# Cysts of the jaw and their removal

> What a cyst in the jaw is, why it is often first seen on an X-ray, how it is removed and its lining tested, the risks and the follow-up. General information.

Source: https://www.nazemalioussef.com/en/clinical-interests/jaw-cysts/  
Updated: 2026-09-28

Clinical interest

A jaw cyst is a small sac of fluid that forms inside the jawbone, most often at the root of a tooth or around a tooth that has not come through. Many cause no symptoms and are first seen on an X-ray. When a cyst needs treatment, it is usually removed in a small operation, and its lining is sent to a laboratory to be examined.

From the professional website of Dr Nazem Al Ioussef Published 28 September 2026 Last reviewed 28 September 2026

## What a jaw cyst is

A cyst is a sac with a thin lining, filled with fluid or soft material. In the jaws, most cysts are linked to the teeth or to the tissues that formed them. Jaw cysts are not cancers, and most grow slowly.

Two kinds are seen most often:

- **A radicular cyst**, also called a periapical cyst, forms at the tip of the root of a tooth whose nerve has died, usually after deep decay, a crack or an injury. Infection from the tooth keeps the area around the root tip inflamed, and a cyst can slowly form there. It is the most common kind of jaw cyst.
- **A dentigerous cyst** forms around the crown of a tooth that has not come through, most often a [wisdom tooth](https://www.nazemalioussef.com/en/clinical-interests/wisdom-teeth/) and sometimes an upper canine.

Other, less common kinds exist, and several look alike on an X-ray, which is one reason the lining of a removed cyst is examined in a laboratory.

## How a cyst is found

Many jaw cysts cause no symptoms for a long time. They are often first seen as a rounded dark area on an [X-ray](https://www.nazemalioussef.com/en/patient-guides/dental-x-rays/) taken for another reason. As a cyst slowly enlarges, it may:

- become infected, which can cause pain and swelling;
- cause a firm swelling of the jaw that can be seen or felt;
- move nearby teeth or make them loose;
- press on a nerve in the jaw and cause numbness or tingling in the lip or chin;
- thin the bone around it, so that the jaw is weaker there.

Most cysts grow slowly, so there is usually time to assess one carefully.

## How a cyst is assessed

The dentist examines the mouth, checks whether the nearby teeth are still alive, and uses X-rays to see the size and position of the cyst. A three-dimensional scan (cone-beam CT) sometimes shows how close it lies to a nerve, the sinus or other roots.

Treatment depends on the size and kind of cyst and on the tooth involved. A small cyst at the tip of an infected root may be treated with [root canal treatment](https://www.nazemalioussef.com/en/patient-guides/root-canal-treatment/) of that tooth. Most other cysts are removed completely, in the operation described below, which is called enucleation or cystectomy. A very large cyst is sometimes opened first so that it drains and shrinks, and what remains is removed later.

## How a cyst is usually removed

### A cyst at a root tip, and the bone once it is removed

1. **The cyst.** A round sac of fluid sits in the bone at the tip of a tooth's root.
2. **After removal.** The cyst has been taken out whole, and the space it leaves in the bone begins to fill with new bone.

Simplified drawing, not to scale.

1. **Anaesthetic.** A small cyst is usually removed under local anaesthetic, which numbs the area. Sedation, or for a large cyst a general anaesthetic in hospital, is sometimes used.
2. **Access.** A cut is made in the gum over the cyst and the gum is lifted back. A small window is made in the thin bone that covers the cyst.
3. **Removing the cyst.** The cyst is lifted out whole with its lining, and the space in the bone is cleaned.
4. **The tooth.** What happens to the tooth depends on its state. A tooth that can be kept is root-filled, before or around the time of surgery, and the tip of its root may be removed and sealed during the same operation, as in an [apicectomy](https://www.nazemalioussef.com/en/clinical-interests/apicectomy/). A tooth that cannot be kept, or a buried tooth at the centre of the cyst, is often removed at the same time.
5. **Laboratory.** The lining is sent to a laboratory and examined under a microscope. This is a routine step for every cyst removed.
6. **Closing.** The gum is stitched back into place, usually with stitches that dissolve.

## Afterwards

Some swelling, bruising and discomfort are common after the operation. The dentist gives written aftercare advice, which usually includes pain relief as recommended, soft food and chewing on the other side, brushing gently near the wound, rinsing gently after meals, and not smoking.

Bleeding that does not stop with firm pressure, swelling that gets worse instead of better, a fever, or a lip or chin that still feels numb once the anaesthetic has worn off should be reported to the dentist promptly.

At a review, the dentist checks the healing and explains the laboratory report. X-rays taken at later visits show the space in the bone filling with new bone.

