Dentistry/Tongue

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Question
Hi,
I have spoke with you in the past concerning my husbands tongue and cancer. I have been very good about not looking at his mouth at all and trying not to obess and worry about it. He went to the dentist today got his cleaning. I guess the dentist saw the area on the left side if his tongue which is constantly broke out with geographic tongue. His dentist uses the velescope and the area appeared darker which it normally does. I always have my husband point this area out and in the past hid dentist has always said it just gt and nothing to worry. Today he told him he thinks its only ft but he wanted to take some pics and make sure the area changes. He had him coming back in two weeks for a recheck. I am concerned bc I am not sure what is different this time around. To me it looks the same as always. The area does change from day to day bug the pale pink/ white are in the side and too of his tongue which looks bare of taste buds normally remains the same. Now of course my anxiety is driving me nuts wandering why this is different and what he saw that he feels the need to recheck. Does this look like anything more than geographic tongue to you? Like cancer? Should I be so concerned? I really have enjoyed this time not worrying and not checking. I would like to go back to that. Aldo in jan of 2012 he had a biopsy if the area which showed chronic inflammation consistent with gt. the outbreaks seems to stay only the left side of the tongue and sometimes on the tip but that never shows up darker under the velescope. I have asked the dentist why the area was darker many times before and he had always schrugged it of bc of the inflammation from gt. I am confused as to why this is different? My husband just said he told him he wanted to make sure the area was changing and moving so who knows.

Pic of what the dentist saw today.

http://i1209.photobucket.com/albums/cc393/kkingery83/AA1E91E0-0DE0-463A-BF3C-28B

Answer
Hi Kim and thanks for your question.

Firstly, well done on trying to break your cycle of obsession over this matter - it certainly is a step in the right direction and having done it once, you can certainly do it again.  Each time, you will find it gets slightly easier and the length of time that you remain "obsession-free", will get progressively longer and you refocus your energies on things in your life that you can change, instead of being predisposed with the idea of cancer.

As I have said before, I am hardly in a position of give you a definitive diagnosis of cancer based on a few facts - your husbands dentist is much better equipped to do so, having the benefit of examining him and evaluating all the diagnostic tools used to aid in that diagnosis.  And should you feel that, for whatever reason, that you do not have complete faith in his diagnostic and clinical abilities as a dentist, then I suggest that you shop around for a dentist whom you do trust.  This would just make your life that much easier, with less to second guess and worry about unnecessarily.  The problem with obsession, is that the more you give into it, the greater the urge becomes to indulge it and the more time you will lose in your normal day to day living.  The end result is increased stress, tension, mental and physical fatigue and exhaustion, mood swings, lack of social interaction and involvement, altered eating and sleeping patterns and so much more. And you are the only one who can put a stop to this - and sooner rather than later, before your whole life is consumed by worrying about something which you have very little control over.

As far as his dentist taking pics of the lesion is concerned - due to the varying and migratory pattern of GT, is seems completely reasonable to get more than 1 image over a time period of the same area to indicate this fact and hence support the diagnosis of GT.  If his dentist said there is nothing to worry about, then take this as an all clear and be happy for this fact.  

I hope this helps and wish both you and your husband all the best further, take care - and stop obsessing, Kim, please!

Kind regards
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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