From Lingering Irritation to Lasting Relief: Melissa’s Oral Health Journey

When it comes to oral health, some conditions aren’t immediately painful but can have a significant impact on daily comfort and overall wellbeing. At Nuffield Dental, we often see patients who have lived with persistent irritation for years before seeking answers. This is the story of Melissa (name changed for privacy), a 44-year-old professional who found lasting relief after years of struggling with oral lesions, angular cheilitis, and allergic reactions to dental materials.

First Signs: White Patches and Irritation

Melissa first presented with white lesions on her tongue and recurrent cracking at the corners of her mouth. Though she had no pain, the changes were concerning. A closer look revealed:

• White striations along the tongue, close to a long-standing amalgam filling.

• Angular cheilitis (soreness at the lip corners).

• Irritation caused by accidental tongue biting during sleep.

These symptoms raised suspicion of a possible lichenoid reaction, a type of chronic irritation sometimes linked to metal dental fillings.

Investigation and Diagnosis

To ensure there was no underlying disease, we carried out an excisional biopsy. The results confirmed a lichenoid reaction—a benign but inflammatory response.

At the same time, Melissa underwent a comprehensive health screening with our medical colleagues, including:

• Blood tests for anaemia and vitamin deficiencies.

• Nutritional assessment to check for systemic factors contributing to angular cheilitis.

• Tests for possible fungal involvement.

The screening revealed multiple food allergies—notably to milk, casein, and cocoa bean. These dietary triggers were playing a role in her inflammation and swelling.

Treatment: A Multi-Step Approach

We replaced her amalgam restoration with a composite resin filling, a biocompatible alternative that reduced the risk of allergic or irritant reactions.

Her treatment plan included:

• Protective mouth guard for night-time bruxism and tongue biting.

• Occlusal adjustment to smooth sharp tooth edges.

• Therapeutic mouthwash (chlorhexidine-based) to calm inflammation and promote healing.

• Nutritional adjustments, avoiding identified allergens.

  
  

The Turning Point: Healing Beyond Dentistry

With these changes, Melissa experienced:

• A marked reduction in swelling.

• Healthier skin and oral tissues, with no recurrence of lichenoid lesions.

• Relief from angular cheilitis, which had previously been a constant nuisance.

Her composite filling remained intact, her mouth comfortable, and her overall confidence restored.

Key Lessons from Melissa’s Case

1. Lichenoid reaction treatment may be as simple as replacing older amalgam restorations with modern composite alternatives.

2. Angular cheilitis isn’t just cosmetic—it can be linked to nutritional deficiencies, allergies, or chronic irritation. A dentist in Singapore can help identify and treat these root causes.

3. Allergic reactions to dental fillings are real. For patients with unexplained oral irritation, allergy testing and the use of biocompatible materials can make all the difference.

At Nuffield Dental, we believe in looking beyond the surface. By combining advanced dental care with nutritional and medical collaboration, we help patients like Melissa reclaim not only their smiles, but also their comfort and confidence.