Oral Lumps

What is an Oral Lump?

Lumps and bumps can occur in the mouth due to a variety of lesions. These can be traumatic caused by biting the lip or side of the tongue, can be cystic with fluid causing expansion of the lump, or can represent a tumour or cancer. Oral lumps occur commonly and their treatment depends on the correct diagnosis.

Common Signs and Symptoms:

• Some lumps especially those on the lower lip in children can cause some pain and discomfort, but oral lumps are typically not very painful.

• They can present as small raised fleshy tissue in areas of trauma or friction, or otherwise as large hard lumps on the side of the tongue in case of cancer.

• Some lumps are fluid-filled and feel soft to touch.

• Many oral lumps are the same colour as the skin of the mouth, and are missed until they become large in size.

Causes:

• Many common oral lumps are caused by trauma to the oral soft tissues from cuts or bites. Most of this can occur without the patient actually noticing.

• Some lumps are caused by fluid accumulating in spaces beneath the skin of the mouth. These can result from inflammation or saliva accumulation (known as mucocele), but can also form for unknown reasons.

• Many lumps on the gums (known as epulides) are caused by plaque, calculus or other debris caught under the gum line which makes it difficult to clean. This can induce the gum tissues to form lumps that often bleed.

• Benign and cancerous tumours are common in the mouth. The most common and serious of these is oral cancer, and this is typically caused by a history of excessive smoking or alcohol consumption.

​​

Diagnosis:

The Clinicians at Perth Oral Medicine & Dental Sleep Centre are experts at differentiating simple traumatic lumps from those that are more sinister. Good treatment for oral lumps depends on the correct diagnosis, and it is better that this occurs early, so any treatment required to remove them is minimally invasive.

• Oral lumps can be assessed on a clinical basis (visual and palpation) as part of a comprehensive head and neck examination.

• This can be done with good lighting and palpation of superficial and deep soft tissues.

• Many oral lumps require biopsy, and this can be either incisional to take a sample, or excisional to remove the whole lump. Small lumps are typically removed in one procedure.

• Sometimes other scans and special tests are required to assess the lumps especially if they are deep and cannot be easily seen and can only be palpated.

Treatment:

• Early and small lumps typically undergo removal in one procedure to obtain a diagnosis but also deal with the lump definitively.

• Large lumps require small samples to be tested first to determine their nature before a plan for their treatment is made. Sometimes these require the involvement of other clinicians or surgeons, especially when they involve bone.

• Lumps on the gum line require deep debridement after surgery to ensure that they do not recur. Good oral hygiene is paramount for their effective treatment.

• Cancerous lumps require wider local excision or resection and may require radiotherapy.

Recovery:

• Most lumps are removed with scalpel surgery and heal without too much difficulty.

• Most oral lumps are benign and can be treated effectively by surgical removal and do not recur.

• Some lumps especially mucoceles and epulides require deeper treatment, so review in certain cases is required.

• Patients with cancerous lumps require more extensive treatment and have additional requirements for care after surgery.