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Mouth Diseases

Small pimple-like bump inside of lower lip

02/24/2009

Question:

Hello, I hope you`ll be able to help me out.

For the past four days I have had this bump on the inside edge of my lower lip (where my teeth meet my lip). At first I thought it might be a canker sore. It started out small and white but then I noticed it had a "white-head" and it started to get bigger (more like a pimple). For the most part, it didn`t hurt and I was able to forget about it and leave it alone.

After a day or so, it still didn`t get better and I decided to see if I might be able to pop it. It was difficult but eventually it gave way and a small amount of white puss was squeezed out. The bump was smaller after that.

The next day it came back, only it was clear and slightly bigger than before. It`s stubborn and doesn`t want to be popped. I don`t want to try anything in case I agitate it even more and and get an infection because of it. It still doesn`t hurt for the most part but it`s really annoying. I thought maybe this was caused by the corner of my tooth rubbing against my lower lip, this is the first time it has occurred in all my life. Thank you for your time. I hope I`ve provided enough information.

Answer:

Chances are you are describing a blocked minor salivary gland and resultant sequelae associated with traumatizing it. The lower lip or the labial mucosa (oral cavity side) has many minor salivary glands located underneath the mucosal covering. These small distinct glands provide a secretion high in mucin and thus help lubricate the oral mucosa. This lubricating effect keeps the tissues from sticking to your teeth, and also helps lubricate the food you eat in order for it to course the GI tract.

Sometimes you bite the lip or traumatize the mucosa and the resultant trauma causes a localized swelling that may in turn inhibit the saliva flow to exit the gland into the mouth.

In some cases the saliva will back up and - in the case of larger, more prominent glands - cause a major swelling of the underlying mucosa. This is frequently observed in the glands located under the tongue (submandibular and sublingual glands). The resultant swelling is termed a ranula or “frog belly”; the minor salivary gland collection of saliva is referred to as a mucoceole.

Now, to explain what you did by manipulating this blocked minor salivary gland, you probably ruptured the pesudocyst, and caused the collection of mucinous saliva to be expressed. The rupture then closed over and the phenomena reoccurred, but this time you had a collection of clear fluid form.

The major problems that can occur is that your “playing” with the mucoeole may delay healing and also you run the risk of an infection. My advice would be to have this evaluated by your dentist and possibly have him or her smooth the incisal edge of the lower teeth to limit the reoccurrence.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University