often depends on underlying causes. Stop smoking or using other tobacco products. Their use may be the cause or may make the problem worse.

No

16. Do you have cracking or open sores in the corners of your mouth?


Yes

These tender sores may result from a vitamin deficiency or from chapped lips.

Use a soothing ointment on these cracked areas. Take riboflavin and/or a multivitamin if you think your diet isn't adequate. See your doctor if your symptoms don't improve.

No

See your doctor if you have a mouth or lip sore that doesn't heal. This may be a sign of oral cancer. For more information, please talk to your doctor. If you think the problem is serious, call your doctor right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

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