Finding a lump or bump under the tongue can cause immediate concern. The area beneath the tongue, known as the sublingual region, is home to several glands, ducts, and folds of tissue, making it a common site for both normal anatomical variations and various non-serious conditions. Understanding the difference between a natural structure and a true abnormality is the first step toward peace of mind. This article details the normal components of the sublingual area and the common, benign causes of lumps that appear there.
Normal Structures Mistaken for Bumps
Many people are unaware of the standard anatomical structures that naturally create small bumps and ridges under the tongue. These features are always present in a healthy mouth but may be misinterpreted as abnormal growths.
One prominent feature is the lingual frenulum, the thin vertical band of tissue connecting the underside of the tongue to the floor of the mouth. On either side of the frenulum, near the base, are two small mounds of tissue known as the sublingual caruncles. These caruncles are the openings for the major salivary ducts and can sometimes appear slightly swollen or prominent.
Running outward from the frenulum are the plica fimbriata, which are delicate, fringed folds of mucous membrane. These folds often run parallel to the two distinct veins visible under the tongue and can sometimes present as a series of small, horn-like projections. Because these folds can be irregular in appearance, they are frequently mistaken for abnormal growths or skin tags. These structures are normal residual tissue from oral development.
Common Benign Causes of Sublingual Lumps
Beyond the normal anatomy, several non-cancerous conditions can cause a noticeable lump to form under the tongue, typically arising from the minor salivary glands. These conditions are usually reactive or cystic and often resolve with minimal intervention.
One of the most common causes is a ranula, a specific type of mucocele found on the floor of the mouth. A ranula is a fluid-filled, blue or translucent cyst that forms when the duct of the sublingual salivary gland is obstructed or damaged, causing mucus to leak into the surrounding tissue. They are generally painless but can grow large enough to displace the tongue, potentially interfering with speaking or swallowing.
Another common finding is a traumatic fibroma, also referred to as an irritation fibroma. This is a smooth, firm, dome-shaped mass composed of dense fibrous scar tissue. Fibromas develop in response to chronic low-grade trauma, such as habitually biting or rubbing the area with a sharp tooth or dental appliance. These growths are benign and typically measure between two and ten millimeters in diameter.
A third condition, known as sialolithiasis, involves the formation of salivary gland stones (calculi). These calcified stones are most common in the submandibular gland duct, but they can also occur in the sublingual gland. The lump is caused by the stone blocking the flow of saliva, leading to painful swelling that worsens during mealtimes when saliva production increases. The pain usually subsides after one or two hours, once the pressure from the blocked saliva decreases.
Identifying Warning Signs and Seeking Professional Care
While most sublingual lumps are benign, certain characteristics warrant a professional evaluation to rule out more serious pathology. Any lump that persists without change or resolution for two to three weeks should be examined by a dentist or physician.
Lumps that exhibit rapid growth, are firm or fixed to the underlying structures, or have an irregular shape are concerning. Color changes, such as white or red patches, or a lump that bleeds easily with minimal trauma, are red flags.
Associated symptoms can be telling. Persistent pain that does not resolve, or the onset of numbness in the tongue or surrounding areas, requires immediate medical attention. Difficulty swallowing, trouble opening the mouth fully, or muscle weakness on one side of the face are significant warning signs. Only a healthcare professional can perform the necessary physical examination and diagnostic tests to determine the nature of the lump.