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Dental and Oral Health (Adults)

Bumps and Cheilitis

07/27/2009

Question:

I am a 38 y.o. male. About eight months ago, the corners of my mouth began to chap and were slightly painful. That had never happened to me before so I decided to see a physician. I was told it was angular cheilitis and probably caused by a vitamin deficiency. I was givin an anti-fungal Rx and a vitamin Rx. I feel and look healthy, eat healthy and I take a multi-vitamin/multi-mineral every day, so I was very surprised to hear what the likely cause was. Nonetheless, I followed the Dr`s instructions and the chapping went away. About a week ago it started to happen again. I still take my vitamins and feel in great shape otherwise, so I started looking around my mouth. I noticed enlarged bumps on the top rear of my tongue. I take care of my mouth and gums (never had a cavity) and do look in and around my mouth from time to time. I have never seen these bumps before and I am getting scared. Today also noticed some very small red spots (like blood) on the inner part of my cheek. What in the world could this all be. Could these three things be unrelated? Could it be an STD? Maybe I`m overreacting...

Answer:

It is highly unlikely that your angular cheilitis is due to vitamin deficiency. Yeast infection of the oral mucosa is quite common, even in normal, otherwise healthy individuals. The yeast that causes angular cheilitis (Candida albicans) is a very common part of the normal microflora (yeasts and bacteria) that live in or on our bodies, and it is impossible for anyone to avoid being exposed to this organism. 

The bumps on the rear part of your tongue are what are known as circumvalate papillae, and these are normal structures that have been there for your entire life. Most people don't critically examine their mouths to the extent that such normal anatomic structures are recognized. 

The red spots on the inner cheek undoubtedly are little bruises where the cheek has been pinched by the teeth. 

If you are still concerned, you should make an appointment to see an oral pathologist. Oral pathology is the only specialty of dentistry or medicine that focuses on the diagnosis of oral disease.

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Response by:

Carl M Allen, DDS, MSD Carl M Allen, DDS, MSD
Professor of Oral Pathology
College of Dentistry
The Ohio State University