NON-NEOPLASTIC AND NEOPLASTIC SWELLINGS IN ORAL MUCOSA
Swellings of the oral mucosa can occur due to accumulation of fluid (e.g. saliva, pus og oedema) or due to soft tissue enlargement. Soft tissue enlargements can be non-neoplastic or neoplastic. Non-neoplastic swellings are most common, and are often reactive, irritation-induced hyperplasias (e.g. the pyogenic granuloma and focal fibrous hyperplasia). They can also be related to systemic diseases, medication-intake or of developmental origin. Infection with human papilloma-virus can lead to development of papillomas, and mucocele can occur due to trauma to salivary gland tissue. Swellings may be seen in Crohn’s disease in terms of mucosal tags with granulomatous inflammation. Gingival hyperplasias are the most common drug-induced swellings. The neoplastic swellings are characterized by abnormal and uncontrolled growth of tumor cells, and can be benign (e.g. fibroma) or malignant (e.g. fibrosarcoma) tumors. Neoplasias occur less frequently, but are important differential diagnoses. Reactive hyperplasias can be difficult to distinguish clinically from actual neoplasias. The excised tissue should therefore always be examined histologically for final verification of the diagnosis. The different oral mucosa tumors can also be difficult to separate clinically. A biopsy is therefore required and obviously crucial for further treatment. It is important for dentists to have insight in the different types of oral mucosa swellings in order to make relevant clinical tentative diagnoses, and to know when there is a basis for biopsy and further referral to a specialist within the field. This article reviews the most common swellings of the oral mucosa and relevant differential diagnostic considerations.