Lump on gum

[pau1200]

Hi,
firstly I am a terrible patient as I have a fear of dentists, not sure why but it’s irrational.
i have a lump on my gum between 2 teeth, one of them is a crown tooth that has had a root canal. There is a gap between the gum and cap.
This lump has been there for 12months and causes me no pain or issue but we have just lost a family member to cancer so I have been convinced to see the dentist. I spoke to them today and they want me to see them and they mentioned the c word which has really made me nervous. It looks like an abscess based on google but the dentist said it wouldn’t be a an abcess as it’s been there for a year.
I have attached a pic is anyone has any ideas, I will see the dentist but really anxious now.

 

[honestdoc]

The lesion looks like an abscess even though you mention that it has been there for a year. Abscess physiology can be unpredictable but most likely the abscess has been draining which is why you're not experiencing too much pressure and facial swelling. A less likely possibility could be a cyst. An x-ray could help map out the internals and I suspect the tooth with the crown and failing root canal to be the source. Fortunately the borders look regular so it is not fast growing (most likely not cancer). Google Squamous Cell Carcinoma of the mouth. It is the most common cancer in the oral cavity. Notice on the google images that the borders are irregular and the lesions look ugly (various and irregular patterns of white and red colors). Of course we dentists recommend you see us regularly. All too often we encounter phobic and unrealistic people that avoid us until the last resort and expect miracles.

 

[pau1200]

The lesion looks like an abscess even though you mention that it has been there for a year. Abscess physiology can be unpredictable but most likely the abscess has been draining which is why you're not experiencing too much pressure and facial swelling. A less likely possibility could be a cyst. An x-ray could help map out the internals and I suspect the tooth with the crown and failing root canal to be the source. Fortunately the borders look regular so it is not fast growing (most likely not cancer). Google Squamous Cell Carcinoma of the mouth. It is the most common cancer in the oral cavity. Notice on the google images that the borders are irregular and the lesions look ugly (various and irregular patterns of white and red colors). Of course we dentists recommend you see us regularly. All too often we encounter phobic and unrealistic people that avoid us until the last resort and expect miracles.

Thankyou for your reply, I have googled like you have said and can see what you mean, it doesnt look like any of the cancer pictures. I am visiting the dentist later on today so hoping for a good outcome. Our dentists is a large practice with about 20 dentists but they all seem quite young and even though good they don’t seem to have learned how to deal with nervous patients. I did find a dentist who was great that spent the extra time and explained everything and even when injecting into the gums I felt nothing but he left the area. I did find a picture I took 12 months ago and it looks the same, size and shape, if it was cancer I assume it would have altered in some way?
Again thanks again for your reply, you sound like the sort of dentist I need to find

 

[pau1200]

Ok, so I have seen a dentist and she was unsure what it is. She used a load of words I didn’t understand but she said there is no pocket and she doesn’t think it periodontal in nature. There is no gum disease but it’s hard. She also said it doesn’t bleed either when poking with the sharp tool. They x-rayed it and she said there was no bone deterioration. She didn’t think it cancerous as it hasn’t changed in shape and size and if it was cancerous it would generally be fast growing and bleed which it isn’t. She said it might be fibro something but she is going to refer me to a surgeon and have a biopsy to see what it is but they will also cut it out.
Still feeling really nervous about it all as I am
Still worried about it being cancerous or some strange type. I was hoping she would have been able to diagnose it.

 

[honestdoc]

Could you provide an x-ray? I believe it is most likely from the crown with root canal. Where are you located? A good evaluation may be from an endodontist (root canal specialist) and if the lesion is still unknown after that eval, then possible biopsy.

 

[pau1200]

Hi,

I did ask for a copy of my X-ray but they wouldnt let me have it as it’s not procedure. Unsure why as I had to pay for it. She did say there was nothing showing on the X-ray and no bone damage. I did mention that there has always been a gap between the bottom of the crown and the gum line and was it possible that food could have got stuck, she did ask if I get food stuck in that location and I did. She did mention that it would be painful if it was cancerous, if I press it it’s sore but not painful. She did seem to think it was a fibro overgrowth or something like that. I’m sorry I can’t give you any more information than that. I know reading the internet is never a wise thing but when I look at pictures it does look like an abcess. Can abscesses be hard or are they always soft. I am in the Birmingham area of the UK

 

[honestdoc]

Have your dentist refer you to endodontist to eval your root canal tooth. Last resort, refer to oral surgeon. I'm not sure about the laws in the UK since I'm in the US, but here we routinely send digital images to specialists or colleagues at no charge (some do charge but many will not charge for good will).

 

[MattKW]

Shouldn't be charging you much if anything at all for a copy of the Xray, you have a right to get copies although sometimes there may be a "reasonable fee". They can't say it's "not their procedure". Like honestdoc, I've never charged for accessing records. Looks like abscess assoc with a dead tooth.

 

[pau1200]

Thanks for the feedback, it has made me realise my current dentist isn’t that great so today I have visited another dentist that is highly recommended. Such a fantastic dentist and the way he explained everything was brilliant and made few at ease. He said what I have is a fibrous epulis. The root canal he said is fine but there is a large deep cavity on the adjacent tooth and that’s the issue. Food/debris has got stuck in there and caused the issue. His plan is to do a deep filling and then deep clean the area and stop food debris getting stuck again. He is hopefully that once sorted my body might be able to correct the issue and see it shrink. If not he will refer me to a periodontist who will remove it. They have such a person at the practice so I don’t have to go to hospital if I would rather they do it. Obviously there is a cost to go private but I feel more confident with them.
He himself has worked at the local dental hospital and has won awards for his work and he said this is quite a common thing they see up there. I’m feeling much better and looks like I have found a fantastic new dentist

 

[honestdoc]

Thanks for the feedback, it has made me realise my current dentist isn’t that great so today I have visited another dentist that is highly recommended. Such a fantastic dentist and the way he explained everything was brilliant and made few at ease. He said what I have is a fibrous epulis. The root canal he said is fine but there is a large deep cavity on the adjacent tooth and that’s the issue. Food/debris has got stuck in there and caused the issue. His plan is to do a deep filling and then deep clean the area and stop food debris getting stuck again. He is hopefully that once sorted my body might be able to correct the issue and see it shrink. If not he will refer me to a periodontist who will remove it. They have such a person at the practice so I don’t have to go to hospital if I would rather they do it. Obviously there is a cost to go private but I feel more confident with them.
He himself has worked at the local dental hospital and has won awards for his work and he said this is quite a common thing they see up there. I’m feeling much better and looks like I have found a fantastic new dentist

Your first dentist couldn't figure that out? She couldn't see the deep cavity on the adjacent tooth from the x-ray that was taken? Are they even licensed in the UK? In the US, there is no such discrepancy in diagnosing between community/public dentist vs private higher end dentist. We all pass the same licensing Board exams.