QUESTION: I wanted to let you know what was going on with my husband. He went two weeks ago for his cleaning the dentist checked his tongue with the velescope. There was an area on his tongue that showed very dark under the velescope but it was hard to distinguish in normal light. I guess he was pretty sure it was just gt and told him to come back in two weeks. So he went back and even though the area was smaller and lighter under the velescope it was still present and there is a spot which he said is almost under his tongue which concerns him. He is now sending him to a oral surgeon for biopsy. This will be the second biopsy, first diagnosing inflammation consistent with gt. you can imagine my anxiety now. I didn't find this spot the dentist did and honestly I have no clue as to what area he is referring to. I go have the velescope images taken two weeks ago but they are so close up and just look like a large dark area. Could the velescope be showing dark like this bc the gt? My other concern is everytime he goes for a check up that portion of his tongue has shown dark under the velescope so I am not sure what's different this time around. In the past he has always dismissed this as gt like the dark area was normal. I just have a bad feeling about this. I honestly am scared to death. He is only 32 and we have two little girls. I just wanted to update you. I hope you still don't think I am completely crazy and obsessive.

Velescope images

Normal light two weeks ago

Normal light Monday

ANSWER: Dear Kim, thanks for the follow up.

Contrarary to what you think, I most certainly do not think you are crazy and obsessional thoughts and behaviour are sadly very much a part of our modern society.  All I wanted to do, was to make you aware of your tendency to become obsessive, which if left unmanaged, can wreck havoc in ones life by allowing yourself to dedicate too much of your time to entities which you simply have little or no control over.  I, myself, am prone to this type of behaviour, so its easy for me to spot the signs.  In hindsight, keeping a close and watchful eye on your husband's oral health the way you do, is far from the worst obsession one can develop and given his history, would not be the worst thing for him.  In fact, I think he is a very lucky man, to have such a concerned and dedicated partner looking out for his best interests.  At this point in time, I also feel that a biopsy might be indicated of the area - if for nothing else but to give you both the peace of mind which I know you need and want. Just remember that using the Velescope is not without its complications, as false positive and false negative results do occur and the degree of inter-personal variances in colour intensity may purely represent physiological differences and nothing more sinister. In my opinion, your dentist is covering himself by having the area biopsied in order to give yourself better clarity and confirmation of what the suspected pathology could be. So there is really no reason to panic or to allow your mind to go to places it really shouldn't, because in my opinion, if the area was malignant, the change would have been detected with much more certainty over the past few months - but there is no harm in getting 100% certainty on this now.  Just promise me that once you have the diagnosis, please let me know and then STOP contemplating or suspecting future oral lesions unless given prior confirmation by your dentist.  You are not befitting anyone, least of all yourself, by adding unnecessary stress to your life through this worry-cycle and you must then force yourself to break your mind-set and negative behavioural pattern in order to stop the obsession.  Hypnosis is very beneficial to help with this.  I hope this helps and wish you both all the very best further, take care and God bless.

Kind regards
Dr Craig Peck

---------- FOLLOW-UP ----------

QUESTION: Thanks. I am just overwhemled because for once the dentist is finding something in his mouth its just not me pointing something out. Since its not gone away in two weeks my mind goes to the worst possible senerio and I am driving myself nuts. I just wish I know the exact spot he was talking about then at least I could compare to previous photos to see if the area has always been that way or changing. We are going to go to the dentist the day before the biopsy which is on the 15th to see if the area is still dark and exactly which area it is so we can point it out to the oral surgeon. I have an area I am concerned about but its always been red like this. I am not sure if this is what he is talking about. He said it was aout 2-3cm and almost on the underside of the tongue. He said it wasnt very apparent in normal light and that it was red with a little bit of a white outline. I dont know what to do but this next week and half is going to drive me nuts. I am just holding on to the hope it will be gone and that it was just gt causing the darkness under the velescpe. I just dont get it bc its seems to always been dark and he has always dismissed it as gt. I have also pointed the area out in the photo for him to check and they said it was fine. So i dont know what to do. I wish this would go away and the anxiety would go away. Do you see anything in the pic which would make you think cancer and biopsy it? I just dont get it bc the first biopsy showed inflammation with gt. I have been dealing with this for two years and I dont want to obsess or worry anymore. I am scared. Thanks for letting me vent my anxiety and for helping me through this tough time.

Hi Kim.  Its only a pleasure to be able to help you out and hopefully ease some of your worries in the process.

As I said before, making a diagnosis of something so serious as cancer from a photograph alone, has to be one of the most heroic and brave things any clinician can do - if not ludicrous and unethical, to say the least.  I will stick to my original diagnosis of GT, even though that is also based on your pics and information supplied.  The impact on GT on ones life is somewhat less than that of cancer and I will not put either you or your husband through the ordeal of making a false-positive diagnosis of a suspected lesion without having all the relevant test results at hand.  I hope you understand and I wish you both well further - stay focussed and strong and just do everything out of love and you cant go wrong.  Take care

Kind regards
Dr Craig Peck  


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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