A bump on the gum: what to do, how to treat?

A lump on the gum is an unpleasant symptom that can accompany many dental diseases. It is worth noting right away that "a lump on the gum" is a rather abstract and simplified concept. This term is used only to describe the clinical picture of the disease and is widespread mainly among the common people. Depending on the specific pathology, a lump on the gum will have a specific scientific name.

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Causes gum bumps

The reasons for the appearance of a lump on the gum can be very different. Since this symptom can appear with dental diseases of different groups (diseases of teeth, periodontium, mucous membranes), it is worth considering each pathology separately. It would be rational to start with the most common diseases and finish with rarer ones. So, the main reasons for the appearance of a lump on the gum are: cyst, hematoma, exostosis, periostitis, hypertrophic gingivitis, benign and malignant tumors of soft tissues.

Cyst

Many inflammatory processes that occur in the ligamentous apparatus of the tooth can be accompanied by the appearance of a lump in the gum. One of the striking examples is the formation and suppuration of a radicular cyst. The pathogenesis of this phenomenon can be described in different ways. For example, a person develops a carious lesion of a tooth. Then this process causes inflammation of the pulp, which subsequently provokes the occurrence of periodontitis. Inflammation of the ligamentous apparatus of the tooth can be acute or primarily chronic (when a chronic course occurs immediately). An acute inflammatory process most often immediately forces a person to consult a specialist. However, primarily chronic periodontitis is asymptomatic, which does not create any reason for a visit to the doctor. Thus, a granuloma is formed around the root of the tooth, which contains a dense epithelial capsule and liquid contents. Another pathogenetic mechanism can be a tooth injury with the subsequent development of traumatic periodontitis and the transition of inflammation to a chronic form. It is also worth noting arsenic and toxic periodontitis, which occur as a result of complications of endodontic treatment. All these situations ultimately lead to the formation of a granuloma. If there are no exacerbations of periodontitis in the tooth, then the formation around the root of the tooth gradually increases. Reaching a diameter of 0.5 cm, the granuloma passes to the stage of cystogranuloma. When the size exceeds 0.8 cm, then we are talking about a cyst. Interestingly, even with sizes of about 3 cm or more, a person may not feel any symptoms. Although some people have certain symptoms: increased sensitivity when biting on a tooth, discomfort in one or more teeth, displacement of teeth without an apparent reason (in advanced stages).

All symptoms of the cyst are absent or appear "blurred" only until it suppurates. When the cyst suppurates, the serous contents turn into purulent exudate. And, as is known, any purulent processes in the body occur with quite vivid symptoms. It is at this stage of the disease that a person can clearly see that a lump has appeared on the gum. Its formation is due to the fact that the pus that is in the cystic cavity tends to come out. As a result, a fistula is formed, which comes out in the gum area and creates a lump with pus on it. In addition to this symptom, the general condition of the body worsens, symptoms of intoxication appear, body temperature rises, and lymph nodes may enlarge.

Previously, we talked about radicular cysts, which are most often a consequence of chronic granulomatous periodontitis. However, in addition to it, there is also a granulating form. The peculiarity of this disease is that during an exacerbation, a fistula opens on the gum. Clinically, a person is concerned about persistent pain in the tooth, which intensifies at the moment of biting. Any touch to the causative tooth causes a sharp pain that is unbearable. In some situations, pus periodically flows out of the gap between the tooth and the gum. The gum in the area of the periodontitis tooth is bright red, painful on palpation. In the projection of the tooth root on the gum, a fistula with a diameter of several millimeters to a centimeter can be observed. It looks like a white bump on the gum, which is located above the tooth. The mechanism of its formation is the same as with suppuration of the cyst: pus tends to go out into the open environment and moves along the path of least resistance. As a result, when purulent masses pass through the bone, they encounter the elastic mucous membrane. This causes a lump to grow on the gum. It is logical to assume that the pressure of pus on the mucous membrane should cause severe pain. However, with periodontitis, the pain in the tooth is much stronger than in the gum. Therefore, patients most often note only the presence of a lump, and characterize the pain as toothache.

