In the Know for You to Know
You’re going about your regular day. Work, school, after school, dinner, homework. Then you walk into your child’s room and notice they’re playing with their lip. They see you standing there and before you can ask anything, they say “Mom, look at this bubble on my lip.”
When you look, there is definitely a bubble on the inside of their lip. Then you think back and don’t recall anything being there yesterday or the day before that.
After a few questions you find out that this bubble comes and goes, it gets bigger and smaller, thankfully doesn’t hurt, and they run their tongue and teeth over it when it’s there.
But what is this bubble? Where did it come from? Why does it come and go, and change shape?
There is a specific type of bubble that is commonly found in the mouth that acts in this way; it’s called a Mucocele.
So, what is there to know about mucoceles?
What Is A Mucocele?
A mucocele is another name for a mucous cyst. By nature, cysts are fluid filled sacs.
Mucoceles are frequently seen in children due to their tendency to bite or suck on their lips and cheeks. These habits can lead to trauma not only to the delicate oral tissues but also to the minor salivary glands which lie underneath.
These glands have ducts which provide a path for the saliva to flow into the mouth. When these ducts are blocked the saliva has no where to go. Saliva keeps forming and with no where to go causes the glands to swell. The swollen salivary glands become a mucocele.
What Does A Mucocele Look Like?
Mucoceles tend to be transparent, mucous-filled dome shaped bubbles.
The bubble may be clear or the same color as the mouth tissues. It can take on a bluish or reddish color depending on where it is and how much pressure there is from the buildup of saliva.
Sometimes the surface may become white, rough or scaly due to repeated sucking on the bubble.
What Causes A Mucocele To Form?
Mucoceles are usually the result of trauma in the mouth which injures the tiny salivary ducts lying just under the surface of the mouth tissues.
Lip or cheek biting and/or sucking causes trauma which injures these salivary gland ducts. Saliva keeps on forming normally. It is the ongoing accumulation of saliva under the surface that causes the mouth tissues to bulge. This bulge is the saliva bubble (mucocele) that you see and feel.
Why Do Mucoceles Get Bigger and Smaller?
Mucoceles may fluctuate in size. They can often grow larger and then shrink. In some cases, they can rupture spontaneously releasing the built up saliva into the mouth.
However, they can reappear if the underlying cause is not addressed.
How Common Are Mucoceles?
4 things to know:
- Mucoceles are most common in children between the ages of 3 and 20 years old.
- This is the age range where you’ll see 70% of mucoceles.
- The peak age for mucoceles to occur is between the ages of 10 and 20 years old.
- The inside of the lower lip is the most common place for a mucocele to form.
Where Else Are Mucoceles Found In The Mouth?
Mucoceles can develop in a few places in the mouth.
These areas include the:
- Lips
- Cheeks
- Underneath the Tongue (called a Ranula)
Do You Need To Worry About Mucoceles?
Mucoceles are generally harmless and tend to resolve on their own. They can be a source of discomfort and may persist if not evaluated and properly treated.
Is Any Treatment Needed For Mucoceles?
When treating mucoceles in children, pediatric dentists often opt for a conservative approach. In many cases, the mucoceles will deflate on their own and heal without intervention.
However, if a mucocele persists, becomes painful, interferes with eating and speaking then surgical excision may be necessary to alleviate discomfort and help prevent recurrence.
When To Seek Care For A Mucocele
If your child experiences any of these symptoms, you need to contact your pediatric dentist or pediatrician:
- Mucoceles That Persist for More Than a Few Weeks – Most mucoceles resolve on their own over time. However, if this remains unchanged for several weeks or shows no signs of improvement, it’s important to make an appointment with a pediatric dentist for a thorough assessment.
- Pain, Discomfort, or Interfere with Daily Activities – While mucoceles are typically painless, the size, presence and location can cause discomfort while eating, speaking, or chewing.
- Frequent Recurrence or Rapid Growth – If the mucocele ruptures and then reappears frequently or grows rapidly, this may indicate an important underlying issue which needs to be identified and addressed.
My First Patient With A Mucocele
Like the saying goes, the first time you see something won’t be the last time. The first time I saw a child with a mucocele was when I was in the 1st year of my pediatric dentistry residency
I have seen mucoceles many times over the years since then. Each time a child comes into my office with one, I remember back to the first time a Mom brought her daughter in to have “her lip bubble” checked out.
What you learn from textbooks is not always how you see it in person. But this was classic.
A Mom brought her school age daughter into see me since this “cheek bubble” was “there for a while.” They were great with giving me an understanding of the time line, what had changed, and what their concerns were.
What Did I See On My Examination That Led Me To Diagnose This “Bubble” As A Mucocele?
The cheeks like the lips have many, many little salivary glands. When 1 or more of these glands is hurt their ducts get squished and the saliva has no place to go so it stays inside the gland.
Saliva is continuously being made so it builds up in each gland. As the saliva builds up it creates a “bubble.”
In this child’s case the bubble was the size of a pencil eraser and the color of her cheek. The cause? Cheek biting. Not just one time. As her Mom said “only when she gets nervous.”
What Caused This Mom To Bring Her Daughter In For An Examination?
According to Mom, she noticed her daughter was biting her cheek a lot. Then during toothbrushing the previous night, she also noticed the “bubble” was bigger than before and came in the next morning.
Why Didn’t Mom Bring Her Daughter In When She First Noticed The “Bubble?”
I asked Mom why she hadn’t called or come in before? Mom said that since it wasn’t bothering her and it would come and go she wasn’t worried. But when she saw it the night before all that changed and she brought her daughter in. Which we were both glad she did.
What Was The Treatment For This Child?
Since this mucocele had been an ongoing issue at the time for almost 6 months I gave Mom a referral to the Oral Surgeon. Once I knew the specifics about the Oral Surgeon’s plan for treatment I made them a follow up appointment with me.
The Outcome?
A happy Mom with peace of mind and a happy daughter.
Has your child had a mucocele? What (if any) treatment did they need? Did you know about mucoceles before? Tell Us, We’d really like to know! Send us an email at kidstoothhotline@proton.me Like Us on Facebook
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