Kenneth Cheng, D.D.S.
Fibromas are growths that form in a person’s mouth in response to repeated injury, irritation or disease. These elevated areas of mostly scar tissue can appear anywhere inside the mouth, including on the tongue, lips, gums and inner cheeks. They can take months or even years to form.
Most fibromas occur as a result of repeatedly biting a certain area of the mouth. Excessive grinding of teeth (bruxism) and a rare genetic disorder called Cowen’s syndrome also are sometimes responsible for fibromas. Fibromas can occur in people of any age, but are most likely to affect adults. Fibromas affect males and females equally.
In diagnosing fibromas, a dentist will carefully examine the tissue to see if it resembles a fibroma. The dentist also may ask about the patient’s oral habits, such as biting the lips and insides of the mouth or grinding teeth excessively.
Unless treated surgically, fibromas continue to grow and can interfere with a patient’s ability to eat or speak. Surgery to remove these lesions is usually safe and simple. However, the patient will have to modify the behavior that created the fibromas, or risk having them return.
Fibromas are raised areas of tissue that appear anywhere inside the mouth, such as on the tongue, lips, inner cheeks (buccal mucosa), gingiva, floor of the mouth and palate. When a person repeatedly injures the same area of the mouth, scar tissue is formed, which can lead to a fibroma. This usually takes months or even years to develop. Fibromas are fairly common mouth lesions.
Fibromas occur when a person injures the mouth by biting the tongue, cheeks or lips, or excessively grinding teeth (bruxism). In some cases, injury may occur from braces, dentures that fit poorly or from a jagged or sharp area of the teeth. Fibromas are considered benign tumors and have a very low likelihood of becoming cancerous.
In rare cases, a genetic disorder called Cowen’s syndrome may cause the formation of fibromas. This condition causes skin lesions and increases the risk of breast and thyroid cancers.
Fibromas that are not surgically removed continue to grow. If left untreated, fibromas may grow large enough to displace the teeth or cause other oral health problems. For this reason, surgical removal is recommended. People are urged to consult their dentist for any lesion that annoys them, causes pain, continues to grow over time, or interferes with a patient’s bite or speech.
Surgery to remove a fibroma does not ensure that the condition will not recur. If the patient continues to engage in the habit that caused the fibroma, it may return. For this reason, patients are urged to take steps to modify their behavior. However, fibromas do not typically return unless the area is irritated again.
Fibromas can occur in people of any age, but are most likely to affect adults between the ages of 20 and 50. Fibromas affect males and females equally.
Signs and symptoms of fibromas
Fibromas typically appear as small areas of elevated tissue that are pink or white. When these scars are traumatized, they may appear reddish or blue. They tend to have a smooth surface and may be round, oval or elliptical in shape. They may have a stalk-like base or be fixed to the surface.
The size of a fibroma can vary from a few millimeters to about 2 centimeters (1 inch). In some cases they feel firm and hard, but in other cases, they are soft, spongy and easily palpable. They are not typically painful but they may become annoying if not removed.
Diagnosis, treatment and prevention
In diagnosing fibromas, a dentist will examine the tissue carefully to see if it resembles a fibroma. The dentist also may ask about the patient’s oral habits, such as biting the lips or inner cheeks or grinding teeth excessively (bruxism). Teeth with sharp edges or a bite that promotes cheek or lip biting will be evaluated and treated. Dentures or prosthesis that do not fit well will also be evaluated.
Fibromas do not disappear on their own and must be surgically removed by an oral and maxillofacial surgeon. This procedure is safe and easy to perform. In most cases, it takes no longer than 20 minutes to complete and involves the dentist cutting the lesion from the mouth using a local anesthetic to prevent any pain. The area is then usually closed with stitches. Once removed, fibromas do not normally return, unless the area continues to be irritated.
In many cases, preventing fibromas involves not biting the cheeks, tongue or lips. In other cases, various aids may be used to try to help modify behavior. For example, a dentist may prescribe a mouth guard to be worn at night by patients who grind their teeth.
The excised fibroma will be submitted to a laboratory for microscopic analysis (biopsied) to ensure that the tissue is not cancerous. This is more of a concern in a patient who drinks or smokes, or when the fibroma has a different color than is typical. Fibromas are considered benign tumors and usually have a very low likelihood of becoming cancerous.
Questions for your doctor regarding fibromas
Preparing questions in advance can help patients to have more meaningful discussions regarding their treatment options. The following questions related to fibromas may be helpful:
- What do you suspect is the cause of my fibroma?
- What are the consequences of failing to treat a fibroma?
- Is there any chance that my fibroma may be cancerous?
- How should I prepare for my surgery to remove the fibroma?
- Will I experience pain following surgery? How long will recovery take?
- Will I require a biopsy of my fibroma tissue?
- How can I modify my behavior so the fibroma does not return?
- What should I do if I notice a fibroma recurring after surgery?
- How can I prevent future fibromas from forming?
- What techniques can you suggest to keep me from biting the inside of my mouth?