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Hematoma

When performing anesthesia, there are sometimes situations when the needle pierces a venous vessel. This may be due to both the individual anatomy of the cardiovascular system and the wrong choice of needle for performing anesthesia. A hematoma on the gum may appear after infiltration anesthesia. Clinically, it manifests itself as a dark blue or black lump. In the dentist's office, a person does not pay attention to the presence of a hematoma. This is due to the fact that the anesthetic blocks pain, thereby smoothing out the symptoms of the hematoma. And after leaving the dentist, the patient may realize that, for example, after tooth extraction, he has a lump on the gum. It is worth saying right away that you should not puncture the blister. If you do this, a wound will form at the site of the lump, into which an infection can get. A hematoma on the gum goes away on its own and does not leave any consequences.

Sometimes hematomas appear in children when baby teeth are erupting. In this case, you should contact a pediatric dentist so that the doctor can conduct an examination. Based on the data obtained, the specialist will decide whether it is necessary to create additional conditions for teething or whether the child's body will cope with this task on its own.

Exostoses

Exostoses are bone protrusions on the jaw that visually and upon palpation resemble a lump. The causes of exostoses have not been fully studied, however, the main risk factor is the absence of a large number of teeth. The fact is that when teeth are lost, the jaw bone in the toothless area begins to atrophy. This process is due to the fact that the bone tissue of the human body is designed to withstand stress. And if there is no physical stress, then the corresponding bone area simply dissolves. It should be noted that each person has individual mechanisms of bone formation and destruction. Therefore, in some areas the bone continues to exist, and in others it atrophies. The surviving bone fragments can have different shapes and sizes. Exostoses often have a triangular, oval or spiky shape. However, regardless of the shape of the bone, it seems to a person that he has a hard lump on his gum. As a rule, it does not hurt and does not increase in size. No changes are observed from the mucous membrane either. The gum is pale pink and has a normal texture that resembles the texture of lemon peel. And everything would be fine, but problems arise when a person begins to use a removable plate denture. If the doctor did not take into account the presence of exostoses when making the denture, then problems with fixing the base may subsequently begin. In this case, the person will stop using the denture and all the efforts of the doctor and the patient will be meaningless.

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Periostitis (flux)

Periostitis is a disease in which the inflammatory process is localized in the periosteum. Most often, the main factor in the development of the disease is pulpitis or periodontitis. The first signs of periostitis are minor swelling in the gum area. Gradually, the swelling grows and a pain syndrome appears, which is characterized by the spread of pain to the temporal, orbital, parietal and other areas. As a rule, the general condition of the body significantly worsens: weakness, headache, body temperature rises to 38 ° C. In some cases, with periostitis, a fistula appears on the gum. As mentioned earlier, it looks like a lump on the gum.

Hypertrophic gingivitis

Hypertrophic gingivitis (hypertrophy - "overgrowth, gingivitis - "inflammation of the gum") is an inflammatory disease of the gum, which is accompanied by the proliferation of its soft tissues. The causes of this disease are described rather abstractly. Great importance in the origin of the pathology is given to disorders of the endocrine system. Also, hypertrophic gingivitis can occur during hormonal surges, which are physiological processes. For example, in adolescents during puberty, there is an active release of hormones. Also important is the menstrual cycle in women and the period of pregnancy. All these conditions very seriously affect the fragile hormonal system. The risk factors for the development of this disease are the following: taking hormonal drugs, a period of physiological hormonal surges, diseases of the endocrine system. The clinical picture of hypertrophic gingivitis is quite vivid. The gum becomes red and swollen. Growths of the gingival papillae appear, which resemble bumps between the teeth. A person feels itching and tingling in the gums, an unpleasant taste in the mouth and increased viscosity of saliva. Diagnosis of gingival hypertrophy itself is very simple. The clinical picture speaks for itself. However, to identify the cause of this condition, a comprehensive examination of the body may be necessary.

Benign tumors

Bumps on the gums are sometimes benign tumors. Among this group of pathologies, papilloma and fibroma are the most common. They can appear in people of any age and gender. Predisposing factors include stress, chronic trauma to the mucous membrane, systemic diseases, and hereditary predisposition.

