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A lump of acute onset with a blueish color on the cheek almost certainly represents a hematoma, or blood blister.These are common lesions, and due to the minor injuries to which the inside of the cheek is vulnerable due to its proximity with the teeth during chewing. The absence of pain
does not eliminate this as the likely diagnosis, because the cheek mucous membranes have a relative lack of sensitivity
when compared to other intraoral surfaces. Also, the initiating traumatic event sometimes occurs during sleep, especially in patients who manifest with nocturnal tooth grinding (bruxism
), at which time the causative trauma would likely pass unnoticed.
The lip and gum ulcers are probably independent issues. Canker sores (aphthous ulcers) are generally of unknown cause, but are considered trivial unless particularly severe or incapacitating, or associated with a more systemic condition (e.g., Behçet's disease or Reiter's Syndrome). However, canker sores do not occur on gum tissue, so your gum ulcer represents something else. Due to the wide variety of conditions that can give rise to oral ulcers of similar appearance, it is not possible to infer the nature of your gum ulcer. Therefore, if it fails to heal, or worsens, or additional ulcerations occur, you should present to your dentist
for additional diagnostic assessment.
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