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Introduction
An oral mucocele is a painless swelling containing fluid usually seen below the lining of the mouth (mucosa). It occurs when there is some form of alteration in the minor salivary glands present below the mucosa of the mouth.
When the mucous cyst appears in the floor of the mouth it is known as Ranula because it resembles the belly of the frog. | |
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Signs and Symptoms
Mucoceles appear as soft, bluish, painless swellings commonly seen in the inner part of lower lip or cheeks as these are areas most prone to trauma. They can appear anywhere in the oral cavity, usually about 1.5cm in diameter but the ones appearing in the major salivary glands can be more larger in size. The retention type may appear slowly growing gradually whereas the extravasation type can appear suddenly in the mouth. | |
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Types of mucocele and their causes
There are basically two varieties
1.Extravasation type- This is seen when there is trauma to the ducts of minor salivary gland causing spillage of its contents into the surrounding soft tissue. The cause could be trauma resulting from biting one’s lip, accidental injury while chewing, prior surgery etc.
2.Retention cyst- If occurs if there is blockage of the salivary duct leading to backup of saliva in the gland. Most of the times they are seen in major salivary gland and the cause of blockage could be a salivary stone (sialolith) or a mucous plug. Rarely chronic infection or inflammation and absence of the duct could be the cause. | |
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Complications
Depending on the location, they can interfere with chewing. Ranula if very large in size can interfere with swallowing and speech. It can result in pain or discomfort due to the pressure of the tongue on it, making it increase in size. Sometimes bleeding can occur within the swelling giving it a bright red colour. | |
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Tests
Your dentist can usually diagnose the condition by examining the cyst for its colour and appearance and feel it for the consistency. He may take detailed information regarding the cyst from you. In some cases, an excisional biopsy may be indicated to be sure of the diagnosis.
Occlusal or panoramic radiographs can be taken if salivary stones are suspected.
Fine needle aspiration biopsy (FNAB) of the contents may also be helpful before a surgery is planned. | |
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Prevention
There is no prevention as such for these cysts however avoiding habits such as lip biting can be helpful in some cases. | |
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Reference
1.Fitzpatrick’s dermatology in medicine, 6th Ed
2.Berket’s oral medicine, 11th Ed, Chap 6
3.Kahn, Micheal A. Basic oral and maxillofacial pathology 2001, vol 1. | |
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Treatment
The mucous cyst usually when left alone will resolve spontaneously in 3 – 4 weeks. It may burst leaving an ulcerated surface which will heal after sometime.
If the cyst returns or fails to regress on its own, then you have to consult the doctor. Avoid chewing and sucking on these cysts when present and never attempt to break the cyst at home as it can result in infection.
A minor surgery may be indicated in recurrent cases where the contents and the lining of the cyst may be removed.
Other advanced treatments options include laser surgery, cryosurgery and injecting medicine inside the lesion. | |