A papilloma is an overgrowth of the papillary layer of the dermis. This neoplasm grows rather slowly (over the course of several months), but under certain conditions (decreased immunity, stressful situations, systemic diseases) papillomas can accelerate their growth, while remaining a benign tumor. Clinically, a papilloma overgrowth looks like a soft, smooth lump on the gum, pink or white, located on a thin stalk. It does not hurt and may not cause significant discomfort. However, over time, a person may notice that the lump on the gum is growing. And in this case, it is absolutely impossible to remain indifferent to this phenomenon. You should consult a doctor and perform all the required tests.

Fibroma is a benign tumor that consists of connective tissue fibers. Externally, it resembles a papilloma, but has a wide base and a bumpy surface, which distinguishes it from the tumor discussed earlier. In general, fibroma has the same growth pattern as papilloma.

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Diagnostics gum bumps

Diagnosis of cysts in the early stages is very difficult. This is explained by the absence of symptoms that can make a person go to the doctor. Therefore, cysts are most often discovered accidentally when performing a targeted image or panoramic radiography. The only "positive" property of a cyst is that it is clearly visible on the radiograph. This allows the doctor to see its boundaries and understand what extent of surgical intervention will be required.

Diagnosis of exacerbation of chronic granulating periodontitis is usually not difficult for a clinician. Patient complaints of pain when biting indicate that it is most likely periodontitis. If the tooth was previously treated, then we can talk about an exacerbation of the inflammatory process. Since the tooth hurts and there is a lump on the gum, then the person has granulating inflammation of the ligamentous apparatus of the tooth. The diagnosis is confirmed by X-ray data. The image shows an area of darkening of the bone in the area of the root apex in the form of "tongues of flame" without clear contours. This indicates the resorption of bone tissue in the focus of granulating infection. During the clinical examination, differential diagnostics with suppuration of the cyst should be carried out. However, this problem can also be solved by analyzing the X-ray.

Diagnosis of exostoses is not a problem. Diagnosis does not require any tests or laboratory diagnostics. A clinical examination is enough to clarify the situation. Most often, bone formations appear in people of mature and old age with partial or complete adentia. Bone protrusions form rather slowly, because atrophy processes occur over several years. Also, the normal state of the mucous membrane speaks in favor of exostoses.

A clinical examination is sufficient to diagnose periostitis. The doctor makes a diagnosis and selects a treatment method.

Tumors are diagnosed only by laboratory examinations. Clinical instrumental diagnostics are only preliminary and do not carry final diagnostic value. Therefore, histological and cytological examinations are performed. If there is a suspicion of malignancy, then "histology" of the taken material is most often performed. The nature of tissue growth (benign or malignant) is assessed on the preparation. If there is no suspicion of malignancy, then cytological examination is performed. Under a microscope, a pathologist evaluates the integrity, condition of organelles and maturity of cells.

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Treatment gum bumps

Today, there are two types of cyst treatment, both of which are surgical. The first method is cystotomy. This method is more conservative, it involves creating an outflow of fluid from the cystic cavity. As a result of decreasing pressure in the cavity, the tissues displaced by the cyst will begin to return to their original position. To do this, a channel is surgically formed through which the exudate will be drained from the cyst. To prevent the created channel from overgrowing, a special obturator is implanted into it. The cystotomy method is used only for large cystic cavities that pose a threat to the integrity of the jaw bones. In other cases, this approach is not recommended. Firstly, the reduction of the cyst can last up to one year, and this involves the presence of the obturator in the oral cavity throughout the entire treatment period. Secondly, the growth of the cyst can recur at any time, which makes the entire therapeutic process ineffective. It is also worth noting that in order to avoid relapse, a cystectomy is required one way or another. Therefore, in most clinical situations, a cystectomy operation is performed.

Cystectomy is the complete surgical removal of the cystic cavity. This intervention involves the total extraction of the cyst contents along with its membrane. It is very important that surgeons do not leave any part of the neoplasm in the bone. If this happens, the cyst may continue to develop. The ideal option is to extract the cyst without damaging its membrane. In this case, you can be completely sure that there is no pathological tissue left in the bone. Also, during cystectomy, a resection of the root apex of the causative tooth is performed. Simply put, the root apex of the tooth is sawed off and the resulting cavity is filled with artificial bone material. As a result, after high-quality surgical intervention, the lump on the gum disappears, the integrity of the bone remains preserved, and the prognosis for recovery is favorable.

