Most of us have experienced some form of discomfort in terms of pain, bleeding, or some aberration on our cheeks. Commonly anything that happens on the cheek is a result of inflammation, infection or physical injury. Let us investigate each of these briefly to help you understand what it is you should be expecting from the diagnosis, treatment, and prognosis of your cheek symptoms.

INFLAMMATORY/ INFECTIOUS CAUSES OF CHEEK SYMPTOMS

One of the most common lesions on the cheek are canker sores that are essentially round or oval with a white or yellow centre and a red border. Canker sores can be caused due to the herpes virus or not and are self resolving once the causative factor is removed. While the aetiology remains unclear some of the most common causes of these sores on the cheeks and soft tissues of the mouth are:

  • Minor traumatic injury in the mouth due to teeth, overzealous brushing, sports etc,

  • Sodium lauryl sulfate in toothpastes

  • Food sensitivity to particularly spicy foods

  • Allergic response to bacteria in the mouth, e.g.: H. pylori (causes peptic ulcers)

  • Hormonal or emotional stresses

  • Diet deficient in Vitamin B12, Zince, folate or Iron

Canker sores can also be indicative of a larger generalized condition like Inflammatory Bowel diseases like (Crohn’s Disease), Celiac Disease and HIV/AIDS.

  • Other inflammatory or infectious conditions that can reflect on the cheek are:

  • Cellulitis

  • Enlarged lymph nodes

  • Ingrown hair follicle

  • Obstruction of the salivary gland

  • Inflammation of the sinuses (sinusitis)

  • Tooth abscesses

  • Viral diseases (Mumps, measles)

TRAUMATIC CAUSES OF CHEEK SYMPTOMS

One of the most common causes of lesions of the cheek is trauma to it. Trauma to the cheeks from external factors can be due to an accident which may also injure the teeth, jaw bones, skin and more. Internally, the cusp of a sharp tooth, roughness from a restoration, a chipped or fractured crown can also cause, what is called “traumatic ulcer” in the trade. This regresses once the causative factor regresses. Many a times there can be scar tissue formation from old injuries. In many children and some adults a hematoma may form. A hematoma is essentially the accumulation of clotted blood from a ruptured blood vessel.

LIFE THREATENING CHEEK SYMPTOMS

Often, whatever happens on the tissues of the cheek is a representation of a bigger problem. This general rule applies to all the soft tissues in the mouth. Therefore it is important to thoroughly diagnose the underlying condition for proper treatment. If left undiagnosed it can lead to a volley of potential complications like:

  • Continuous and uncontrolled bleeding

  • Neurological complications

  • Chronic and persistent facial pain

  • Spread of infection

  • Spread of cancer

  • Facial asymmetry

The two emergency events that mandate an immediate medical evaluation are:

  • Anaphylactic Shock:

To put it simply, an anaphylactic shock is kind of our body’s over-reaction to a severe allergic reaction. This happened commonly in case someone is allergic to drugs like penicillin, insect stings or certain food groups like nuts, eggs, shellfish and more. The body releases an excess of chemicals that cause severe breathing difficulty, ultimately cutting off the blood supply and oxygen to vital organs. This can be potentially harmful, unless treated immediately.

One of the first symptoms in an anaphylactic allergic reaction is the swelling of the face and tongue, accompanied by other symptoms like tight feeling in the throat, hives, vomiting, dizziness and rapid heartbeat. So in case you realize a sudden swelling (edema – fluid filled tissues) of the cheeks, you need to rush to the hospital.

 

  • Malignancy (Cancer):

Oral Cancer is one of the most prevalent malignancies in our country. Skin, bone or soft tissue cancer of the face can result in various lesions of the cheek, ranging from a small ulcer on the cheeks to a much more disfiguring problem.

The following are symptoms of lesions on the cheeks that are an immediate red signal and should be overlooked by a physician.

  • A persistent, painful rash on the cheek

  • Redness, warmth and swelling on the cheeks

  • Pain or tenderness which cannot be accounted for

  • Deformed or uneven cheek bones

  • A mole that seems to have changed in size, shape, or colour recently

Just as we look after our teeth, it is important to conduct a thorough examination of the soft tissues that surround our chompers!