A bump in the mouth often causes immediate concern. The term “bump on the tooth” can be misleading, as the growth may be located on the tooth structure, the adjacent gum tissue, or represent a change in the underlying jawbone. Identifying the location and texture of the growth is the first step toward understanding its origin. While many oral growths are harmless, others signal an active infection or a serious underlying condition that needs professional attention.
Bumps That Are Normal Anatomy or Developmental
Sometimes, a bump is a natural feature of dental anatomy, often present since the tooth first emerged. The Cusp of Carabelli, for example, is a small, accessory cusp found on the mesiopalatal surface of the upper first molars. This tubercle is a non-functional part of the tooth crown, composed of enamel and dentin, and its presence is a heritable genetic trait.
Hard, non-mobile bumps on the roof of the mouth or along the inner side of the lower jaw are likely bony growths called tori (singular: torus). Torus palatinus is the growth on the palate, while torus mandibularis appears on the mandible. These are slow-growing, dense bony exostoses that are generally painless and harmless. They often arise in early adulthood and are sometimes linked to stress factors like bruxism, or teeth grinding.
Swelling Caused by Localized Irritation or Trauma
Growths can develop suddenly in response to external factors like friction or minor injury, typically found on the soft tissues of the gum. A common example is an oral fibroma, a non-cancerous, dome-shaped lump of fibrous tissue. This firm, smooth, pink mass forms due to chronic irritation, such as repeated cheek biting or rubbing from a poorly fitting dental appliance.
A pyogenic granuloma is another benign growth, often appearing as a reddish, blood-filled bump that may bleed easily with minor contact. This growth results from an exaggerated tissue response to localized irritation or a minor injury. Less dramatic soft tissue swelling can also result from simple inflammation of the gums, particularly near a tooth where plaque and bacteria have accumulated. This localized gingivitis can cause the gum tissue to become puffy and slightly raised.
Small, painful, and typically short-lived bumps with a whitish or yellowish center and a red border are usually canker sores, also known as aphthous ulcers. These shallow ulcers form on the gums or inner cheeks and usually heal on their own within one to two weeks. Canker sores are not caused by bacterial infection from the tooth but are often triggered by minor trauma, stress, or certain foods.
Bumps Indicating Infection or Underlying Disease
The most concerning type of bump signals a deep-seated infection, often originating from a tooth’s root or the surrounding gum pocket. A dental abscess is a pocket of pus caused by a bacterial infection, which manifests as soft, warm, and painful swelling near the tooth. This condition requires immediate professional treatment because the infection can spread.
When an abscess attempts to drain, it creates a tunnel through the bone and soft tissue called a fistula, appearing on the gum surface as a small, pimple-like bump called a parulis or “gum boil.” This bump may rupture and drain, causing temporary release of pressure and pain relief. Even if painless, the parulis confirms an active, chronic infection at the tooth root that requires root canal therapy or extraction to resolve the source of bacteria.
A cyst, such as a radicular cyst, forms around the root of a nonvital or dead tooth. This fluid-filled sac grows slowly and is often asymptomatic until it causes visible swelling or pressure on the surrounding bone. Less commonly, a persistent, unexplained lump that is painless, firm, and does not heal can be an early sign of oral cancer. These lesions require an immediate biopsy for definitive diagnosis.
When to Seek Urgent Dental Attention
Recognizing specific warning signs helps determine if a dental appointment needs to be scheduled immediately. Any bump accompanied by severe, continuous pain that does not respond to over-the-counter medication warrants urgent attention. This pain often indicates an active infection or nerve involvement requiring immediate intervention.
Facial swelling that is rapidly increasing, especially if it extends to the jaw or neck, suggests the infection is spreading and must be evaluated without delay. A fever accompanying a dental bump is another sign of systemic infection and should prompt an emergency visit. Additionally, any open sore or lump that persists for more than two weeks without healing needs professional assessment to rule out serious pathology, such as oral cancer.
When a patient presents with a bump, the dentist performs a thorough visual and tactile examination to determine its texture, size, and mobility. Diagnostic imaging, such as dental X-rays, is then used to check the tooth roots and surrounding bone for signs of abscess formation or bone loss. The dentist may also probe the area or take a small tissue sample for laboratory analysis if an unusual growth is suspected.