Oral Mucocele: Prognosis and Treatment

What is an oral mucocele?

An oral mucocele represents a painless fluid-filled cyst inside the mouth. It is caused by mucous leakage from a damaged salivary gland into the surrounding tissue. The lesion typically appears as a bluish-white, slightly raised, and soft bump, usually harmless. They are often called mucous cysts and appear most frequently on the inner part of the lower lip. They can also occur over the inner cheeks, tongue, gums, and the floor of the mouth (area below the tongue). An oral mucocele on the floor of the mouth is termed a ranula. 

Oral mucoceles are primarily reported in people younger than 30; however, they can affect people of any age. The peak age of occurrence is between 10 and 20 years old.

Oral mucoceles typically resolve independently; however, larger ones may interfere with talking, chewing, swallowing, and in rare cases, breathing. A healthcare provider may remove them if you face any such problem.

Prognosis

Oral mucoceles usually represent harmless, painless cysts that don't cause any long-term complications. Its prognosis is generally good. However, larger cysts may interfere with daily activities. In rare cases, ranulas may cause difficulty in breathing. The healthcare provider can remove the mucocele with treatment and eliminate any possible issues.

Sign and Symptoms of an oral mucocele

An oral mucocele looks like a soft, dome-shaped lesion inside the mouth. They have a clear or a bluish tint and vary in size from 1 millimeter to 2 centimeters wide. Other symptoms of oral mucocele include swelling, numbness, tingling, or sensitivity in the area. In some cases, the site may become red or discolored. Oral mucoceles usually don't cause pain; however, larger ones may cause discomfort if they interfere with speech, chewing, or swallowing. However, the mucocele may rupture in severe cases, resulting in pain and bleeding. 

If you suspect you may have an oral mucocele, it is essential to consult your doctor as soon as possible.

What causes the development of oral mucocele?

They often occur following minor trauma, like biting your lip or cheek. This injury may damage or block a salivary gland, ultimately obstructing saliva flow from draining into the mouth, which may build up and form a cyst. However, oral mucocele may also occur due to other reasons like-

• A lip-biting or lip-sucking habit.

• Long-term (chronic) insult due to smoking or using tobacco products.

• Condensed or damaged salivary ducts.

• Trauma from intubation.

Diagnosis Strategy and Tests

Oral mucocele is often diagnosed based on the symptoms and a physical examination. However, in some cases, the physician may request further tests to confirm the diagnosis, like-

• Ultrasound: to get a real-time picture or video of the oral tissue.

• Biopsy: to remove some part of the tissue from the cyst for examination.

• Computed tomography (CT) scan: is requested in rare cases when a ranula has grown into the neck.

Management and treatment of oral mucocele

Oral mucocele may not need treatment because most lesions rupture and resolve themselves. One should not try to rupture them by themselves as it may lead to infection or damage oral tissues.

If the oral mucoceles repeatedly come back or in cases of large mucoceles, the healthcare provider may recommend some other treatment options like-

• Cryotherapy: It uses the application of extreme cold to freeze and destroy the mucocele cyst.

• Laser treatment: A special laser will be used to remove the lesion.

• Surgical excision: An oral surgeon or dentist will surgically cut out and remove the entire cyst or the cyst with the salivary gland.

The recovery following any procedure will depend on the type of treatment received. The healthcare provider may recommend a liquid or soft diet after cryotherapy or laser treatment for a few days. However, following a restricted diet may be needed longer in case of surgical excision.

Preventive Measures

Oral mucocele usually occurs accidentally biting the lip or cheek while eating; there's no way to prevent that. But it can be prevented by kicking bad habits, such as stopping to bite the lip or sucking on the inside of the cheeks. It gives one more reason to quit tobacco.

Since most lesions arise following trauma and habitual lip biting, a school-based educational awareness program for children and parents should be done at six monthly intervals and interception of the oral habit among children. Moreover, Patients undergoing orthodontic therapy (corrections of mal-aligned teeth) should be monitored periodically for areas of irritation in the oral mucosa. 

The Bottom line

We often accidentally bite our lip, tongue, or cheek resulting in the appearance of oral mucoceles. Fortunately, these harmless cysts often clear up and go away on their own. However, if you observe them not going away or causing trouble with speech, chewing, or swallowing, you should visit a doctor or the dentist. They can help get relief.