Oral Cysts and Periodontal Issues: Expert Dental Advice

A small cyst has developed on the inner mucosa of the lower lip, along with periodontal disease and dental issues?

Hello, Doctor.
I have two questions I would like to ask.

First, before June 8, I often bit my lower lip while eating, repeatedly injuring the same spot.
After the wound healed, a small cyst (painless) began to form in that area, and it has been growing larger (about 0.5 cm).
I consulted a dermatologist who diagnosed it as a cyst and performed cryotherapy.
The doctor mentioned that if it wasn't treated soon, it would continue to grow.
After two follow-up treatments, the cyst has flattened.
However, I have now noticed a small hard bump in the same area, similar to my previous experience, and I am unsure if it is a recurrence.
Since June 8, after the cyst treatment and recovery, I have not bitten my lower lip again.
The only factor is that I wear a retainer at night due to previous orthodontic treatment.
Could the friction from the metal parts of the retainer be causing the cyst to recur?
Second, during my orthodontic treatment, I had a molar with a small bracket that felt loose while eating.
After I reported this to my orthodontist, he removed the bracket to check the molar, which was already worn down and no longer protected.
The doctor mentioned that this tooth has periodontal disease, which is why the root is loose, and he suggested dental implants.
This molar has undergone root canal treatment, and currently, the dentist has filled the deep cavity with cotton, but it has gradually fallen out over time.
The dentist recommended extraction and suggested either a bridge or an implant.
I would like to know if a tooth with periodontal disease and looseness is still suitable for an implant.
If I continue to leave this untreated, will it cause the previously corrected teeth to shift? Thank you for your patience in reading this and for your assistance in answering my questions.

Pacey, 20~29 year old female. Ask Date: 2015/07/13

Dr. Zeng Guanghui reply Dentistry

1.
After frequently biting the lower lip while eating, it was determined to be a cyst.
Following cryotherapy, the cyst has disappeared.
However, a small, hard bump has reappeared in the same location, similar to the previous one.
It is possible that the mucosa of the lower lip has been irritated again due to friction.
If it is suspected that the retainer used after orthodontic treatment is causing this issue, a detailed examination by the orthodontist should be requested.
2.
During orthodontic treatment, the molars with the small brackets felt loose.
After the orthodontist removed the brackets, it was found that the looseness was due to periodontal disease.
If the periodontal disease is severe and has caused significant looseness, it is recommended to extract the affected teeth and repair them using a dental bridge or implants.
Generally, after extracting teeth affected by severe periodontal disease, it is advisable to wait 3-6 months for the gums to heal before considering implants.
If left untreated, this could lead to the misalignment of the orthodontically adjusted teeth, so it is essential to have a thorough evaluation by a dentist.

Reply Date: 2015/07/13

More Info

Hello! Thank you for reaching out with your questions regarding oral cysts and periodontal issues. Let's address each of your concerns in detail.

First Concern: Oral Cyst Recurrence
It sounds like you have been dealing with a recurring cyst in your lower lip area, which developed after repeated biting. The fact that you have already sought treatment from a dermatologist and received cryotherapy is a positive step. However, the recurrence of a hard lump in the same area raises some questions.

1. Cyst Recurrence: It is possible for cysts to recur, especially if the underlying cause is not addressed. In your case, the initial injury from biting may have contributed to the formation of the cyst. If the area continues to be irritated or traumatized, it could lead to further cyst formation.
2. Potential Causes: The metal components of your orthodontic retainer could indeed be contributing to irritation in the area, especially if they are in close contact with the soft tissue of your lip. Consider discussing this with your orthodontist to see if adjustments can be made to minimize irritation.

3. Next Steps: Since you have already undergone treatment, it may be beneficial to consult with an oral surgeon or a specialist in oral medicine. They can provide a more thorough evaluation of the cyst and recommend appropriate treatment options, which may include surgical removal if necessary.

Second Concern: Periodontal Disease and Tooth Mobility
Regarding your second concern about the tooth that has been diagnosed with periodontal disease and is experiencing mobility:
1. Periodontal Disease and Tooth Mobility: Periodontal disease can lead to the loss of supporting structures around the teeth, including bone and gum tissue. If a tooth is loose due to periodontal disease, it indicates that the supporting structures are compromised. This can make the tooth less stable and may necessitate extraction.

2. Implant Consideration: If the tooth is extracted, dental implants can be a viable option for replacement. However, the success of an implant largely depends on the health of the surrounding bone. If periodontal disease is present, it may be necessary to treat the disease and ensure that the bone is healthy enough to support an implant.

3. Impact on Orthodontic Alignment: If the tooth is not addressed, there is a risk that the alignment of your previously corrected teeth could be affected. Teeth can shift if there is a gap or if adjacent teeth are not stable. Therefore, it is crucial to address the mobility of the affected tooth promptly.

4. Recommendations: I recommend that you consult with a periodontist who can assess the extent of the periodontal disease and provide a treatment plan. They may suggest scaling and root planing, surgical intervention, or other therapies to stabilize your periodontal health before considering an implant.

Conclusion
In summary, it is essential to address both the recurrence of the cyst and the periodontal issues with appropriate specialists. For the cyst, an oral surgeon can provide targeted treatment, while a periodontist can help manage your periodontal disease and assess the viability of dental implants.
Maintaining good oral hygiene, attending regular dental check-ups, and addressing any discomfort or changes in your oral health promptly will be crucial in managing these issues effectively. Please feel free to reach out if you have further questions or need additional clarification. Thank you!

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