Treatment of exacerbation of granulating periodontitis is a difficult test for both the doctor and the patient. The course of therapy can last several months or even a year. The entire period of treatment requires strict adherence to all the doctor's instructions. Statistics show that 70% of people under 40 have lost at least one tooth due to inflammatory processes in the periodontium. Most of these people consulted a doctor late or ignored the dentist's recommendations during the therapy. From this, we can conclude that preserving a tooth is a goal that must be achieved together with a doctor.

If a person has a lump on the gum and the doctor has diagnosed an exacerbation of chronic granulating periodontitis, the first thing the dentist must do is open the tooth to create access to the canals. Unfortunately, this process will remove the fillings and crowns that cover the tooth. It should be said right away that it will no longer be possible to carefully remove the crown and fix it back on the tooth after treatment. This can lead to fluid getting between the crown and the tooth, which will lead to tooth decay or an exacerbation of periodontitis. After opening the tooth, the doctor cleans the canals and removes the filling material from them. It should be noted here that cleaning previously filled canals is a very complex process. You need to be prepared for the doctor to work with the canals for several hours. And if the specialist manages to do it faster, let it be a pleasant surprise for you. After cleaning the canals, they are repeatedly washed with various antiseptics. No matter how strange it may sound, the main source of infection is in the canals of the tooth, and not in the periodontium. Therefore, high-quality root canal treatment is an important stage in the treatment of periodontitis. When the canals are prepared, antibacterial and anti-inflammatory pastes are introduced into them. After this, the tooth is closed with a temporary filling. The next visit is in 3-6 days. The tooth is opened again, the canals are washed again and this time substances that stimulate bone tissue regeneration are introduced into the root canals. This is necessary in order to eliminate the focus of bone tissue resorption. After this, the tooth is closed with a temporary filling again and the next visit is expected, which will be in about a week. The last stage is repeated a large number of times. If positive dynamics are observed, then the bone darkening focus on the radiograph will gradually decrease. This will indicate that the treatment method is effective and the therapy should be continued. When the bone in the image acquires the desired density and texture, then we can say that the tooth treatment is complete. It is worth noting that this is a classic example of periodontitis treatment. Today, there are many effective methods. Therefore, the therapeutic method suggested by your doctor may differ from that given in the article, but be quite acceptable.

Treatment of exostoses is not always required. The fact is that bone surgery is always a serious surgical intervention. And, given the fact that most patients with exostoses are people aged 50 and older, it is worth considering the advisability of this type of intervention. Therefore, if exostoses do not create obstacles for fixing the prosthesis, then they can be omitted. It is only recommended to make a prosthesis that will not rest against bone protrusions or will have a soft lining. Sometimes the size and shape of exostoses do not allow achieving the optimal result of removable dentures, which requires alvelectomy. This operation consists of several stages. The first is local anesthesia. The second is peeling off the mucous membrane of the gum. The third is preparation of the bone protrusion with burs. The fourth is placing the flap in place and suturing the wound. This operation is very effective, however, the age of many patients is the reason for refusing the operation. On the other hand, the chewing function should be present at any age. This means that you need to look for a way to restore the dental arches. Implantation, alveolectomy, dentures with holes for exostoses, dentures with soft lining, elastic dentures - all these are options for solving one problem, and which one to choose should be decided together with the doctor in the dental office.

There are conservative and surgical methods of treating periostitis. Conservative treatment involves the use of anti-inflammatory drugs, antibiotics to eliminate the purulent process. With the surgical method, the doctor makes an incision in the area of the inflammation, washes and drains the wound. Only a qualified specialist decides which treatment method to choose.

