Lymph Node Issues in the Neck: Common Concerns and Symptoms

Lymphatic issues in the upper central neck?

Hello, doctor.
I have a problem with my lower left wisdom tooth and the adjacent tooth.
A few days ago, the gum in that area became infected, and I noticed that the lymph node in the upper central part of my neck, slightly to the left, was swollen to about 2 centimeters (it was painful, smooth on the surface, and movable).
I visited a dental clinic, and the doctor prescribed anti-inflammatory medication, which caused the abscess to disappear and the lymph node to shrink and become painless.
However, when I used my tongue to touch the wound, I found something that feels like a cord left behind (parallel to the tooth and movable up and down), and the lymph node has not disappeared; it has just reduced in size (about 1 centimeter, movable, and smooth on the surface).
I can only feel it when I tilt my head.
Additionally, I checked other areas in my mouth and found a small, pointed, movable nodule in the middle of the inside of my left cheek, about 0.3 centimeters in size.
I would like to ask: 1.
Is there a problem with the lymph node above my neck? It has not disappeared and is only on one side.
2.
Are lymph nodes typically symmetrical? 3.
What is the cord-like structure under my wisdom tooth? 4.
What could the small nodule inside my cheek be? 5.
Is there a possibility that I could have oral cancer or any malignant tumor?

Xiao Wei, 20~29 year old female. Ask Date: 2004/01/06

Dr. Cai Hongyan reply Otolaryngology

1.
Is there a problem with the lymph nodes above my neck? They haven't disappeared and are only on one side – it should be fine; some inflamed lymph nodes can persist for up to six months.

2.
Are the lymph nodes symmetrical? – No.

3.
What is the string-like structure under my wisdom tooth? – It could be other smaller lymph nodes.

4.
What could the small bumps inside my cheek be? – It needs to be examined to know for sure.

5.
Is there a possibility that I could have oral cancer or any malignant tumors? – It needs to be examined to know for sure.

Reply Date: 2004/01/06

More Info

When dealing with lymph node issues in the neck, especially in the context of dental problems, it’s important to understand the underlying causes and the implications of the symptoms you are experiencing. Based on your description, it seems that you have had an infection related to your wisdom tooth, which can lead to lymphadenopathy (swelling of the lymph nodes) in the neck. Let’s address your questions one by one.

1. Is there a problem with the lymph node in the upper neck?
The lymph node you mentioned, which was swollen to about 2 cm and painful, is likely a reactive lymph node responding to the infection in your mouth. The fact that it has decreased in size to about 1 cm and is no longer painful is a positive sign. Lymph nodes can remain enlarged for some time after an infection has resolved, as they may take a while to return to their normal size. However, if the lymph node remains enlarged for an extended period or if you notice any changes in its characteristics (such as becoming hard, fixed, or painful again), it would be prudent to follow up with a healthcare provider.

2. Are lymph nodes symmetrical?
Lymph nodes are not always symmetrical. It is common for one side of the body to react more than the other, especially in cases of localized infections. In your case, the unilateral swelling of the lymph node on the left side is likely due to the infection in that area (your left lower wisdom tooth).
3. What is the "string-like" structure under the gum near the wisdom tooth?
The "string-like" structure you feel could be a few things. It might be a fibrous band of tissue or a remnant of the healing process after the infection. Sometimes, after an infection, the tissue can heal in a way that leaves behind fibrous tissue that feels different from the surrounding gum. If it continues to cause concern or discomfort, it would be wise to have it evaluated by a dentist or oral surgeon.

4. What about the small bump inside the left cheek?
The small, movable bump you feel inside your cheek could be a minor salivary gland or a small fibroma, which are benign growths. It’s not uncommon to have small bumps in the oral cavity that are not harmful. However, if it changes in size, shape, or becomes painful, it should be evaluated by a healthcare professional.

5. Is there a possibility of oral cancer or any malignancy?
The risk of developing oral cancer or any malignancy is generally low, especially in the context of a recent infection and given your age and health status. Oral cancer typically presents with specific symptoms such as persistent sores, lumps that do not heal, or changes in the texture of the tissue. However, if you have concerns about your risk factors (such as smoking, heavy alcohol use, or a family history of cancer), it is advisable to discuss these with your healthcare provider. Regular dental check-ups and oral examinations are essential for early detection of any potential issues.

In summary, while your symptoms are likely related to the recent dental infection, it’s crucial to monitor the lymph node and any other changes in your oral cavity. If you have any persistent concerns or if the lymph node does not continue to decrease in size, seeking further evaluation from a healthcare professional is recommended. Regular follow-ups and maintaining good oral hygiene will also help in preventing future infections and complications.

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