This page was printed on

25/3/2020

Oral irritated broma

Author: Dr Delwyn Dyall-Smith FACD, Dermatologist, 2010.

What is oral (irritated) broma?

An oral broma is a common benign scar-like reaction to persistent long-standing irritation in the mouth. It
is also known as a traumatic broma, focal intraoral brous hyperplasia, brous nodule or oral polyp.

Oral broma

Oral broma

Who gets an oral broma?

An oral broma is most commonly seen in older adults but can occur at any age. It a ects 1–2% of adults.

It is usually due to chronic irritation such as:

cheek or lip biting

rubbing from a rough tooth
dentures or other dental prostheses.

What are the clinical features of an oral broma?

An oral broma presents as a rm smooth papule in the mouth. It is usually the same colour as the rest of
the mouth lining but is sometimes paler or, if it has bled, may look a dark colour. The surface may be
ulcerated due to trauma, or become rough and scaly. It is usually dome-shaped but may be on a short stalk
like a polyp (pedunculated). If it has developed under a denture it may be at with a leaf-like shape.

The commonest location for an oral broma is on the inside of the cheek where the upper and lower teeth
meet. Other common sites include the sides of the tongue, gums and inside the lower lip.

Apart from the feel and appearance, oral bromas do not cause any symptoms. Oral bromas develop
over weeks or months to reach a maximum size usually about 1 cm in diameter, but can sometimes be
larger.
An oral broma is usually a solitary lesion. When there are many lesions, associated diagnoses need to be
considered including tuberous sclerosis, Cowden syndrome, familial bromatosis and brotic papillary
hyperplasia of the palate.

Oral bromas do not develop into oral cancer.

In addition to the irritation broma, there are a number of other well-recognised types of oral broma:

Oral elasto broma

Epulis ssuratum
Giant cell broma
Myo broma and myo bromatosis
Peripheral ossifying broma
Peripheral odontogenic broma
Retrocuspid papilla
Sclerotic broma.

How is oral broma diagnosed?

The diagnosis of oral broma will be suspected clinically when there are the usual history and examination
ndings. A biopsy may be taken to exclude other conditions or to remove the lesion. Histology shows
typical dense brous tissue with relatively few cells. The overlying epithelium may be ulcerated, thinned or
thickened.

What is the treatment of oral broma?

When treatment is required, the only option is surgical excision of the broma with narrow margins. It may
recur after surgery if the source of irritation continues. It is therefore also important to manage the source
of the irritation. Oral bromas do not disappear without treatment.

Related information
 

References
Gonsalves WC, Chi AA, Neville BW. Common oral lesions: Part II. Masses and neoplasia. Am Fam
Physician 2007;75: 509-12.
Lederman DA, Fornatora ML: Oral bromas and bromatoses – Medscape Reference
Stoopler ET, Alawi F. Clinicopathologic challenge: a solitary submucosal mass of the oral cavity. Int
J Dermatol 2008; 47: 329–331.

On DermNet NZ
Epulis
Giant cell broma
Peripheral ossifying broma
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