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Oral Surgery/salivary gland tumor or something else?

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QUESTION: I have question about bump in back of mouth could be related to previous dental work for past year.  1)Feb 2014 last year had dental night guard made which gave me dry mouth, severe blisters, leading to plugged gland side of face and antibiotic. My doctor made me switch to a new dentist after this. 2)New dentist & orthodontist recommended wisdom teeth removal.  Had wisdom teeth removed by board certified oral surgeon 9/12/14. One month later had teeth ground to correct bite.  3) Then Nov 2014 noticed bump near tonsils. 4) Today I had mini-surgery on bump and sent off for biopsy.  The oral surgeon said biggest concern would be "salivary gland tumor, which there are many kinds."  I'm 42, female, never smoked, don't drink that much alcohol, have really good oral hygiene.  Could this be plugged gland?

ANSWER: Maria -  From what you describe, the swelling could be a clogged salivary gland, but if the swelling is near the tonsils, it is not a major salivary gland.  There is not a major gland there, but there are minor salivary glands there.  A clog of one of those can produce the swelling.  My main question is if salivary gland problem might be due to an allergic reaction or irritation reaction due to the night guard.  Depending on the type of material used to make the guard, some people get reactions to the material.  So if the biopsy is not definitive as a salivary gland problem, the doctors should have you tested for the materials used to make the appliance.

So it could be a plugged gland, but the cause might be due to a reaction to the guard.

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mouth blister/lump
mouth blister/lump  
QUESTION: I stopped wearing night guard dental appliance after about 6 weeks sometime around Feb 2014.  I had a lot of mouth blisters and plugged salivary gland right side of face during that time.  Dentist thought I had Herpes STD, but my doctors of 12 years disagreed with him and said the dental appliance caused it (then I stopped wearing it).  A month after wisdom teeth removal (9/12/14) I got a similar thing (like picture) under left top wisdom tooth. I went to doctor, but it went away on its own.  The thing in picture started mid-Nov 2014 and was removed on 1/22/15. My husband said the thing in picture looked like yellowish white pus ball.  Oral surgeon sent off for biopsy because said you can't leave anything on soft palate of mouth because of chance of tumor.  I've never had any mouth problems until last year and am concerned.  I don't see how it could be cancer but am worried.

Answer
Maria - It does not look like cancer.  It looks like a gland blockage or small infection due to trapped bacteria.   The fact that it comes and goes, usually indicates a blockage of a gland that builds up pressure to a point and then releases on its own.  What causes the recurring blockage could simply be a small opening to mouth from the gland.  My suggestion, when you get these or to prevent them occurring, I would suggest warm salt water rinses in the area for a minute or so 2-3 times a day.

The surgeon is correct in saying you cannot leave anything there, but I suspect, depending on how deep the biopsy went, the pathology report will say clogged and inflamed gland and duct.

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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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