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Oral Medicine Restorative Dentistry

Your opinion: How would you treat this case?

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By Dr. Emad Girgis

A female patient in her 50, with no medical conditions and is not taking any medications, had CTG done 8 months ago. Now she complains of burning sensation from the donor site in the palate, the tissues look normal, but she says she experiences a burning sensation when her tongue touches the area. She says she sometimes has to take Advil.

Any advice????

 

2 Comments

  1. Ron Kellen March 20, 2014

    Emad,
    I suspect that the connective tissue graft from the palate may have taken too deep a segment, and disrupted the nerves at a deeper level. Upon healing, the nerves were probably distorted. During healing, the patient MAY have used alcoholic drinks or very hot coffee/tea or used alcohol containing mouth wash which is traumatic / toxic to the exposed nerves & tissue, and would BURN. This could create nerve memory distortion. – a habitual pathway rather than the real situation?

    Question: How long after taking Advil does the burning calm down? If it is say 5 minutes – psychogenic component. i.e. Legit complaint as a sympathy trigger to help other issues she cannot deal with? How long does the Advil last? 200 mg or 400 mg. etc.

    Remedy? I would refer to a neurologist, and a periodontist familiar with this sort of syndrome. It is likely FAR MORE COMPLEX than you should deal with. Especially as it could result in a potential lawsuit.

    Its been about 9 years since you and your wife visited my office.

    Ron Kellen

    Reply
  2. maria cristina iova April 2, 2014

    I found that many patients rinse with lots of mouth rinses that has alcohol and this can cause a burning sensation .
    It could be also psychogenic but I would refer her to a psycho or hypnotherapist to find the event that create the oral symptom.

    Reply

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