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 en-
largement. 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 oc-
cur due to trauma to salivary gland tissue. Swellings may be
seen in Crohn’s disease in terms of mucosal tags with granu-
lomatous 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. fibro-
sarcoma) 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 histologi-
cally 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 dif-
ferent 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.