There's a Lump on My Gums: Is it Cancer or Something Else?

If you notice a lump on your gums, it may be nothing of consequence; it may be worrying, as in an infection; or it may be serious, as in cancer. The only way to know for sure is to get it medically checked.

At Preva Dental, Prathima Rasamsetty, DDS and her team use biopsies to help determine the nature of any unusual bump, lump, or growth. Biopsies take a small sample of the suspicious tissue to examine in detail. Here’s what you need to know about what the results may mean.

What can oral lesions mean?

Oral lesions are areas of abnormal cells in the tissues in and around the mouth. They’re most often seen on the floor of the mouth, sides of the tongue, upper soft palate, and lips. Most mouth lesions aren’t serious, but because a growth might be cancerous, the oral surgeon performs a biopsy to determine its exact nature. There are three main types of growths:

1. Noncancerous growths

Noncancerous growths, referred to as benign, are usually not serious and don’t lead to cancer. One common cause of such growths is simple irritation of the gums. The growth can be left alone, or it can be removed surgically, if necessary.

Other common noncancerous lesions include warts (caused by the human papillomavirus), fluid-filled cysts (can be drained), oral thrush (a yeast infection), odontomas (an overgrowth of tooth-forming cells), and salivary gland tumors.

2. Precancerous growths

Precancerous growths aren’t yet cancerous, but they can become cancerous if they’re not removed.

Leukoplakia, a common precancerous lesion, appears as a flat white spot that develops when the gum tissue is irritated over a long period. It’s white because it has a thickened layer of keratin, the same protein that covers your skin, hair, and nails.

Erythroplakia develops when the mouth’s lining thins, and it appears as either a red and flat spot or a worn-away area. The red coloring comes from the underlying capillaries becoming more visible. Erythroplakia is a stronger predictor of oral cancer than leukoplakia.

Lesions may also appear as a mix of red and white. These areas contain both leukoplakia and erythroplakia, and may become cancerous if not removed.

3. Cancerous growths

Cancerous growths are cells that rapidly divide to form a mass, don’t readily die off, and can spread from the point of origin to other parts of the body, crowding out healthy cells and impairing their function. Left unchecked, they can prove deadly.

Types of biopsies

There are four different types of biopsies, depending on the nature of the lesion:

1. Incisional (the most common type)
2. Excisional biopsy
3. Percutaneous biopsy
4. Brush biopsy

Our team performs gum biopsies in our office as an outpatient procedure. We start by sterilizing the gum tissue, then we inject a local anesthetic so you won’t feel a thing. We may use a cheek retractor for easier access to your entire mouth, as well as to provide better lighting.

For an incisional or excisional biopsy, your surgeon makes a small incision in the gum and removes the suspicious tissue, either in part or the whole thing. She sends the sample to a lab for analysis. She closes the wound with stitches or electrocauterization — either an electric current or a laser. If the stitches aren’t dissolvable, you come back in about a week so we can remove them.

For a percutaneous fine-needle biopsy, your surgeon inserts a needle into the suspicious tissue to extract some cells. She may need to do this at several points in the lesion to obtain enough tissue for study.

For a brush biopsy, you probably won’t need an anesthetic. Your surgeon strongly rubs a brush against the abnormal gum tissue to collect the cells. Because there’s no skin breakage, you should only experience minor bleeding and/or pain, and you won’t need stitches.

The biopsy is a quick procedure, and you’re free to go after it’s done. You won’t require any downtime, and as soon as the anesthetic wears off, you can resume your normal diet.

You may experience some soreness at the biopsy site for a few days, and we caution you not to brush the area for about a week after the test. We notify you when we have the results, and depending on the outcome, we discuss next steps with you.

If you have a lump on your gums, it may be nothing serious, but because it may be serious, you need to come into Preva Dental to get a biopsy done. To schedule, call us at our San Antonio, Texas location, or book online today.