Ash-colored patch spreading inside mouth with gum pain and burning sensation - #10772
Initially, I noticed a small ash-colored patch on the inner skin between my side jaw and cheek around a year ago. Over time, it slowly spread and now affects a larger area inside my mouth, including the inner cheek and jawline. The affected area is grayish/ash-colored, painful while chewing, and very sensitive to spicy or hot food. I also feel gum pain and skin irritation on that side of my mouth, but there’s no visible swelling outside. The discomfort has been persistent for a long time and affects my daily eating. I consulted a doctor earlier, and they prescribed Kenacort New 0.1% Buccal Paste, which contains Triamcinolone Acetonide 0.1% w/w, along with some mineral tablets. However, I didn’t find any significant relief, so I discontinued it. Lately, I’ve been using home remedies like turmeric paste application and warm salt water gargling, which give temporary relief but don’t solve the problem. It’s been over a year, and I am worried as it’s spreading inside the mouth. I would like to know what this could be, whether it's serious, and what treatment or further investigation is recommended. Please help.
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Doctors’ responses
Hello dear Please be advised See as per clinical history it seems either lichen planus or intradermal nevus Differential diagnosis includes oral submucous fibrosis Since you haven’t shared any clinical pic so I cannot confirm the exact diagnosis Kindly share clinical pic since all the above conditions are premalignant and biopsy or fnac may be required Regards
These signs suggest this is not a simple irritation or allergic reaction. It can be - 1.Oral Lichen Planus (Erosive/Atrophic type) Autoimmune inflammatory condition. Presents as white/gray patches, burning, pain, sensitivity. Requires biopsy for confirmation. Chronic, may require long-term topical treatment and monitoring. 2.Leukoplakia (Potentially Premalignant) Non-scrapable white or gray patch. Often linked to chronic irritation or habits (tobacco, alcohol). Can show dysplastic or early malignant changes on biopsy. Oral Cancer (Needs to be ruled out) A persistent, non-healing, spreading lesion that does not respond to medication may warrant exclusion of early malignancy. Especially important if there are habits or a strong family history. Recommended Investigations 1. Incisional Biopsy Essential for histopathological diagnosis. Can distinguish between inflammatory, dysplastic, or malignant pathology.
Usually done under local anesthesia — a small portion of the lesion is sent for lab analysis. 2. Clinical Examination by an Oral Medicine Specialist or Oral Pathologist To check lesion characteristics, mouth opening, fibrous bands (if any), trauma sources, etc. 3. In some cases: Blood tests (vitamin deficiencies, diabetes), imaging (if deep tissue involvement is suspected). In the meantime Continue warm saline rinses (3x/day). Avoid tobacco, pan masala, spicy/hot foods, alcohol. Use bland toothpaste, avoid mouthwashes with alcohol. Avoid sharp or coarse foods that might irritate the area. Treatment till biopsy is done ---- 1.Tacrolimus 0.03% oral ointment 2.Apply a small amount with clean hands 2–3 times a day after meals. 3.Avoid eating/drinking for 30 min afterward. 4.Antoxid HC tablet once daily post meal (Zincovit tablet) Your symptoms are chronic, progressive, and unresponsive to initial therapy, with potential signs of a premalignant or autoimmune oral condition. A biopsy is not optional at this stage — it is the only way to get clarity and guide proper treatment.
Please don’t delay further — early diagnosis can make a major difference in outcome
As a dentist;A long-standing, ash-colored patch inside the mouth that is painful, sensitive to spicy food, and spreading could suggest a chronic inflammatory condition like oral lichen planus, or less commonly, precancerous changes—especially if it’s not responding to steroid paste like Kenacort. Since it’s persistent for over a year, it’s important to consult an oral medicine specialist or oral pathologist for a detailed evaluation, including a biopsy if needed. Early diagnosis is crucial to rule out anything serious and guide proper long-term treatment.
Hello,
Your condition could be :- 1. Fungal -> can be treated by Natifungal 2.lichen Planes -> steroids can help ( you alert used) 3.OSMF (Oral Submucosal Fibrosis) -> FNAC and follow up 4.LeukoplaKia-> have to remove
Means some alarming conditions also there, diagnose and treatment them earliest. Kindly consult Dental surgen / Orofavial surge
Avoid Irritants:
- Spicy, acidic, or hot foods.
- Alcohol-based mouthwashes.
- Tobacco/smoking (if applicable).
Supportive Care:
- Continue warm saltwater rinses.
- Consider soft diet to reduce trauma.
With regards
Oral Lichen Planus (OLP) – Most likely based on your symptom Or Leukoplakia / Erythroleukoplakia – Potentially pre-cancerous White/grey patch that does not rub off May slowly enlarge over time
Investigation Biopsy of the lesion Exfoliative Cytology / Smear Blood tests CBC, fasting sugar (rule out diabetes), Vitamin B12, iron studies
Treatment till biopsy is done Tacrolimus 0.03% oral ointment Apply a small amount with clean hands 2–3 times a day after meals. Avoid eating/drinking for 30 min afterward.
Antoxid HC tablet once daily post meal
DO: Eat bland, soft food Use a soft-bristle toothbrush Rinse with salt water or antiseptic mouthwash e.g., Betadine
When to Urgently Seek Help If lesion becomes ulcerated or bleeds
Mouth opening reduces
Sudden growth in size or thickness
Lymph node swelling in the neck
Kindly get biopsy done as it is growing since 1 year
Your symptoms describe an ongoing issue that could be linked to a condition like oral lichen planus, leukoplakia, or other oral lesions. Given the persistence, changes in color, and irritation with certain foods, it’s essential to re-evaluate the situation. An ash-colored patch could signify several conditions, some of which may have risk factors or complications that require closer monitoring. Conditions like lichen planus are chronic inflammatory conditions while leukoplakia sometimes can be precancerous.
You should schedule an appointment with an oral specialist or a dermatologist who specializes in mucosal diseases. A biopsy might be necessary to confirm the diagnosis and rule out any dysplastic or malignant changes. They may also recommend specialized imaging or further pathological studies. The triamcinolone was aimed at reducing inflammation and should be beneficial in cases of inflammatory conditions but might not have been the right treatment for what’s going on.
In the meantime, continue avoiding irritants like spicy, hot foods, tobacco, and alcohol, which can exacerbate the symptoms. Maintaining good oral hygiene and regular check-ups are also vital. A potential next step could be introducing a topical or systemic medication tailored to the specific condition identified by the specialist. This could include stronger corticosteroids, immunosuppressants, or other agents based on the findings. Avoid any delay in follow-ups as some conditions could progress or affect your oral health further. Monitoring changes in the lesion’s size, color, and texture is important since it aids the specialist in mapping the disease progression and evaluating treatment effectiveness.
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