Treatment of hypertrophic gingivitis should be directly related to the factors that provoke the appearance of this condition. This is a very important point that must be realized before trying to cure gum bumps with hypertrophic gingivitis. For example, during pregnancy, drug treatment of this condition is absolutely undesirable. The fact is that in this situation, gum hypertrophy is caused by hormonal changes that always accompany the course of pregnancy. Therefore, the use of drugs can have a toxic effect or disrupt hormonal balance, which can lead to serious consequences.

In adolescence, drug treatment of hypertrophic gingivitis is also not indicated. This is again due to the fact that hormonal surges at this age indicate normal and timely development of the body. Therefore, only the following questions remain: "What to rinse with?", "What to smear the gums with?", "When will the bumps on the gums go away?" Since there is an inflammatory component during hypertrophic gingivitis, it is recommended to use infusions of medicinal herbs that have antiseptic and anti-inflammatory properties. You can also use rinses and toothpastes containing medicinal herbs. In short, the basis of treatment is optimal oral hygiene and herbal medicine.

In some cases, a doctor's intervention is still required. However, the main role in this case is played not by a dentist, but by an endocrinologist. If a person has a hormonal imbalance, the specialist must determine the cause of this condition and draw up a hormonal correction plan. If treatment by an endocrinologist was started before the appearance of bumps on the gum, it is quite possible that one of the hormonal drugs provoked gingivitis. In this case, the question is decided whether it is possible to cancel the causative drug or whether there is a need to continue taking it. In any case, the dentist in such a situation carries out only symptomatic treatment. He prescribes rinses, applications of medicinal ointments, physiotherapy and sclerosing therapy.

Treatment of a lump on the gum, which is a papilloma or fibroma, is carried out using various methods. The classic method is surgical excision of the altered tissues. The operation is carried out under local anesthesia. The surgeon carefully removes the neoplasm and sutures the wound.

There is also a cryodestruction method. It involves removing the tumor using liquid nitrogen. This method is longer than classical surgery, as it involves several visits. That is, cryodestruction involves a course of treatment in which the tumor is gradually "cauterized" with liquid nitrogen.

Another effective method is radiosurgery. Using this method, it is possible to point-irradiate the lump on the gum. For this, a special device is used, which is a source of ionizing radiation. The procedure is performed only once, and then the quality of the treatment of the lump on the gum is assessed.

It is worth paying attention to such a method of tumor removal as electrocoagulation. The procedure involves the effect of high temperature on the papilloma or fibroma. A special coagulator is used for this. Outwardly, it resembles an ordinary soldering iron, which is used to cauterize the tumor.

The latest and rapidly gaining popularity method is laser surgery. Removing a tumor with a laser is a highly accurate, low-invasive, painless and bloodless operation. This method shows excellent long-term results. However, the laser unit is an expensive piece of equipment that requires financial justification. Therefore, laser operations are considered the most expensive and difficult to access for the population.

Prevention

The approach to preventing a lump on the gum should be comprehensive. Therefore, precautions should be aimed at preventing the occurrence of all the diseases considered.

As for the prevention of cysts, this task is quite difficult. Firstly, all the mechanisms of the formation of a cystic cavity have not been fully studied. Secondly, the growth of this formation is rarely accompanied by any symptoms. Thirdly, people in exceptional cases perform X-ray examination of teeth without a good reason. Therefore, the only way to avoid the appearance of a cyst is to exclude those factors whose negative impact has been scientifically proven. Therefore, it is necessary to avoid dental injuries and promptly treat caries, pulpitis and acute periodontitis. This allows you to avoid the appearance of foci of chronic infection in the periapical tissues.

Prevention of cones in hypertrophic gingivitis can only be done by maintaining a healthy lifestyle. It should also be noted that hormonal drugs should not be taken without a doctor's prescription.

Papillomas and fibromas have very abstract data about their origin. Therefore, recommendations for preventing these pathologies will be the same as for other diseases considered.

Unfortunately, it is impossible to avoid the occurrence of the listed diseases. Even if all recommendations are followed, the probability of occurrence of the pathologies considered still remains. This is due to the fact that we cannot exclude some risk factors from our lives. Genetics, environmental situation, exposure to radio waves - all this cannot be fully controlled yet. Therefore, all that remains is to maintain a healthy lifestyle, improve your material and spiritual well-being, live positively and believe in the best.

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