Q: I have been having mouth problems. I was at an outdoor BBQ in August and the boys sprayed tons of pesticides on the lawn as the mosquitoes were thick. I later got a rash on my back from sitting on the grass and noticed white patches in my mouth, on the side of my tongue and cheek the next day. I don’t know if this is related but after weeks of my mouth not healing, I went to the doctor and had tests for thrush and a vitamin deficiency but nothing was wrong. Later my mouth started to peel all over.
I saw an oral pathologist and he said stress and my toothpaste were the problem so I changed my toothpaste to Biotene and moisturizing my mouth so it wasn’t so dry. I take no meds whatsoever and only take an occasional Tylenol when needed for pain.
The peeling is gone inside my mouth but my tongue is affected. It is whitish gray and dry. It is as if my mouth cannot be lubricated. Can I get some insight please or do I need to have another test for thrush done? I do have a low white blood cell count but that is normal for me according to my doctor. What is going on with me?
A: Initially you appear to have had an extreme allergic reaction to the pesticides used at the BBQ. An allergy is a hypersensitive disorder of the immune system that can result from the ingestion of specific food or medication, inhalation of airborn substances, contact dermatitis from such things as touching poison ivy or wearing latex gloves, receiving a bee sting, and even from heredity.
Treatment for allergies includes avoiding those known to cause a reaction, taking steroids that modify the immune system, and antihistamines and decongestants that reduce symptoms.
Thrush is a fungus known as Candida that grows in the mouth and tends to be painful. While a small amount of this particular fungus is present in the mouth most of the time, our immune systems keep it in balance; however, when a person’s immune system is weak or when other normal bacteria die, the fungus can grow out of control. Causes for thrush to occur include being on long-term use or taking high doses of antibiotics, taking steroid medication, having HIV/AIDS, or being in poor health. Symptoms present with creamy white or plaque-like lesions in the mouth and on the tongue that can increase in both number and size. I can understand why your physician may have chosen to test you for thrush but I don’t believe that is the primary concern in your case.
The peeling inside your mouth may stem from a harmless condition known as geographic tongue that may occur because of a vitamin B deficiency. While the tongue may be streaked with red lines, other symptoms may include lesions anywhere within the mouth that migrate from one location to another, skin peeling, and discomfort with eating spicy foods. Medical intervention isn’t always necessary unless the lesions fail to heal within about 10 days. If the tongue is painful, over-the-counter pain relievers might be used, as can corticosteroid ointments or rinses and antihistamine mouth rinses.
Dry mouth can be caused by numerous medical conditions, one of which is Sjogren’s syndrome. Some people with Sjogren’s can develop parotid gland inflammation in the cheeks that can lead to dryness of the ducts. I am unfamiliar with the specialty of oral pathology but strongly urge you to see a good ENT specialist. Be sure to maintain good oral hygiene, drink plenty of fluids, ask whether a saliva stimulant prescription might be appropriate, consider lozenges and perhaps even try chewing gum to combat your dry mouth.
It was recommended you modify your toothpaste because most brands on the market contain sodium lauryl sulfate (SLS) that can cause canker sores. While not dangerous in small doses, this ingredient is found in floor cleaners, engine degreasers and in other products that make things foam, but on the downside for some individuals, it can cause skin irritation and mouth lesions.
In summary, all your symptoms may have been triggered by the pesticides or the timing could have been coincidental.