It is common, and quite normal, to receive patients who are worried because they have seen (and touched with their tongue) a strange lump on the gum that did not seem to be there yesterday. Depending on the characteristics of the lump, we can tell whether or not it is a cause for concern when we receive their phone call, although the most common scenario is that if the patient is a good patient and we know they have proper dental hygiene, it is a simple fibroma. But,
What is a fibroid and how can we distinguish it?
Fibroids are benign conditions caused by irritation. They usually cause some concern in the patient, but no pain or discomfort beyond that caused by the irritation mentioned above, as well as being a hard lump of a healthy colour for the gums.
Of course, in most cases it is worth going to a dental clinic for a professional assessment, so that we can be reassured, but most often if it is indeed a fibroid the professional advice is that you should do nothing at all about it.
The causes are usually hormonal changes, trauma or genetic factors, and the fibroid disappears by itself without any action on our part. In other cases, it is necessary to remove it, but as it is a benign lump, if it does not bother much, it is not usually removed.
Another probable cause is a removable prosthesis that fits poorly and rubs against the gum until it occurs. In this case, the irritation will increase and the discomfort in the area will also increase, so it is essential to remove the fibroma and readjust the prosthesis to prevent it from coming back, including a thorough cleaning of the area and the patient's mouth.
And if it's not a fibroid, what is it?
If it is not a fibroid, then it is a lump caused by an infectious process, either an abscess or a fistula.
Abscesses are soft and occur in periodontal patients, when the gum papillae surrounding the tooth become inflamed due to tartar. Their cure requires antibiotic medication (for the infection) and curettage to clean the area. Depending on the degree of the patient's condition, they are considered gingival or periodontal, as with periodontal disease itself.
In this case, gingival abscesses are those that erupt close to the tooth and are the mildest case. Periodontal abscesses appear when there is already a certain degree of bone loss due to periodontal disease.
A fistula, however, is an opening in the gum that generates pus, unlike an abscess, which is an infected cavity. The fistula comes directly from the root of the tooth and works its way into the gum. The most common reason, therefore, for a fistula is that the decay has advanced to the root of the tooth and is spreading from there to the face.