Q. There is a painful nodule between canine and premolar and I am on braces. What is that?

Answered by
Dr. Bharat Joshi
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 24, 2020

Hello doctor,

I got braces last year as there were spaces between my teeth. For the last 10 days, I noticed a nodule coming out behind the braces between canine and premolar on the left side of the mandible. It is painful only while brushing when the bristles rub against it.

Before this, around 10th July (after my consultation with orthodontist for braces), I had slight swelling in the same region associated with pain. Now due to lockdown, I am unable to consult for my next appointment. It started as painful swelling and now appears as a nodule which is pale-colored. I just want to know if I should take this nodule seriously.



Welcome to icliniq.com.

See, as per your details, it seems to be gingival polyp due to irritation from braces. But you are saying it is turning pale so it can be lipoma also. I request you to please send a good clinical picture and tell me some more details regarding the nodule to confirm my diagnosis. Please tell me about the consistency, bleeding, and pain now.

The Probable causes:

Gingival polyp (to be confirmed after picture and details).

Investigations to be done:

Gingival polyp (to be confirmed after picture and details).

Probable diagnosis:

Gingival polyp.

Treatment plan:

Maybe excision.

Regarding follow up:

Two to three days as diagnosis is must and treatment will be accordingly.

Thank you doctor,

It is painful while brushing my teeth. It is soft, but there is no bleeding.



Welcome back to icliniq.com.

Thank you very much for the picture (attachment removed to protect patient identity). It is nothing but gingival enlargement, which is response to orthodontic therapy. Do not worry. Let your orthodontic therapy be completed then, just by scaling and curettage, this enlargement will subside. No lipoma, no fibroma nothing serious but response to ortho treatment which is normal.

The Probable causes:

Ortho treatment.

Probable diagnosis:

gingival enlargement (inflammatory).

Treatment plan:

Scaling and curettage after completion of treatment.

Preventive measures:

Maintain oral hygiene. Do warm saline rinses Every six hourly for two weeks and practice brushing twice day. Rinse with water after every meal.

Regarding follow up:

After completion or orthodontic treatment or if enlargement increases consistently. Until then maintain hygiene and do not worry.

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