Oral Swollen Lump Differential Diagnosis Table

Oral Swollen Lump Differential Diagnosis Table:

Lumps are a common finding in the oral cavity. These lumps might originate from nerves, glands, connective tissues, bones, or muscles. According to the origin, they are either soft or hard to palpate. Moreover, some of them are compressible, while others are not. Some can be smooth and some are rough. These lumps can be benign or malignant and should always be evaluated. Malignant lesions are usually painless, while the benign ones tend to be more painless.
Hard Swollen Lump: A hard swollen lump in the mouth can be due to a variety of causes. Sometimes it is just an anomaly like tori, and sometimes they are tumors. The most common benign tumor is ameloblastoma, which causes bony expansion, while in severe cases, they can be malignant like osteosarcoma.
Soft Swollen Lump: One of the most common causes of soft tissue oral swelling is the abscess. Other reasons can be salivary gland disorders (sialadenitis, sialolithiasis, salivary gland tumors, and mucocele), ulcers, vesicles, fibromas, odontomas, and cysts.
Diagnosis is based on the history and clinical examination. After taking the history of the time of onset, nature of pain, aggravating factors, and relieving factors, clinical examination is done by palpating the lump. After clinical examination, the lump can sometimes be referred for a biopsy.

How To Recognize Which Disease Is Causing The Oral Swollen Lump

How to Recognize if Oral Abscess is Causing Oral Swollen Lump

An oral abscess or dental abscess is a collection of pus under and around the tooth surface. It usually occurs as a result of bacterial ingress due to dental cavitation or gum infection. Oral abscesses are of two types: periapical and periodontal. Periapical is around the tip of the root caused mainly by infected pulp tissue of the tooth. The periodontal abscess is located along the root surface, mostly in the coronal region of the tooth.
The symptoms include spontaneous pain in a tooth that lasts more than a minute. It can also be triggered by hot and cold food, biting, and chewing. Other symptoms include fever, malaise, lymphadenopathy, salty taste in the mouth, bad breath, visible oral swelling, and in severe cases, difficulty swallowing or breathing.

How to Recognize if Aphthous Ulcer is Causing Oral Swollen Lump

An aphthous ulcer is a shallow ulcer present in the lining of the oral cavity. It can be present anywhere in the lining of the mouth and takes 7-10 days to resolve. They have a characteristic appearance of an ulcer yellow in color with red borders that are flat. An aphthous ulcer is very painful and the pain usually worsens while eating as the ulcers are usually sensitive to hot and spicy foods. Sometimes cold water relieves the pain.

How to Recognize if Traumatic Ulcer is Causing Oral Swollen Lump

A traumatic ulcer is any ulcer in the oral cavity appearing as a result of traumatic injury. The most distinguishing feature of these types of ulcers is the history of trauma. Traumatic ulcer is usually flat in appearance and can be present anywhere in the oral cavity. They are commonly found on the cheek mucosa along the biting surface of the teeth and along the denture borders. They heal in a week after the source of the trauma is removed.

How to Recognize if Mucocele is Causing Oral Swollen Lump

A mucocele is an oral swelling filled with mucus appearing as a result of trauma or salivary gland blockage. It usually appears as a well-circumscribed fluid-filled soft swelling with a bluish tinge. Although they can be present anywhere inside the oral cavity, mucoceles induced by trauma are present along the lower lip. They are painless and usually produce discomfort while talking and chewing.

How to Recognize if Sialadenitis is Causing Oral Swollen Lump

An infection of the salivary glands is called sialadenitis. The sialadenitis will result in swelling of the salivary glands which can be observed only in the neck and the cheek region where the salivary glands are present. It can also cause diminished salivary production leading to dry mouth. Moreover, it may sometimes produce pain while eating.

How to Recognize if Oral Cancer is Causing Oral Swollen Lump

Oral cancer is the malignant transformation of the cells of the oral cavity. An oral cancer lesion is usually painless, while most of the other benign swellings are painful. The lesion of oral cancer can be a swollen patch, growth, or an ulcer. Any ulcer present for more than 4 weeks is suspected of malignancy. If the lesion appears as a patch, the patch appears rough on palpation and cannot be wiped off. Usually, oral cancer is associated with other signs like lymphadenopathy, dysphagia, and dysphonia.

Important Red Flags with Oral Swollen Lump

Oral swollen lumps are a common occurrence. Sometimes they don’t need treatment and they go away on their own. In any case, they should always be evaluated with care as they can be fatal in some cases and need emergency management. For instance, an oral abscess can be easily treatable through antibiotics and incision followed by drainage of the pus. The prognosis is usually good, and people are pain-free within days. However, sometimes, the infection can spread into the deeper structures and can cause life-threatening conditions like cavernous sinus thrombosis and deep neck space infections. These infections have a tendency to cause sudden death by causing airway obstruction, jugular vein thrombosis, and sepsis. Other warning signs are non-healing ulcers, painless lesions, lesions present with lymphadenopathy, dysphagia, dyspnea, and dysphonia.