Dentistry/Tonsil

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Question
QUESTION: Hi,
I just noticed this white creamy area in the right tonsil. I know it hasn't always been there so I am not to sure if it's from a trauma. It's been this way for a few days now. Should I consolt my doctor or dentist if it remains this way? Could this just be normal tonsil tissue.

Right tonsil- more so on the tonsilar pillar

http://i1209.photobucket.com/albums/cc393/kkingery83/638F35FF-A76A-48AB-8732-BD0

ANSWER: Hi Kim and thanks for your question.

Being an immune organ, the tonsil is often the first line of defense from external bugs and hence its appearance can fluctuate quite vastly from "normal" to infected.  If you do not have any pain and inflammatoric symptoms, then I would monitor it for 3 days. Should it persist past that, then consult your GP.  Wishing you a speedy resolution of this matter, take care.

Kind regards
Dr Craig Peck

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

QUESTION: Thanks. If this is not related to infection what could it be? I tend to puch in this area to remove tonsil stones could this be related to a trauma or scar from that? Does thus look like anything serious like start of cancer?

Answer
Hi Kim

You cannot possibly expect anyone to give you a positive diagnosis of that nature based on a picture of a lesion - that's hopefully not where modern technology has taken medicine to...

Only a small percentage of head and neck cancers are tonsil cancers. Tonsil cancer sometimes presents itself as small ulcers, whereas in other areas of the mouth, cancer can start as small white patches. the prognosis and success of the treatments depends on many things, including the size, stage, type and location of the cancer. Cancer of the tonsils is especially dangerous because the tonsils sit in a critical area, right at the base of the skull, where the cancer can invade major blood vessels and nerves of the brain, but also, people who have a cancer in one place, like the tonsils, have a 15-20 percent increased risk of having it somewhere else, too. As can be expected, smoking and drinking alcohol are highest on the list as causes of tonsil cancer, together with any irritant that passes through the oral cavity, including cigar or pipe smoke. A genetic predisposition toward cancer may play a role in some cases, and predominantly affects people over 45 years old. Sometimes, tonsilar cancer develops due to primary lymphatic cancer, as the tonsil forms part of the lymphatic, or immune, system.

In general, one of the early warning signs of oral cancer is a persistent sore throat, with/without difficulty in swallowing, with/without swollen neck lymph glands.

Give yourself the peace of mind and get the all clear from your GP or dentist. Tonsilar cancer is very rare but it can be dangerous so get it checked out and relax. Given the positioning of the tonsils on the wall of throat, it is not unusual to see areas of trauma on these organs, together with areas indicating healing and/or inflammation. Bear in mind that they are organs of immunity, so what looks to you like "disease" is often their activity in preventing that very thing.

I hope this helps, take care.
Dr Craig Peck  

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

Expertise

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.

Experience

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.

Organizations
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.

Education/Credentials
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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