Terrified after Dentist discovered black spot on gum. Fearful it may be oral melanoma

[Bella19]

I had a Dentist’s appointment today.
Was particular anxious as I thought I’d discovered a black/brown spot on the the bottom of my front tooth, way below the already receded gum line, and I had suspected the tooth may be decaying.

The Dentist informed me the mark is actually on my gum, not my tooth.

He told me I need to take photos and monitor this spot in terms of size, colour and shape. And also said that he is very happy with the health and state of my mouth and teeth.

He also wrote the following notes on a referral to my oral surgeon, who will soon be removing my wisdom tooth.

“Kindly review pigmentation (2-3mm diameter, black, round, distinct margins) on lower anterior 31-41 buccal attached mucosa.”

Can someone explain what those notes mean exactly please?

Of course with my severe health anxiety, dental anxiety, and Generalized anxiety disorder, I am now terrified that this may be some form of oral cancer. I’m absolutely terrified I may have oral melanoma. And I can’t stop crying. I feel like I’m going to spend every day for the rest of my life worrying that this will turn to cancer (if it hasn’t already).

I’m wondering what the process will be like from here on. Will they take a biopsy of it? What sorts of things can cause brown or black marks on the gum in that area?

Thank you for your help, in advance. I really need all the help and support I can get right now.

 

[Gordon]

1 Oral melanoma is INCREDIBLY rare, they're usually a secondary from a long established malignant melanoma elsewhere in the body and even then they're incredibly rare
2 It's most likely to be a mole (which is what the note are saying, an area of pigmentation
3 The process will be to take photos of it and keep an eye on it if it changes appearance it might be worth a biopsy
4 Did I mention that oral malignant melanoma is incredibly, unbelievably, rare?

 

[Bella19]

1 Oral melanoma is INCREDIBLY rare, they're usually a secondary from a long established malignant melanoma elsewhere in the body and even then they're incredibly rare
2 It's most likely to be a mole (which is what the note are saying, an area of pigmentation
3 The process will be to take photos of it and keep an eye on it if it changes appearance it might be worth a biopsy
4 Did I mention that oral malignant melanoma is incredibly, unbelievably, rare?

Gordon, you really are marvellous.
I wish you were my Dentist ?
I must add, I do find it odd that this brown/black spot is occurring right on the receded gum, where I’ve had pain/Gingivitis frequently over the years.
Could it indicate that that particular part of gum is dying?
Or is it also still a possibility, that I may actually have plaque/tartar build up on the tooth that has pushed beneath the gum line, so much so that it is causing the gum to appear discoloured? It’s always been such a difficult part of my tooth to clean, and I know I’ve not cleaned it sufficiently.
I really feel it may be wise for me to see a Periodontist for a deep clean, and through check. Would you agree this could be a good step to take?
The Dentist I saw yesterday was extremely young and very inexperienced. Also refused to prescribe pain killers for my severely impacted wisdom tooth (which causes me absolutely excruciating pain, and need to be removed in hospital ASAP).
He was totally different to the usual, highly knowledgeable, gentle, efficient Dentists I usually see at that practice.

 

[Gordon]

No you don't, I've been retired for 2 years, I think I'd be worse than a new undergraduate by this time!

Any chance of a decent photo of the area? You'd need somebody to take it for you while you held your lip down out of the way.

No, gums don't just "die" like that, there is a condition where a bacterial infection causes some gum to die off a bit, called ANUG, but the symptoms of that are extreme pain and the dead areas are a sort of grey colour and very very smelly! You don't have that thank goodness.

If you're worried about your gum health then a perio. consultation would always be sensible if you can afford it.

 

[Bella19]

I’ve tried so hard to get a clearer image for you, but unfortunately it hasn’t worked well, my Mother is hopeless at taking photographs ?
Excuse my ugly teeth ? they were once straight and beautiful!

 

[Gordon]

Thanks that's much better. It's interesting, doesn't look like pigmented skin. I'd bet my mortgage it's nothing serious though
Your gums look fine there.

 

[Bella19]

Thanks that's much better. It's interesting, doesn't look like pigmented skin. I'd bet my mortgage it's nothing serious though
Your gums look fine there.

Hello Gordon

Just wanted to let you know what happened at my appointment with the Oral Surgeon today.

Initially, he had me lie down, looked at the mark very briefly, and immediately said he’d need to take a biopsy of it , just to be sure. Of course, at that point, I became terrified. Especially when he said I’d have to wait 3-5 days for the results.

He and his assistant then got me all set up in the other room, injected me with local anaesthetic, and he began to explore the area more closely with a different microscopic lens (or something like that, forgive me, I'm not sure of the correct terminology ).

At that point, he surprisingly exclaimed, oh wait, you’ve got a little hole in your gum!
And very awkwardly, with my numb mouth, struggling to get my words out, I said, what does that mean, has cancer caused a hole in my gum?!

And he said nooo, no this isn’t cancer, and you actually don’t need a biopsy, you’ve simply had some plaque build up and slip under the hole in that receded gum. The plaque has turned black, which has given the gum the appearance that it had a pigmented mark on it.
But there’s no mark on your gum, and no need for a biospy, we just need to remove that plaque.

And at that point we all laughed, cheered, and I cried, and said, oh my goodness, I love you! hehehe

I actually wasn't supposed to see the surgeon until next week, but yesterday they contacted me to tell me they had a cancellation, and asked if I'd like to come in today, for an earlier appointment. But I discovered today, there was no cancellation, they simply chose to fit me in on an extremely busy day, as his first patient of the day, because they knew how absolutely terrified I was, and wanted to put my mind at ease. I am truly touched by their kindness.

They were extremely happy for me, commented that I can now go and relax and have a great time on my trip to Italy in 3 weeks

I’m extremely sore now after the cutting and stitches. But extremely relieved and happy.

I am ever so grateful for all the support you've provided to me on this forum Gordon, you've helped me get through this difficult time, and it actually brings tears to my eyes. From the bottom of my heart, thank you

I've attached a photo for you, of the plaque that they removed, and of what my mouth looks like currently (pretty awful hehehe)

 

[Gordon]

Good news, I like a story with a happy ending Well done for going through with it all.

 

[Kns]

Congratulations on facing it and the good news! Have a great trip and I hope your soreness eases up soon. What a relief for you!

 

[RustyRebecca]

Read your story, love it! And just to say, I think you have beautiful teeth

 

[Bella19]

Hello Gordon, I hope you’re doing well.
My gums healed nicely from the surgery.
There’s one thing I’m still bothered about, an area of my mouth that I didn’t ask the oral surgeon about, and he never commented on it (though I’m assuming he looked over it thoroughly, as it’s located very close to the area where he cut my gum open and removed the plaque.
The area of gum looks a little raised and thickened, and there’s a red, circular mark on it. I do t know how long this mark has been there, I only noticed it before going to the surgeon a few months back, when I was concerned about the other area.
Now I’m panicking about this area, worrying it’s cancer. But surely if there was something abnormal, the oral surgeon would have biopsied that area? He was very rushed that day.
I’m worried he may be didn’t inspect it properly, or perhaps thought it was just thickened and red due to issues caused by the other area?
I’ve attached a (bad quality ?) photo.
Any ideas on what it could be?
I will be returning to a different oral surgeon in a few weeks, as I’ll be having surgery to remove a wisdom tooth.
Thanks,
Lauren

Good news, I like a story with a happy ending Well done for going through with it all.

 

[Gordon]

Sorry, I can't make anything useful out from that. Try again?
Oral Melanoma is rarer than a really rare thing though.