Oral Surgery/Bump in gum

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QUESTION: I Have on my lower right side, beneath my front teeth, a small, movable hard little lump. I don't know how long it's been there. Found it friday 31-05-13. It doesn't hurt or anything. It seems to be of the same color as the rest of my gum.

It seems quite hard and can be moved around a lot, does that make any difference? I have had a mucocele before and it was much more soft than this. it don't seem to be able to burst in the near future. The first pic (pic 1) is how it looked when i found it. The second today (pic 2).

I was stupid enough to try to punctuate it the same day I found it, it became smaller at the time but now is almost a bit bigger. It healed in a week, is now just a little bit sore.

I went to the dentist , they couldn't say exactly what it was more than that they didn't believe it to be something suspicious and neither of the two dentists that looked at it didn't seem that concerned and said I shouldn't worry because malignancy has other trademarks than this (which was/is my main concern). They sent me to a oral surgeon anyway just to see if it should be removed anyway, but I guess that will take some time because the waiting- list is long. Another dentist over at Justanswer.com also said it is nothing to worry about, maybe a calcification of one of the minor salivary glands.

The dentist said it was located in the frenulum (I think it's called that). It's very moveable, looks skin colored but when I push on it from the side it becomes like the second pic (white/light yellow), it is hard.

Even though they said it was harmless i'm still worried...

ANSWER: Frankie -  I cannot be completely sure without examining you, but the lesion appears to a benign lesion.  Where is comes from is a little difficult.  In the location, it cannot be a minor salivary gland lesion. Without the tenderness, it seems that this area is not infectious.   

It does not appear to be located in the frenulum area.  It looks like a lesion caused from a minor inflammatory lesion.  It does appear to be harmless.  It could have originally been inflammatory, but now it appears to be an area of scar tissue formation and not dangerous.

Leave the area alone, unless you detect pus or other signs of infection.  If you have additional questions, feel free to contact me again.


---------- FOLLOW-UP ----------

QUESTION: Ok, thank you so much! I really value your opinion since you're a oral surgeon and not "just" a dentist. Just a couple quick questions.

1: The dentist said it was in the frenulum on the side (not the one in the middle) if that changes anything.

2: I'm a bit confused, are there not any salivary glands in the alveolar mucosa (if that's the correct name for the place I think it's located).

3: What is it that make you feel it's a benign/harmless lesion?

4: Do u think it's necessary to remove it? Of course I will listen to the Oral surgeon I will meet later on but at the same time it cost a lot to have this kind of surgery in Sweden.

ANSWER: Frankie -  the bump does not appear, from the pictures, associate with any frenulum.  There are minor bands of tissue throughout the area, but they are not frenulum.  

There are no salivary glands within the alveolar mucosa.  The minor salivary glands need pliable tissue to hold the glands, their ducts and saliva as it flows.  Alveolar mucosa is the mucosa over the bone.  Minor salivary glands are not associated with the mandible at all and are usually found on the lips and the floor of the mouth.

The rounded appearance and lack of an irregular surface helps define the area as benign.

I think removing it, due to the increase chance of it getting irritated, is not a bad idea.  The removal should be done by a surgeon and sent for a biopsy.  Not because it is bad, but to make sure.

---------- FOLLOW-UP ----------

QUESTION: Ok, thank you so much! I'm now much more confident that this is not something dangerous which was the feeling I couldn't shake off even though the dentist also found it harmless. Thanks!

Answer
Frankie - so don't worry, but do have that bump removed and biopsied.  Not because I think it is dangerous, but I am a "belt and suspender" doctor and want all the bases covered.  In addition, bumps like you have can become inflamed just because of the normal friction that would occur due to it sticking out.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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