- Are they soft and did they appear rapidly
- Are they hard and have been there a while
- Are they painful to push against
- Where are they on the jaws
Swellings which are soft and appear rapidly and are adjacent to teeth either on the cheek side of the tooth or on the roof of the mouth side of the tooth and may be painful are usually a sign of a tooth or gum abscess. Usually a tooth nerve has died and has become infected and in this case the infection has tracked to the side of the jaw.
Swellings which are hard and been there a while can be a natural phenomena where in the sides of he lower jaw or in the roof of the upper jaw the body has produced extra extensions of bone, we call these in the lower jaw-torus mandibularis and in the upper jaw-torus palitinus. Usually the patient finds these and doesn't realise that they had these there all their lives.
Some hard swellings that occur on the side of the jaws adjacent to teeth can be what we call periapical granuloma- this is where there has been an infection at the root of a tooth but because this has been very slow and the body has had a chance to try and arrest this process and there is a continuous “fight” between the body and the area of infection/damage the growth is slow and the body accommodates this expansion.
Finally there are growths which are more sinister.
THEREFORE it is very important that if you see any swellings appear in your mouth you MUST see you dentist immediately.
If it is a soft rapid swelling adjacent to a tooth the dentist will initially take an X-ray and determine if there is any tooth that has an infection which has given rise to this problem. If so then there is a number of options either you may opt for the extraction of the tooth preceded by antibiotics to remove the infection and he will then anaesthetise the area and lance the abscess, drain it and give antibiotics and upon a mutually agreed time have the tooth removed. The patient on the other hand may want the tooth saved and so after lancing the abscess and a course of antibiotics the dentist will institute root canal therapy.
For the so called torus mandibularis and palitini, these are left alone they pose no harm in most instances. If however they are such that the allow food to continuously be trapped in their folds then to prevent infections among other problems they are surgically removed.
The periapical granulomas are treated with root canal therapy over a period of time.
If there are other swellings that the dentist is unsure of or do not meet certain criteria then an immediate referral should be sought to see respective specialists.