Saturday, December 7, 2013
Lump on Floor of Mouth
I have had a very small lump (probably 2-3 mm) on the floor of my mouthright upbehind my front teeth for about four years. I`ve asked dental professionals about it a couple times over the years but neither of them could feel it and basically said to not worry. I don`t think it has grown over time, or if it has it has been so gradual that I haven`t noticed. It feels soft and moveable and it does not hurt, it only feels tender when I rub at it. Given this information should I be concerned?
The possible explanation for the symptoms described could be that you have some form of salivary gland obstruction (ductal) that is producing the small swelling on the floor of the mouth. Now the other possibility is that you might have a small protuberance of bone (lingual tori or exostosis), but this type of lesion is fixed and very hard.
Salivary gland obstructions can be the result of a salivary "stone" or small calcification, or can be the accumulation of saliva that can't be normally expressed due to some form of blockage. There are 3 paired major salivary glands in the oral cavity (parotid, sub-mandibular, and sub-lingual). The parotid and sub mandibular have a high likelihood of sialolith formation, the sub-lingual is the one that has greater chance of saliva retention and has been called a "ranula" or "Frog Belly" due to its appearance on the floor of the mouth looking like a large bloated swelling or belly.
Minor salivary glands can become blocked and swollen. There are approximately 3-4,000 minor salivary glands within the oral cavity.
These small glands produce a high mucin (mucous) content secretion and when they become blocked, can also enlarge to 2-4 mm in diameter, be very fluctuant and also mobile. In most cases pain is not a problem unless a significant amount of swelling occurs or the stone is completely blocking the salivary flow. Interestingly, the pain occurs just before eating, and is related to increase in salivary flow. Treatment for salivary flow problems can range from doing nothing to surgical removal of the blockage. For most cases, the problem resolves and treatment is not required.
Therefore, if your dentists were not concerned, I would not be too worried, unless the symptoms increase or you experience pain.
Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University