What Causes a Mucocele?
A mucocele is usually caused by some kind of trauma, like biting your lip. It more than likely occurs inside your lower lip. Mucocele is the result of swelling or scar tissue blocking the duct of a minor or auxiliary salivary gland. Humans have, in addition to the major salivary glands such as the parotid, the sublingual, and the submandibular, many minor salivary glands on the inside of the lips and cheeks, on the roof of the mouth, and on the tongue. Trauma can cause blockage of the ducts of these glands. This results in the “bubble-like” swelling that is full of fluid or salivary mucous. A mucocele is a fairly common salivary gland problem which occurs mostly inside the lower lip, the oral cavity. But it can occur in other areas of the body. As might be expected, the patient is genuinely concerned.
These mucous swellings seem to get in the way of chewing food and speech. One is prone to biting them again causing even more swelling. They can be quite a nuisance but usually go away within a few short weeks. On a rare occasion, they may become infected and require surgical removal. This is quite simple and painless, yet resolves the problem. The need for surgical removal is the exception to the norm, as usually, a new duct is created and the situation resolves itself.
How to Treat a Mucocele
A mucocele is not a dangerous medical problem as it is a benign (non-malignant) lesion. It is usually painless and short-lived. Being mostly a nuisance, it may also affect speech, swallowing, and chewing. The patient often feels that everyone notices it, when the fact is not true. As has been mentioned, the mucocele usually heals or disappears on its own. Popping it may lead to slower resolution of the problem as well as secondary infection. So make sure to avoid it if possible. That being said, the majority of those with a mucocele accidentally pop it, but one should not do so intentionally.
If the mucocele does in fact, continue to be a problem, the surgical removal may become necessary, although it is rare. Laser oblation or precise removal of the minor salivary gland may become necessary. An easy and comfortable option of keeping the procedure efficacious as well as minimally invasive is by the use of certain lasers. Vaporization with the ND:YAG laser has been described for the treatment of mucoceles. This laser is intensely absorbed by the gland itself and power-setting parameters must be lowered to avoid excessive thermal (heat) damage to the soft tissues. This could yield consequentially unfavorable postoperative symptoms. The laser is quicker. And if uneventful healing occurs after the laser therapy, the end result yields a very happy patient.
Bhaskar, et al. suggested obstruction of the salivary gland ducts as the main cause of mucoceles. This hypothesis has lost support in favor of a traumatic origin of the lesions. Many studies confirm the traumatic etiology (cause) of mucoceles. The incidence of mucoceles in the general population is 0.4 % – 0.8% with little differences between males and females. Some 75% occur in those under the age of thirty.
The Fluid-Filled Sac Ranula
When this same thing happens to the sublingual gland on the floor of the mouth, the fluid-filled sac is called a ranula instead of a mucocele. A ranula is usually caused by blockage of the duct of the sublingual gland by a syalolyth, or stone in the salivary gland. Ultrasonics (pulverization by vibration), or simple removal may be required. The oral surgeon would help in this case. If it occurs on the gums, it is called an epulis. Epulis usually results from wearing an ill-fitting partial denture or full denture too long without necessary adjustments. The appliance itself shuts down the minor salivary gland which then results in swelling of the tissue. The denture must be adjusted and usually, the epulis must be removed. Your general dentist can easily handle this.
We have been referring to mucoceles as cysts when in fact they are not truly cysts because they have no epithelial (tissue) lining. Usually, no treatment is required of these lesions, but you may want to try a very warm compress as this is very effective in treating cysts. They are not considered to be dangerous as they usually eliminate themselves. Heat will help it feel better. You do not need special care unless it will not disappear on its own, or it becomes secondarily infected.
If you are concerned or feel that you have a secondary infection, you should see your dentist. But remember, the greatest majority of mucoceles are self-limiting.
Life Member American Dental Association, Emeritus Fellow of Academy of General Dentistry, American Association of Implant Dentists