Common kinds of lump
Most growths inside the mouth are not cancer. Biting, rubbing against a sharp tooth, and warts are among the common causes of harmless lumps. The kinds seen most often include:
- A fibroma, also called a fibroepithelial polyp: a firm, smooth, pink lump, usually on the inside of the cheek, the lip or the tongue. It is an overgrowth of the lining of the mouth in response to repeated biting or rubbing, often along the line where the back teeth meet. It usually does not hurt, but once it stands out it tends to be bitten again.
- A mucocele: a soft, bluish or clear swelling just under the lining, most often inside the lower lip. It forms when a tiny salivary gland is blocked or injured, often after the lip has been bitten, and it may burst and then fill up again. It is a small cyst in the soft tissue; cysts in the jawbone are a different matter.
- A papilloma: a small, wart-like growth with a rough surface, caused by the human papillomavirus (HPV). In the mouth, it is usually treated by removing it.
A lump or raised area on the gum can also come from a gum or tooth abscess, or from irritation by a rough filling or a denture that rubs.
When to have a lump checked
A lump that does not go away should be looked at by a dentist or doctor. The NHS advises seeing one if you have:
- a mouth ulcer that has lasted more than three weeks;
- a lump in your mouth or on your lip;
- a red or white patch in your mouth;
- pain in your mouth that is not going away.
The NHS lists these among the possible signs of mouth cancer, and adds that they are very common and can be caused by other conditions. Having one does not mean cancer; it means the area should be checked. The guide to mouth ulcers explains the three-week advice.
How a lump is assessed
The dentist asks how long the lump has been there, whether it has changed and whether the area has been bitten or knocked. They look at it and feel it, and check nearby teeth, fillings or a denture for a sharp edge that could be rubbing.
A small lump is usually removed completely and sent to a laboratory, which confirms what it is. This is called an excisional biopsy. For a larger area, a small piece may be taken first (an incisional biopsy), and any further treatment is planned once the report is back.
How a small lump is usually removed
How a small lump inside the cheek is removed
- The lump. A small, smooth lump on the inside of the cheek, near the line where the teeth meet.
- After removal. The lump has been removed and the site is closed with a few stitches.
Simplified drawing, not to scale.
Anaesthetic. A local anaesthetic is injected next to the lump, much as for a filling, and numbs a small area.
Removal. The lump is removed whole with a small blade. A mucocele is usually removed together with the tiny salivary gland beneath it.
Closing. The small wound is usually closed with a few stitches, often ones that dissolve on their own. Sometimes the area is sealed with heat (cautery) instead.
Laboratory. The tissue is sent to a laboratory, where it is examined under a microscope. This is routine.
Review. At a review, the dentist checks the healing and goes through the laboratory report.
Afterwards
Take care not to bite the lip, cheek or tongue while it is still numb. When the anaesthetic wears off the site is often a little sore, and simple pain relief as the dentist advises is usually enough.
On the day itself, avoid rinsing hard, as this can start bleeding again. Keep brushing as normal, including the teeth next to the wound. From the next day, if food catches around the stitches, rinse gently with warm salt water or a mouthwash without alcohol. Softer food is easier while the area heals.
A little bleeding usually stops with firm pressure on a rolled-up gauze or clean handkerchief. Bleeding that does not stop, pain or swelling that gets worse instead of better, or a fever should be reported to the dentist.
Risks
Removing a small lump is a minor procedure, but as with any surgery there can be discomfort, swelling, bleeding and infection. Less often:
- the lip or tongue near the site feels numb or tingles for a while, particularly after a mucocele is removed from the lower lip;
- a small firm scar forms where the lump was;
- the lump forms again, especially if its cause continues.
What a lump is can only be confirmed by the laboratory report, not by how it looks. The dentist explains the report, and any further care, at the review.
Many small lumps form where teeth rub or bite the lining of the mouth. A sharp tooth, a rough filling or a denture that rubs can often be smoothed or adjusted, which takes away the source of the irritation.
Questions patients ask
Is a lump in my mouth likely to be cancer?
Most lumps inside the mouth are not cancer, and many form where the cheek or lip has been bitten or rubbed. The NHS lists a lump in the mouth among the possible signs of mouth cancer, and notes that these signs are very common and can be caused by other conditions. A lump that does not go away should therefore be checked by a dentist or doctor.
Does every lump have to be removed?
No. A small fibroma or mucocele that causes no trouble can often be left alone, and some mucoceles go away on their own. A lump is usually removed when it keeps being bitten, gets in the way or is visible, keeps coming back, or when what it is needs to be confirmed.
Why is the tissue sent to a laboratory?
Many lumps look alike, even to a trained eye. Examining the tissue under a microscope is how the diagnosis is confirmed, so it is done as a routine step, not only when something looks unusual. The dentist goes through the laboratory report at a review.
Can a lump come back after it is removed?
Sometimes, particularly if its cause continues. A lump from cheek biting can form again if the biting goes on, and a mucocele can return if the small gland beneath it is left behind. Part of treatment is looking for the cause, such as a sharp tooth, a rough filling or a denture that rubs.
Does removing a small lump hurt?
It is usually done under local anaesthetic, so the area is numb; the injection may sting briefly. Once the anaesthetic wears off, the site is often sore for a while, a little like a mouth ulcer, and simple pain relief as advised by the dentist is usually enough.
What this page rests on
This page rests on patient information from the NHS, an NHS hospital trust and the Merck Manual, listed below. The advice on when to have a lump, patch or ulcer checked is the NHS's. It is general information: what a particular lump is can only be judged at an examination, and is confirmed by the laboratory report on the tissue.
General health information, not a diagnosis or a treatment recommendation for any individual.
Sources
- NHS — Symptoms of mouth cancer
- Merck Manual, Consumer Version — Mouth growths
- Royal Berkshire NHS Foundation Trust — Oral (mouth) biopsy
- Royal Berkshire NHS Foundation Trust — Fibro epithelial polyp (FEP)
- Royal Berkshire NHS Foundation Trust — Salivary mucoceles