ABC of oral health: Swellings and red, white, and pigmented lesions

It is not unknown for people to discover and worry about oral lumps, but they usually first notice a lump because it becomes sore. Pathological causes include a range of different lesions, but neoplasms are most important (see earlier article). Mucocele in a typical site #### Causes of salivary gland swelling Most salivary swellings are caused by mucoceles in minor glands in the lower lip. These are best removed surgically. In the major glands salivary duct obstruction is more common, but sialadenitis, Sjogren's syndrome, and neoplasms are important causes to be excluded. It can be difficult to establish whether a salivary gland is genuinely swollen, especially in obese patients. A useful guide to whether a patient has parotid enlargement is to look for outward deflection of the ear lobe, which is seen in true parotid swelling. Management —Diagnosis is mainly clinical, but investigations such as serology for autoantibodies or HIV antibodies, liver function tests, and needle or open biopsy may be indicated. Treatment is of the underlying cause. #### Lesions which may present as lumps or swellings in the mouth Normal Developmental Inflammatory Traumatic Cystic Fibro-osseous Hormonal Drugs Blood dyscrasias Neoplasms Others Most red oral lesions are inflammatory in nature, but some are potentially malignant, especially erythroplasia. #### Causes of red lesions Widespread redness