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white spot on lip
white spot on lip  
I have an odd pale white thing on my lower lip, almost dead center, that is some on the lip and more on the inner lip. It's about the size or smaller than a pencil eraser, doesn't hurt at all, tho was tender a few days ago when I pressed my lip and used chapstick. It has a rough feel to it, tho that has improved.

It is not a canker sore or not anything like I've ever had! No indentation. No halo or ring around it. It almost has a clover design but swirled. The pale white spot doesn't look thick or like the pictures of Leukoplakia. I can't find any Google pictures that look like what I have.

Here are some things I've done in the last week that make me wonder if it could be trauma and NOT HURT. Since I found this by accident when putting on lipstick in the rear view mirror, I don't remember the time line of these events.



Two nights last week I woke long enough to know my lips had stuck to my night guard and was hurting my mouth. I just licked at them and went back to sleep.

I had made a pot pie for supper and rushed to eat. Put a chunk of chicken in my mouth which was very hot and instead of spitting it out, moved it quickly to between my lips, which hurt, and then spit it out.

I use an electric toothbrush and Crest Pro (which makes my mouth peel) and held the toothbrush between my lips for a few seconds.

I rub my face (exfoliate) with my towel after a hot shower and know that one day last week I rubbed my lips, too.


The hypochondriac and dental phobic me screams lip cancer but I've never smoked. I haven't drank alcohol even at social events for over 20 years. No HPV. Never had a cold sore. Got my Shingles vaccine. Female. Never used a tanning booth and always 99% of the time, wear lipstick if I go out. NEVER used gloss.

Other than age, I have no risk factors for the usual lip cancers.

Answer
Hi Diane and thanks for your question.

I am sure you can appreciate the danger and difficulty of me giving you a definitive diagnosis without having the privilege of examining you personally.  A physical examination of the characteristics of the lesion are vital in establishing a differential diagnosis, which is usually confirmed by gradual elimination and via biopsy of the lesion. For this reason I would strongly advise you to get your dentist to check this out in greater detail and even get a referral to see a specialist in oral medicine for confirmation, which would give you the peace of mind that you deserve over this matter. From what you have explained, you certainly do not have any of the major risk factors for developing oral cancer and the description of the lesion does not match that of typical oral cancer but given the wide range of presentations thereof, I suggest getting absolute confirmation on the matter. It does seem to either be leucoplakia or a area of possible trauma - mechanical, heat or friction related - which could be in the healing phase and presenting as a pale scar-like area. I hope this helps and hope you appreciate my hesitance to either mis-diagnose or mis-inform you on the matter with the limited information available. I wish you all the very best, take care.

Dr Craig Peck

Dentistry

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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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