American Medical Association Family Medical Guide - American Medical Association [481]
Treatment
The treatment of leukoplakia depends on the cause. If leukoplakia is the result of smoking or using tobacco, your doctor will recommend that you stop immediately. He or she may remove the patches with a laser (a highly concentrated beam of light). If the leukoplakia is the result of a dental problem, your dentist can smooth the tooth or adjust the denture that is causing the irritation.
Oral Lichen Planus
Lichen planus is a skin disorder that can affect the lining of the mouth. Half of all people who have oral lichen planus also have lichen planus of the skin (see page 1071). The cause of lichen planus is unknown, but it seems to be triggered by a weakened immune system. An outbreak usually lasts about 9 months; in rare cases, it can last several years. The disorder occurs most often in middle-aged and older women but can also develop in young people. Less than 5 percent of cases of oral lichen planus develop into cancerous tumors (tumors of the mouth and tongue; see page 747).
Symptoms
The symptoms of oral lichen planus are often unnoticeable and may include only thickening and hardening of the lining of the mouth. In rare cases, symptoms can include small, pale pimples that gradually join to form either a thin, white, lacy network or shiny, red patches of slightly raised tissue (usually on the inside of the cheeks and the sides of the tongue). You may also have a sore mouth and a dry, metallic taste in your mouth. Symptoms can develop suddenly. See your doctor about any sore or swelling in your mouth that recurs or that doesn’t heal within 2 weeks.
Diagnosis and Treatment
Doctors usually can diagnose oral lichen planus by its appearance. The doctor may take a sample of tissue from the affected area for examination under a microscope (biopsy) to confirm the diagnosis and to rule out other disorders.
The treatment of oral lichen planus depends on the cause. The symptoms of the disorder can usually be relieved, but the condition itself cannot be cured. Your doctor may prescribe a topical or oral corticosteroid to reduce inflammation or a pain reliever. If the disorder is caused or worsened by a dental problem such as a jagged tooth or a poorly fitting denture, the doctor will recommend that you see your dentist.
Infections of the Salivary Glands
The most common cause of a salivary gland infection is the viral infection mumps (see page 440), but a salivary gland infection can also be caused by bacteria. A persistent salivary gland infection can cause extensive scarring in the affected gland and prevent the gland from producing saliva.
Symptoms
Symptoms of a salivary gland infection include swelling and pain on each side of the neck below the jaw, or above the angle of the jaw. You may have a bad taste in your mouth from pus discharged by the infected gland. Eating spicy foods or citrus fruits increases the flow of saliva, which can cause swelling if the gland is completely or partially blocked. See your doctor about any swelling in your mouth that recurs or that doesn’t heal within 2 weeks.
The salivary glands
The mouth contains three pairs of salivary glands: the parotid glands, the submandibular glands, and the sublingual glands. All of the salivary glands secrete saliva, which contains a digestive enzyme that helps break down carbohydrates. Saliva also keeps the mouth moist and lubricates food for swallowing. The parotid glands, the largest salivary glands, are just below and in front of the ears. The sublingual glands lie just beneath the tongue toward the front of the mouth. The submandibular glands lie deeper than the sublingual glands at the back of the mouth and can be felt beneath the jaw.
Diagnosis
If you have symptoms of a salivary gland infection, your doctor will look for swelling, tenderness, and redness in the glands and pus flowing from your salivary ducts. (He or she will massage the glands to see if pus comes out.) If the infection has persisted for a long time, your doctor may recommend