Gums or gingiva is the soft tissue around the teeth, which is tightly bound to the underlying bone. It is common to find soft or hard masses on the gingiva. Granular cell tumors, including epulis and myoblastoma, usually arise from the gingiva covering the alveolar ridge of the maxilla. They might grow big enough to come out of the mouth and interfere with breathing or feeding. These masses are almost always benign and treated with simple excision. Smaller lesions may resolve spontaneously.
Epulis is primarily seen in the early ages and affects the girls ten times more than boys. It can grow large and interfere with feeding but it is benign and usually regresses spontaneously. A lesion that carries a similar name is known as pregnancy epulis (also called pregnancy granuloma or granuloma gravidarum) which usually arises from the gingiva but can be seen in other parts of the oral cavity. As the name implies, it is primarily seen in pregnancy as a soft, pink and smooth outgrowth that bleeds easily. These lesions also go away after the birth of the child.
Some lesions might appear on the gums following a dental procedure. Just like other tissues, inflammation is expected following dental manipulations especially when it comes to complicated cases. Sometimes abscesses might develop from an underlying infection but these masses look peculiar and are usually accompanied by pain.
Benign and malignant tumors may also develop on gums or from the underlying tissue. One of the features of such lesions is development over a relatively long period of time. Tumors arising from the underlying bony structures of the jaw could also be placed in this category.
Some lesions are more commonly seen in patients with an underlying immune system diseases. These lesions usually heal after the control of the underlying diseases and do not need direct treatment. A fair number of oral cavity lesions are seen in patients with AIDS and sometimes these patients are identified first by development of such lesions.
Some drugs have side effects on gingiva and cause hypertrophy or development of mass-like lesions. An important example is some antiepileptic drugs, which should be prescribed with care especially in adolescence. These side effects are usually self-limiting with the termination of the medication but at times, some form of intervention is required to correct these changes.
It should also be noted that there is a possibility for the gingival mass to develop in reaction to an exogenous substance. It could be as simple as a reaction to an ingredient in the toothpaste or more commonly elicited by long-term exposure to cigarette smoke. It is always recommended to see a physician or dentist when a gingival mass appears and does not resolve over a few weeks.
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