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An_241101 posted:
I had a root canal in July and a month or so after noticed that my face still felt numb. I have been a smoker for 16 years, fairly heavy. I went to my physician for a yearly physical and my blood work up was fine, and he did look at my mouth and saw nothing concerning. My dentist did a follow up filling and I mentioned the metallic taste to him as well. He did a thorough check and saw nothing that concerned him, but did note a mouth ulcer. Still, I was somewhat concerned and went to the individual who performed the root canal and he did an examination and noted that I may have Lichen Planus, and asked if I had been stressed recently. The fact is, I have been for about a month very much, and the previous three months was stressed about some things.

He noted to me that he did not think it was anything cancerous. He did ask if I used smokeless tobacco, and I told him no, but that I did smoke. Again, he referenced Lichen Planus, and asked I go see an Oral Surgeon to be sure, but he didn't think anything looked cancerous. Still, the metallic taste in my mouth is nuts, and my cheeks seem a bit numb, more on the side where my root canal was performed. I can be somewhat of a hypochondria with my smoking history. I'm 36 years old and scared to death I have Oral Cancer. I have since quit smoking, but hope it isn't to late, what are my chances of Oral Cancer at my age?
DMCD75 responded:
Please note, I also had a CT scan done on my lungs for the peace of mind in early October, could the remaining metallic taste be related to the dye at all?
MarkMHB responded:
This would be an ideal question to be fielded by Dr. Gwen Cohen Brown, but in her absence, I will gently step into the breach.

Before I say anything else, you should know that there is nothing as conclusive in identifying an unknown soft tissue lesion than a formal biopsy, and you should not be sidetracked by any of the increasingly popular non-invasive cancer screening methodologies, be they brush biopsies, Vizilite, Velscope, or other shortcuts. If the ulcer to which you refer persists more than two weeks and cannot be identified on sight, the thing to do is a biopsy-- period. The best person to do this would either be an oral surgeon, or an oral pathologist who provides clinical services.

Oral lichen planus is one of those conditions that can be identified on sight-- usually. When it assumes its "reticular" form, it can barely be mistaken for anything else. However, lichen planus sometimes takes on atypical appearance, especially when in its erosive variant, where it can be mistaken for a variety of other muco-cutaneous disorders (e.g, mucous membrane pemphigoid, lupus, psoriasis, or Crohn's disease). Also, there is some reason to suspect that malignancy (rarely) can emerge in tissues affected by erosive oral lichen planus. Therefore, it is often prudent to err on the side of caution and opt for a biopsy if there is any doubt.

A metallic taste is a useless diagnostic indicator, because it can be a result of any inflammatory condition of the mouth, upper respiratory tract, and digestive tract, In short, it is non-specific, and doesn't get a diagnostician any closer to the goal of identifying the problem.

There's no point in speculating on your chances-- get that ulcer checked by an oral surgeon or oral pathologist .

Good luck!

Mark Bornfeld
Brooklyn, NY

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