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Q. I have a painless soft lump on the gum between my crowned teeth?

Answered by
Dr. Mousam Chattopadhyay
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 05, 2020

Hello doctor,

I am a 50-year-old male. I am having good health and no medications. About three days ago, I noticed with my tongue a lump, mass on my upper gum right to my front teeth and towards the top of the jaw, gumline. It feels smooth and dome-like. I took a look at it in the mirror and of course it looks big to me because I get paranoid about anything even though I have been healthy my entire life and never even get a cold. It just feels smooth, round and mostly solid. There is no pain or tenderness and when I press on it turns white. It has been about three days now since I noticed it and no apparent change. It appeared out of nowhere from what I can tell.

As far as dental history, I do have two crowns on teeth. The crowns are the two teeth right next to my two front teeth and the lump is directly between my front tooth and one of the crowned teeth, but it is up high on the gum line at the top.

Dr. Mousam Chattopadhyay

Dentistry Endodontist
#

Hello,

Welcome to icliniq.com.

Kindly upload an image of the lump. It can be a cyst or an abscess due to the crown. I need to find out soon. I need your cooperation and faith. Kindly upload the image as soon as convenient as the lump is a serious issue. It is not cancerous or something to be super worried but hangs between cyst or abscess due to chronic infection. I can understand that sudden notice of such swellings can be frustrating, but I assure you I will be there and I will help you. I will be waiting for the image.


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Thank you doctor,

I have attached the image.

Dr. Mousam Chattopadhyay

Dentistry Endodontist
#

Hello,

Welcome to icliniq.com.

I have seen the image (attachment removed to protect patient identity).

It looks like a cyst to be specific, a periapical cyst. Can I ask which front tooth you got a new crown? If the upper left central incisor or the lateral incisor.

It is an easy fix. Did your dentist take an x-ray before placing a new crown? Since I need multiple queries to discuss, for that reason, I requested you to get me in chat.

Please take an x-ray to confirm. Removing a small cyst is a very simple press with no complication. It needs a root canal bypassing the crown. I guess your dentist missed the x-ray before getting you a new crown.

Kindly reply queries. You can also post images.

Capsule Sporodex 500 mg (Cephalexin 500 mg) one capsule BD for five days, tablet Metronidazole 400 mg one tablet BD for five days, tablet Zerodol SP (Aceclofenac + Paracetamol + Serratiopeptidase) one tablet BD for five days, capsule Pan D (Pantoprazole + Domperidone) one capsule BD before meals for five days. Betadine (Povidone iodine 2%) mouthwash gargle in lukewarm water two to three times a day.


The Probable causes:

Carious under the previous crown.

Investigations to be done:

Need x-rays you have. Upload them to confirm.

Probable diagnosis:

Periapical cyst.

Treatment plan:

Removal of the cyst followed by the root canal of the affected tooth.


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Thank you doctor,

My main concern is to make sure it is nothing serious? But just to clarify the crown was redone about 10-12 years ago and is not new. And it is the small tooth right next to my front tooth. You can see the lump is right between that crown and my front tooth. I am assuming you are saying that it will not go away on its own, and I have to see my dentist.

Dr. Mousam Chattopadhyay

Dentistry Endodontist
#

Hello,

Welcome back to icliniq.com.

Yes, it is developing a cyst. I got you, the upper left lateral incisor has the crown. Yes, I have prescribed you medications that will deal with an abscess but it is more likely to be a cyst need an x-ray to confirm. Whatever be the outcome you need to see your dentist.

Treatment:

First, start the medications. If it is an abscess by the x-ray, you need root canal treatment and apicectomy to drain the abscess. If it is a cyst, need a root canal followed by apicectomy to remove the cyst.

The tooth will be saved. The whole thing will take just 30 minutes and you will be fine in two days. Complete healing needs three weeks. It is a very common procedure with no side effects. So, it is not at all a serious issue. Yes, you will need to see a dentist. Start medications as soon as possible.

I hope this helps.


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