Doctors who can solve gum infection that won't heal
September 22, 2018 11:03 AM   Subscribe

I have been to multiple dentists, otolaryngologists / Ear Nose Throat specialists, a gastroenterologist, an allergist to try to identify and treat my medical problem. Does anyone know of a doctor in the Midwest region of US who treats gum infection that won't heal? I've had my salivary glands inspected, but no one can figure out what's causing my constant pain and whether it's originating in my lymph nodes or if something else is causing it and the lymph pain is a side effect of whatever the actual problem is. It feels like one of my submandibular glands is constantly in pain, but I have sores near my back molars that don't seem to go away. Is it gingivitis and is there a comprehensive treatment for that besides having excellent oral hygiene practices which I implement already? Or what else causes a gumline painful lesion that could make my lymph glands swollen chronically?

Mostly I am looking for a specific doctor or doctors who have experience with treating such a health issue. But also a doctor who has experience identifying what the cause is in the first place.

Ideas for what is ailing me? Suggestions for specific doctors (by personal name or practice) who can cure what I think is potentially some kind of gingeval infection of some unknown type? Is gum cancer a thing? What else could cause a painful gum lesion that never (think: years) heals?
posted by anonymous to Health & Fitness (9 answers total)
What is the status of your wisdom teeth? Because in my mid-20s and early 30s -- with all four of my wisdom teeth emerged, and causing no obvious problems -- I had recurring infections in my salivary glands and problems in the back of my mouth that my dentist, ENT and other docs attributed to various causes. They would go away but recur and it definitely felt like something I was gonna have to manage for the rest of my life. It wasn't until I had another instance and asked a GP for antibiotics that he said, "This is all being caused by your wisdom teeth."

I had all four out at once, over 15 years ago, and haven't had a single problem since then.
posted by BlahLaLa at 11:30 AM on September 22, 2018

It might be helpful if you have had(and provide) definitive "rule outs" by one or, hopefully, more physicians. If there is a chronic lesion/sore I am guessing that malignancies have been considered by most of the specialists--also--has there been xrays/lab tests that have provided conclusive rule outs. Assuming you have confidence in these physicians, there has been no improvement and this is causing ongoing distress/limitations I would consider something such as MAYO, Cleveland Clinic or the outpatient programs and the closest well established medical schools--you might also consider requesting an appointment at a nearby dental school and indicate when scheduling that this has been a chronic issue unresponsive to intervention and you are not needing specific dental work--I assume they have specialists in diseases of the oral cavity--in any case a referral(formal/informal) by one of the physicians you have seen would be helpful.
posted by rmhsinc at 11:38 AM on September 22, 2018

There are some autoimmune diseases that cause mucousal sores. Any other symptoms? Have you seem a good GP or rheumatologist / dermatologist? The GP can run a lot of the same blood tests a rheum can for diagnostic purposes and will be easier tho get in to see. If anything pops up they will refer you.
posted by fshgrl at 11:47 AM on September 22, 2018

You do not mention periodontists in the list of doctor types you have consulted- are you including them in "dentists"?
posted by thelonius at 11:53 AM on September 22, 2018 [2 favorites]

Have you been screened for HIV?
posted by DarlingBri at 12:17 PM on September 22, 2018 [1 favorite]

A dentist (i am one) or ENT, or allergist or any specialist should work through a differential diagnosis based on your signs/symptoms, lab results, biopsy results, etc. You should, if you are communicating with them well, have some ideas as to what it isn't by now, and what it might possibly BE.
A multidisciplinary approach is a good one for rare or mysterious conditions. it might be reasonable to go to a dental school, where you can be seen by an oral pathologist, oral surgeon, periodontist and general dentist all under one roof, or a teaching hospital for the same reasons.

There simply isn't enough info in your post to even hazard a guess, and even if there were, internet guesses aren't worth the space they take up.
posted by OHenryPacey at 12:46 PM on September 22, 2018 [2 favorites]

Mostly I am looking for a specific doctor or doctors who have experience with treating such a health issue

Oral Medicine is the discipline of dentistry concerned with the care of medically complex patients - including the diagnosis and management of medical conditions that affect the oral and maxillofacial region.

Qualifying as an oral medicine specialist requires 2 years of advanced training after dental school.

Google "oral medicine specialist near me"
posted by BadgerDoctor at 1:40 PM on September 22, 2018

A dentist (i am one) or ENT, or allergist or any specialist should work through a differential diagnosis based on your signs/symptoms, lab results, biopsy results, etc.

They should but they don't. I've had a rash on my legs for 2 years and have seen multiple doctors and not one of them, except my GP, has done anything systematic at all. They just test for the one or two things they specialize in then say nope, sorry and send you on your way. And the systematic thing my GP is doing is just sending me to specialists. Sometimes you have to be more proactive or just lucky enough to find the one specialist who treats the disease you have.

I haven't even had a biopsy yet because the rash wasn't that bad the day I saw the dermatologist and he hadn't received my records and of course it's a 3 month wait to get back in when the rash does come back. Doctors have a very rosy view of how referrals work, ignoring the fact they don't even review them most of the time or follow up
posted by fshgrl at 5:41 PM on September 22, 2018

Have you ever taken a round of antibiotics, and the lesions go away?
I had a persistent infection in two molars that previously had root canals. This pain was chronic and nagging. I would feel sore down the right side of my neck and into my chest.
Once a bump appeared on my gum, a round of antibiotics tamed the pain. The teeth had to be pulled and eventually, implants placed.

This makes very little sense; after a root canal on each molar, there was no good reason for an infection to be present. But... it happened. My PCP was useless in this situation; I relied on my dentist and my oral surgeon for treatment. I suffered for about two years until this was resolved.
posted by FergieBelle at 3:47 PM on September 23, 2018

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