Subgingival Growths: What to Do About Gum Lesions

A尖-shaped polyp on the inner gum area of the lower teeth beneath the tongue?

Hello, Doctor! I have noticed a pointed growth resembling a polyp at the bottom of the gums on the inner side of my lower teeth, measuring approximately 0.2 mm in width and 0.3 mm in height.
It has the same color as the surrounding gum tissue and has been present for about a week.
It is not painful! When I touch it with my tongue, it feels slightly hard, like a small lump, and its size has not changed.
I am currently pregnant and have had no sexual contact.
Could you please tell me what this might be? Is it a minor salivary gland tumor or a pointed wart? Should I see a general dentist, an oral surgeon, or an ENT specialist? Thank you.

Alice, 30~39 year old female. Ask Date: 2017/04/03

Dr. Zeng Guanghui reply Dentistry

A尖-shaped growth resembling a polyp has developed at the bottom of the gums on the inner side of the lower teeth.
This may be due to hormonal changes during pregnancy, which can lead to increased gum inflammation.
It is advisable to consult a dentist for further examination.

Reply Date: 2017/04/03

More Info

When it comes to subgingival growths, particularly those that appear as small, firm, and painless lesions on the gums, it is essential to approach the situation with a thorough understanding of potential causes and appropriate management strategies. Based on your description, the growth you are experiencing at the base of your lower gums could be a variety of things, including but not limited to a fibroma, a mucous retention cyst, or even a benign tumor. Given that it is painless and has not changed in size, it is less likely to be malignant, but it is still important to have it evaluated.

Possible Causes of Gum Lesions
1. Fibroma: This is a benign growth that can occur in the oral cavity, often as a response to irritation or trauma. They are usually firm, painless, and can vary in size.

2. Mucous Retention Cyst: These cysts can form when a salivary gland duct becomes blocked, leading to the accumulation of mucus. They are typically soft and may fluctuate in size.

3. Papilloma: This is a benign epithelial tumor that can appear as a small, wart-like growth. They can be caused by the human papillomavirus (HPV) and are generally painless.

4. Salivary Gland Tumors: While less common, tumors of the salivary glands can present as firm masses in the oral cavity. These can be benign or malignant, so evaluation is crucial.

5. Condyloma Acuminatum: These are warts caused by HPV and can appear in the oral cavity, although they are more commonly found in the genital area.

Recommended Actions
1. Consultation with a Dentist or Oral Surgeon: Given the nature of the growth, it would be advisable to first consult with a general dentist. They can perform an initial examination and determine if a referral to an oral surgeon or an ear, nose, and throat (ENT) specialist is necessary for further evaluation.

2. Biopsy: If the dentist or oral surgeon deems it necessary, a biopsy may be performed to obtain a definitive diagnosis. This involves removing a small sample of the lesion for histological examination.

3. Monitoring: If the growth is determined to be benign and not causing any symptoms, your healthcare provider may recommend monitoring it over time to ensure it does not change in size or character.

4. Oral Hygiene: Maintaining good oral hygiene is crucial, especially during pregnancy, as hormonal changes can affect gum health. Regular brushing, flossing, and dental check-ups can help prevent further issues.

Conclusion
While the growth you described is likely benign, it is essential to have it evaluated by a dental professional to rule out any serious conditions. Early diagnosis and management are key to ensuring your oral health remains optimal, especially during pregnancy when hormonal changes can impact gum health. If any changes occur, such as pain, bleeding, or an increase in size, seek immediate attention. Your healthcare provider will guide you through the appropriate steps based on their findings.

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