## Risks

As with other surgery in the mouth, there can be pain, swelling, bruising, bleeding and infection. Less often, and depending on the size and position of the cyst:

- the lower lip, chin or tongue feels numb or tingles, when the cyst lies close to a nerve. This usually settles, but occasionally it is long-lasting;
- the roots of nearby teeth are affected and need treatment later;
- a denture no longer fits well, because the shape of the jaw has changed;
- very rarely, when a cyst is very large and the bone around it is thin, the jaw breaks during or after surgery;
- the cyst forms again, which is more likely with some kinds than with others.

How a cyst is treated, and how long it is followed afterwards, depends on its size, its position and the laboratory report. The dentist explains these for each case.

## Mucoceles: small cysts in the lip

A mucocele is a different kind of cyst. It lies in the soft lining of the mouth, not in the bone. It forms when a tiny salivary gland is blocked or injured, often after the lip has been bitten, and shows as a soft, bluish or clear swelling, most often inside the lower lip. It may burst and then fill up again. A small one that causes no trouble can be left alone; one that stays or keeps coming back is usually removed together with the small gland beneath it. The page on [small lumps inside the mouth](https://www.nazemalioussef.com/en/clinical-interests/small-lumps-in-the-mouth/) says more.

Routine check-ups, with X-rays when the dentist advises them, are how most cysts are found while they are still small.

## Questions patients ask

**Is a jaw cyst a cancer?**

No. A jaw cyst is a sac of fluid with a thin lining, and most grow slowly. The lining is still examined in a laboratory after it is removed. This is a routine step: it confirms which kind of cyst it was and whether any follow-up is needed.

**Does every cyst have to be removed?**

Not always. The choice depends on the size and kind of cyst and on the tooth it is linked to. A small cyst at the root tip of an infected tooth may be treated with root canal treatment of that tooth instead, and a very small cyst that causes no trouble is sometimes watched with X-rays at check-ups. Larger cysts, and cysts that keep growing, are usually removed.

**Why is the lining sent to a laboratory?**

Several kinds of jaw cyst look alike on an X-ray. Under a microscope, a pathologist can tell which kind it is. Some kinds are more likely than others to form again, and the laboratory report shows how closely a cyst should be followed afterwards.

**Is anything put into the space in the bone?**

Usually not. After the cyst is removed, the space in the bone gradually fills with new bone, and X-rays at later reviews show how it is healing. Bone heals slowly, and how long it takes differs from person to person.

**Can a cyst come back?**

It can. The common kinds, such as a cyst at a root tip or around a buried tooth, do not usually come back once removed completely. Some less common kinds come back more often, so the dentist plans the follow-up visits and X-rays around the laboratory report.

## What this page rests on

This page rests on patient information from the British Association of Oral Surgeons, Cork University Dental School and Hospital, two NHS hospital trusts and Cleveland Clinic, listed below. It is general information: whether a shadow on an X-ray is a cyst, and whether it needs treatment, can only be judged at an examination, and the kind of cyst is confirmed by the laboratory report on the tissue removed.

General health information, not a diagnosis or a treatment recommendation for any individual.

### Sources

1. British Association of Oral Surgeons — [For patients: dental and jaw cysts](https://www.baos.org.uk/for-patients/)
2. Cork University Dental School and Hospital — [Jaw cysts: patient information leaflet](https://www.ucc.ie/en/media/academic/dentalschool/patientinfoleaflets/JawCysts.pdf)
3. Calderdale and Huddersfield NHS Foundation Trust — [Oral and maxillofacial surgery: patient information](https://www.cht.nhs.uk/services/clinical-services/oral-and-maxillofacial-surgery/patient-information)
4. Cleveland Clinic — [Jaw cysts and tumors](https://my.clevelandclinic.org/health/diseases/jaw-cysts-tumors)
5. Royal Berkshire NHS Foundation Trust — [Salivary mucoceles](https://www.royalberkshire.nhs.uk/leaflets/salivary-mucoceles)

## Related pages

- [Frenum surgeryTongue-tie and lip-tie: when a tight frenum matters, and how it is released.](https://www.nazemalioussef.com/en/clinical-interests/frenum-surgery/)
- [GingivectomyWhen gum overgrows and covers part of a tooth: why it happens, and how the excess gum is removed.](https://www.nazemalioussef.com/en/clinical-interests/gingivectomy/)
- [Small lumps in the mouthCommon harmless lumps inside the mouth, when to have one checked, and how one is removed.](https://www.nazemalioussef.com/en/clinical-interests/small-lumps-in-the-mouth/)