What does this mean?
Swellings inside the mouth are told apart by how they feel. A fluid-filled blister shifts when you press it, looks clear or bluish, and now and again empties and fills again. Swelling from an infection is painful, red around it, and its source can most often be traced back to a tooth. A hard lump is like none of these.
There are three features to watch for: that it feels hard, that it does not move independently of the tissue beneath it, and that it causes no pain. If these three are there together and the lump has not got smaller for more than three weeks, it is not expected to settle on its own. Lumps that bleed easily, have an uneven surface, or carry a sore on them that will not heal, call for attention as well.
Not every hard lump means the same thing. Bony-hard outgrowths that have sat in the middle of the palate or on the inner side of the lower jaw for years, present on both sides, are most often the bone's own extra structure; they grow very slowly. A lump that is new, on one side only and growing follows a different path. This distinction is not made by looking alone, but at an examination and, where needed, with imaging or a sample of tissue.
Behind a hard lump inside the mouth there can be anything from a structural bony outgrowth to a lump arising from a salivary gland; how long it has been there, whether it is growing and whether it shifts are the first step in telling them apart.
Likely causes
What helps at home?
- Photograph the lump today and write down the date; whether the size changes over the weeks is the most valuable information.
- Do not squeeze the lump, and do not try to burst it or drain it with a needle; even if the contents come out, the cause does not go away.
- If you smoke and drink alcohol, cut down; both are known risk factors for changes in the lining of the mouth.
- If a broken tooth edge or the edge of a denture is rubbing against the lump, note that down; a source of constant irritation is looked for at the examination.
- If the lump has been there for more than three weeks and is not getting smaller
- If it is hard, painless and does not shift when you press it
- If its surface bleeds, or there is a sore on it that will not close
- If you can feel a hard gland in your neck on the same side
- If numbness in your tongue, your lip or your jaw has been added
Frequently asked questions
- If the hard lump does not hurt, can I wait?
- Being painless is not a reassuring finding. Some of the important lumps inside the mouth are noticed late because they cause no pain, and that delay makes assessment harder. A hard lump that has passed three weeks and is not easing should be examined even if there is no pain; having it looked at does no harm, waiting can cost you time.
- A hard raised area formed after I bit my cheek, is that the same thing?
- Hard raised areas that form from repeated biting or rubbing are common, and they tend to settle once the irritation is gone. Even so, rather than making that judgement on your own, it is better to have it confirmed at an examination, because a raised area that does not get smaller although the source has been removed is assessed differently. Tell your dentist when you bit it and whether it has grown since that day.
- Can what the lump is be worked out just by looking?
- An examination says a great deal, but on its own it may not be enough. The site of the lump, how it feels, how mobile it is and how long it has been there set the first direction; an X-ray or other imaging may then be needed. In most cases the definite answer comes from examining a sample of tissue. Being asked for that examination does not mean bad news, it means the right path is being worked out.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.