Pictures, Causes, Symptoms & Treatment of Oral Mucocele

What is Oral Mucocele?

Oral mucocele or also known as the mucus cyst of the oral mucosa is a swelling in the oral cavity
particularly in the lower lip of the oral cavity. The condition is linked to the obstruction and rupture
of the salivary gland and the accumulation of mucin within the connective tissue of the oral mucosa.
Mucocele is rated as 17th most common oral lesion affecting children and young adults with peak
prevalence occurring in individuals aged 10 to 20 years. It is a common condition of the oral cavity
that equally affects men and women without racial predilection. The oral mucocele is characterized
by a lump forming inside the lower lip which is rather firm and can be discomforting.

The salivary glands are exocrine glands that have a duct and produces saliva. It is also a gland that
secretes an enzyme necessary for the breakdown of starch into maltose. The saliva that is produced
by the salivary gland is an essential factor in digestion. There are different types of glands in the
oral cavity that function in producing saliva and are located in the different areas of the oral cavity.

Parotid glands are the largest of the salivary gland that envelopes the mandibular ramus. The serous
saliva is secreted through the oral cavity via the Stensen's duct. The gland can be located close to
the mandibular ramus just in front of the mastoid process of the temporal bone.

Submandibular glands are located below the lower jaws and produced both the serous saliva and the
mucus. The saliva is secreted to the oral cavity passing through the Wharton's ducts. The majority of
the saliva in the oral cavity is coming from the submandibular gland although it is much smaller than
the parotid gland.

Sublingual glands are situated beneath the tongue in front of the submandibular glands. This gland
secretes mainly mucus that is secreted to the oral cavity through numerous excretory ducts as this
gland has no striated ducts.

Minor salivary glands are distributed in the submucosa throughout the oral cavity. There are
approximately 800 to 1000 minor salivary glands.

Symptoms

Oral mucocele is generally painless and asymptomatic. The onset of the swelling is rapid with the
lump fluctuating in size. It usually occurs as a single lump or bump on the inside of the lower lip with
a color that may be light bluish or translucent. The size of the lump also varies and ranging from a
half inch to an inch and is often soft and firm.

The mucocele often develop on the surface of the lower lip but it can also develop on the inner side
of the cheeks, floor of the mouth or in the front of the ventral tongue. The superficial lesion usually
has a bluish tinge while deeper lesion has a normal skin color.

The lump in mucocele is dome shaped and superficial mucocele are transparent and fluid filled that
may appear as single or multiple. Mucocele on the anterior ventral surface of the tongue on the
other have a reddish color resulting from constant or repeated trauma against the lower teeth.

The mucocele that develop on the floor of the mouth is relatively large in size with blue to
translucent hue resembling the belly of the frog. The large size of the oral mucocele or know as oral
ranula can displace the tongue. The consistency of the lump is like mucus and do not blanch when
pressed with a finger or tongue depressor.

The mucocele is generally painless except when accidentally bitten can the pain be perceived. It can
get in the way of mastication and can also affect the speech or manner of speaking. The mucocele on
the hand can be annoying and may rupture and release a reddish fluid. The onset can linger for a
few weeks although there are instances where mucocele linger for a year.

Causes

The incidence of oral mucocele is basically due to an obstruction in the duct of the salivary gland.
The obstruction is the result of a break or a discontinuation in the duct caused by trauma. The
obstruction in the salivary duct results to an interference in the release of saliva to the oral cavity.
The increase in the size of the salivary gland is the result of the accumulation of the saliva that was
not released into the oral cavity due to the obstruction.

There are actually two phenomena that explain the etiology of the oral mucocele which are:

Mucus extravasation phenomenon explains oral mucocele arising from the rupture in the salivary
gland that resulted from trauma and thereby resulting in swelling of the connective tissue that
composed of machine that accumulated.

Mucus retention cyst explains the onset of oral mucocele as a result of obstruction or rupture of the
salivary gland.
The trauma in the salivary gland may be the result of the following:

Mechanical injury during the process of mastication where the tissue of the lower lip gets caught
between the teeth in the maxillary anterior and in the mandibular anterior.

Habitual biting of the lip may accidentally bite the salivary gland resulting in trauma subsequently
the onset of oral mucocele.

Crush type injury can also result to oral mucocele

Chronic irritation of the oral cavity such as from cigarette smoking and extreme heat can injure the
salivary gland.

Surgical procedures in the oral cavity may also cause trauma to the salivary gland.

Congenital mucocele in newborn babies is believed to be the result of birth trauma affecting the oral
cavity.

Treatment

Oral mucocele usually resolve on its own without treatment in a matter of 3 to 6 weeks from initial
onset. Other mucocele on the other may linger longer and may also increase their size while others
may recur after it has resolved.

Superficial oral mucocele can be treated with application of Clobetasol 0.05% or may also be treated
with a gamma-linolenic acid. The drawback however with these treatments is the tendency of the
mucocele to recur after is has resolved from the treatment.

Oral mucocele from mucus extravasation phenomenon is recommended for surgical removal of the
mucocele together with the adjacent salivary glands. A simple and small incision on the inside of the
lower lip where the mucocele occurred can be done to remove the oral mucocele. Recovery from
surgical removal of the oral mucocele generally takes about two weeks with recommended limited
range of motion of the lips for about 3 to 5 days following the operation. A soft diet is also required
for a period of 3 to 5 days after the surgical removal procedure.

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