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Julian Chen
Julian Chen, Dentist
Category: Dental
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Experience:  Practicing General Dentist since 2002
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I have a lump on my bottom left gum. It feels hard like a

Resolved Question:

I have a lump on my bottom left gum. It feels hard like a bone at times, but also feels soft. When I push on it, it moves or goes away. What could this be.
Submitted: 8 years ago.
Category: Dental
Expert:  Julian Chen replied 8 years ago.

I have a few questions and I hope you're able to provide me with the information to better help me narrow the possibilities of what you're seeing/experiencing:

1. How long have you noticed this lump being there?
2. Is the lump near the top or is it lower towards the jaw?
3. Do you have any large fillings or crowns near the lump?
4. Have you ever had a root canal done on a tooth near the lump?


Jul***** *****, DDS
Customer: replied 8 years ago.

I noticed it here for only a couple of weeks.

The lump is towards the jaw

No fillings or crowns

No root canal either.

Expert:  Julian Chen replied 8 years ago.
Thank you for getting back to me.

Unfortunately, without a closer examination and possible X-rays of this lump, I will not be able to provide you with much more assistance specifically to your currently condition. (So if you don't click on "Accept", I will totally understand.)

Initially, prior to your answers, I would have thought that you may have an abscess and developed a fistula. A fistula presents as a fluid-filled lump on the gum and it is filled with pus. The size of the lump can grow, and can sometimes feel fairly hard, but when you put pressure on it, one can either pop it, or disperse the pus and cause the lump to briefly disappear. The most common causes of a fistula is a dental abscess where the nerve of a tooth has become necrotic and there's chronic infection.

Thus it lead to my asking whether you have had fillings/crowns/root canal treatments done in the area, which you denied ever having. So the chances of it being a dental abscess/fistula is pretty small, however, not impossible. There have been a number of documented cases (and I've personally come across 2 patients in my practice) where the nerve of a tooth randomly died without any rhyme or reason. It is unlikely, yet possible, that you could be unfortunate enough to have a tooth on the lower left go bad on you, even when no fillings/crowns/root canal treatments were ever done on it.

Of course, the only way to tell is to go see your dentist and get an X-ray taken of the area to determine what might be causing this lump.

Again, prior to your answers, I briefly though the lump may simply be the early manifestation of a mandibular torus (exostosis). Many patients develop boney protrusions on the side of their jaws. They range significantly in size but are almost always benign and no treatment would be needed. However, it's doubtful that this is an exostosis for the fact that you can push the lump and make it disappear, and the fact that the lump feels mobile.

The last possibility is that if this lump is near the area where you used to stash your chewing tobacco, then it is possible that the exposure to the tobacco had caused the tissue in the area to become dysplastic. Oftentimes, the gum tissue will thicken and harden, becoming more fibrotic (which can feel like a lump). Tissue dysplasia can potentially lead to something more malignant, however, the initial stages of dysplasia itself does not mean you've developed oral cancer. Oftentimes, when the patient successfully quits the use of chewing tobacco, the tissue will quickly revert back to normal in a matter of a few months.

In any case, without the opportunity to visually examine the lump myself, I really couldn't tell you what it is. At this time, my 2 potential diagnosis would either a dental abscess/fistula, or possible fibroma or tissue dysplasia related to previous use of chewing tobacco.

If possible, I would recommend that you swing by your dentist for a closer evaluation and take any necessary X-rays to either identify, or rule out potential causes.

I wish you the best,

Jul***** *****, DDS
Customer: replied 8 years ago.
Thank you for this. I will accept the answer. It is a great answer and explores everything. One more question. I also chew gum a lot, could that have an effect.
Expert:  Julian Chen replied 8 years ago.
I apologize for the wait.

Gum chewing would not alter your gums in the way you described. The only remote possibility is if you are chewing some kind of nicotine gum and keeping it in the same region where you use to keep your chew tobacco. Because the nicotine is actually a vaso-constrictor. So the blood vessels in the area (where it contacts) can shrink and prolonged exposure can cause the tissue to thicken slightly, and discolor. However, the changes wouldn't be like a fluid bump where you could push or squeeze away.


Jul***** *****, DDS
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Customer: replied 8 years ago.

sorry to bother you again dr. chen, but I wanted to thank you again and have another follow-up question. I went to my dentist and he told me that it was a bone between my nerves. He told me it is more prevalent on one side, but it is nothing else. Should I seek a second opinion.

Expert:  Julian Chen replied 8 years ago.
Hm... he said it was a bone between your nerves? I'm not quite sure what that would be. Did he use terms like "mandibular torus" or "exostosis"?

Although mandibular tori (plural) are usually bilateral, sometimes it can only manifest on one side. That or one side can be significantly larger than the other. So if all we're looking at here is a mandibular torus, then that's good news.

I'm just curious because in your initial description, you mentioned that you can apply enough pressure and seemingly move it or make it go away, suggesting there is actual fluid build-up. However, if you could go ahead and push on it some more now, and it does feel fairly hard and does not move underneath the skin, then that's definitely a bone projection and would be the mandibular torus.

Tori/exostoses tend to grow over time. Sometimes in spurts, other times seemingly a gradual increase in size. So say by the time you're 40 years old, you may notice the lump being much bigger than it is today. Most of the time, the increase in size does not affect anything at all and does not need treatment. But for some patients, their boney exostoses can grow very rapidly and become large enough where it can become a problem. If that is the case, an oral surgeon/periodontist can go in and surgically trim the exostosis back down to size. However, the torus often does come back over time.

In any case, if the lump still feels "mobile" underneath the gum, and fluid like where upon applying pressure, the lump disappears, then I would recommend getting a 2nd opinion with an oral surgeon. But if it's just a hard, fairly solid lump that does not move nor go away, then I would accept your dentist's diagnosis.


Jul***** *****, DDS
Customer: replied 8 years ago.
I don't remember the exact term he used; however, I insisted that he feel it numerous time, and he did. Finally, I can still move the lump or shift it, almost like it would disappear.
Expert:  Julian Chen replied 8 years ago.
If it's mobile, then it's definitely not a mandibular torus/exostosis. The only way that it could be a bone fragment if it is somewhere near where your 3rd molars (wisdom teeth) were, assuming you had the wisdom teeth extracted. And that during the extraction, a piece of the bone, (or possibly even a broken root) was left under the tissue and allowed to heal.

This is a far-fetched theory, but it's a certainly a possibility.

I think for your added peace of mind, I would recommend a consultation/evaluation with an oral surgeon. If the specialist also notes that "It's just some floating piece of bone between your nerves, don't worry about it," then I guess we'll just have to accept the fact that you have some random bone chip loose in your gum tissue.


Jul***** *****, DDS
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