While there is a known response to blood pressure medication it does not develop in every patient. Gingival (gum) overgrowth has occured in patients taking beta blockers and ACE inhibitors as well as numerous other drugs that are not used for regulating blood pressure.
The good - or bad - news is that ginival overgrowth does not develop in all patients taking these medications, however, if gingival overgrowth does develop as a result of the blood pressure medication it can be difficult to treat and you will need to have your physician and dentist work together. There are two separate issues that need to be addressed.
You need to know that the gingival overgrowth is neither dose or time related, in other words if you are going to develop gingival overgrowth secondary to a specific medication - because you are susceptible - you are going to get it and it does not matter how long you have been taking the medication or what dose (size of pill) the pill is.
The other issue is that once you have developed gingival overgrowth to one beta blocker the likelihood is that all beta blockers will result in gingival over growth. The same goes for ACE inhibitors, if you develop a gingival overgrowth to one ACE inhibitor chances are the entire category of medication will cause you to develop gingival overgrowth.
So if you are taking a beta blocker to treat your high blood pressure you cant switch to a different beta blocker as all of the beta blockers will cause you to develop gingival overgrowth. The same goes for the ACE inhibitors.
As you can imagine this presents problems for the patients cardiac care. If the only medication that is effective in treating a patients high blood pressure is a beta blocker and beta blockers cause that specific patient to develop gingival overgrowth the regulation of blood pressure trumps the gum disease. If the patient can be treated with a different classification of high blood pressure medication then great, switch the classification of medication, the gingival overgrowth will need to be treated but should not recur with the new medication, so if you are on beta blockers and you develop gingival overgrowth you can switch to an ACE inhibitor and visa versa.
If you can't switch to a new blood pressure medication in a different classification you must understand that the gum tissue will continue to grow as long as you are taking that specific medication to treat the high blood pressure.
Either way you will need to treat the gingival overgrowth as it will not go away on its own. Your dentist or periodontist (gum specialist) will need to remove the gingival overgrowth. Once it is healed you will need to maintain scrupulous oral hygiene and ideally you should see a dental hygienist three to four times a year. This is the only way to prevent bone loss in under the affected gingiva and subsequent loss of teeth.
I realize that this is a very long answer to a very short question, however it is complicated. The main thing to remember is this; your heart health is more important than your oral health and which ever high blood pressure medication is the most effective for you is the one you should use. Any oral problems that develop as a result of the medication can be treated by your dentist and dental hygienist.
I hope this helps. Let me know if you have additional questions.
Sorry to hear you have been having pain, hopefully you will be mending before you see my post.
There are a number of reasons to develop a bit of loose tissue in the mouth. Fortunately most are very minor. The number one reaso I see patient with peeling of the gingia is the result of direct contact to the affected area, this can be traumatic in origin like a pizza burn or chemical burn from tooth paste or mouthwash. For my patient population the toothpastes tend to be "organic" or "natural" and the mouthwash has a high alcohol content.
There are also a small number of skin conditions that can present with similar signs and symptoms associated with peeling of the gingiva when the oral mucosa is involved.
If the wound heals normally within a week barring other factors it should be an isolated incident. If the tissue does not heal or it appears to be growing or spreading I suggest that you see an oral surgeon to have a biopsy done. A biopsy will give you a specific diagnosis which will allow for appropriate treatment.
Although I am not able to diagnose online I do not believe that the bumps you are seeing on the back of your tongue are from smoking.
The top of the tongue normally has three types of papilla. The circumvallate papilla are found in a V shape at the back of the tongue, are typically the size of a pencil eraser and contain hundreds of taste buds. The fungiform papilla are the small (1 - 2 mm.) mushroom shaped bumps that are distributed evenly over the top of the tongue - from the tip to the back of the tongue - and they also contain taste buds. The filliform papilla are the little hair like projections distributed evenly over the top of the tongue. The filliform papilla are made of keratin (like hair) and they protect the surface of the tongue.
The bumps on the back of your tongue should be biopsied to rule out a viral origin (like a wart) as they are not consistent with the size or distribution pattern of the typical papilla seen on the tongue.
Please remember that this is only a clinical impression and not a diagnosis.
I suggest that you see an oral surgeon and that the biopsy be sent to a pathologist familiar with oral pathology.
I am sorry to hear that you have been having severe pain. You did not mention if this was an acute (sudden) or chronic (long term) problem.the reason I am asking is that I am not sure of I should suggest that you see an oral surgeon, a specialist in oral pathology or a neurologist. If you are near a dental school you should see if they have a dentist who specializes in neuropathology.
There are a number of potential diagnoses and I strongly recommend that you have a face to face consultation since the pain you are having is severe enough to wake you up at night.
Unfortunately I cannot provide accurate guidance without more clinical information. Howver, in general, nodules in the upper lip are slightly more worrisome that nodules in the lower lip which tend to be due to trauma. If the nodule is still present after a month I suggest that you see an oral surgeon for a biopsy and a definitive diagnosis.
Laser treatment for periodontal disease can be an effective treatment for some patients. Without X-rays and a clinical exam it is not possible to determine if you would benefit from the procedure.
I strongly recommend that you see a periodontist - a gum specialist - for a second opinion prior to beginning the laser treatment. You can look online at the American Dental Educators Association web site to find a periodontist near you or if you have a dental school or a hospital with a dental department close to home you can make an appointment for a second opinion.
As this is a relatively new procedure you can ask your dentist why they prefer laser treatment over traditional surgical care and if they have had a chance to compare both procedures.
Although I cannot provide a diagnose online I can provide guidance. Leukoplakia is a clinical term used to describe a white patch in the mourh that does not rub off and does not have a specific diagnosis. This is a clinical diagnosis only not a microscopic diagnosis. Without a biopsy you do not have a definitive diagnosis. The issue then becomes how to treat a lesion without actually knowing what it is.
The lesion is painful and long standing and obviously causing you both physical and psychological distress. I understand that you have had conflicting advice from multiple sources and I know that a biopsy can be scary however I strongly suggest that you have a biopsy and that the tissue should be sent to an oral pathologist for an accurate diagnosis.
On the positive side the leukoplakia has not changed in size, texture or color, and these are all good signs and suggest that the lesion is benign! The other benefit to having a biopsy - besides peace of mind - is that the process of having the biopsy done can actually help heal the affected lesion, the process of removing the lesion gets rid of dead tissue and brings fresh blood flow to the area which also supports and improves healing.
I suggest that you see your dentist who can smooth down any rough edges on your teeth. Orthodontic wax can temporarily be used to fill in the spaces between the teeth. If at all possible you should try not to play with the affected area as chronic irritation also can lead to swelling and pain.
If the leukoplakia has been present for more than six weeks it is not likely to resolve on its own and it should be biopsied. You need a definitive diagnosis so you can receive appropriate treatment.