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Mouth Diseases

Oral mucocele treatment/info

07/15/2009

Question:

I have had a small flat whitish/clear are on my lower lip for a few weeks. Have had two dentist and one doctors appointments for it. They both said it was clogged ducts aka mucocele. Both doctors also said that there was not much I could do besides wait and see if it goes away on it`s own. My questions are 1. Aren`t mucocele`s usually a `bubble` shape, mine is flat? 2. Are there ANY ways of unclogging these ducts on my own (lemons, salt water, etc) ???

Answer:

Mucocole or “mucous extravasation phenomena” occur when the secretions of a salivary gland collect within the salivary duct or become sequestered subepithelially. The cause can be the result of trauma to the duct orifice, or a small blockage the result of a salivary stone or sialolith. The saliva continues to be produced but is retained within the tissue and not expelled out into the oral cavity as spit.

Shape and size can be quite variable and site/location dependent (i.e., underneath the tongue/floor of the mouth is a common site and these things can get big and resemble a “Frog’s Belly”, hence the other name for the mucoele that being a “ranula”).

The large “cyst” can be a problem, and some cases require surgical intervention (Marsupialization or stone removal). In your case, the flatness you describe may be positional and also due to the small amount of saliva being retained. In some instances, especially if the problem exists in one of the three major pairs of glands (parotid, sub-mandibular, and sub-lingual), eating sour foods, chewing gum, milking the gland and duct, may facilitate removal of the obstruction. This would be the result of increased secretion as a result of these stimuli, and disrupting the blockage within the ductal system. This does not always work and more specific procedures would then be required (imaging by sialographic methods, or NMRI, followed by surgical removal of the stone or obstruction).

On the other hand, small minor salivary glands, which are high in mucin, and have small flow volumes may not respond to these attempts at unclogging the duct.

As your clinicians have mentioned “watch and see”. I realize that is not what you would like to hear but in most cases, leaving the area alone and reducing the irritation/trauma may be more advantageous than messing around with them.

Above all, do not try and puncture them, as you run an increased risk of infection, and a really swollen lip.

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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