Oral fibromas are common, noncancerous growths in the mouth that develop from fibrous connective tissue. These benign lesions are frequently found during routine dental examinations because they are generally painless and do not cause noticeable symptoms. The fibroma itself is typically asymptomatic, but pain can develop when the growth is subjected to constant friction or trauma. Therefore, any pain associated with an oral fibroma is almost always a secondary consequence of external irritation.
What Exactly is an Oral Fibroma
An oral fibroma is a reactive overgrowth of tissue, often referred to as a traumatic or irritation fibroma. This lesion forms when the body responds to persistent, low-grade injury by producing excess fibrous connective tissue, a process known as focal fibrous hyperplasia. The primary cause is chronic local irritation, such as habitual cheek or lip biting, rubbing from ill-fitting dental appliances, or a sharp tooth surface.
These growths appear as smooth, dome-shaped lumps that are firm and rubbery. They usually match the color of the surrounding oral mucosa, though they may appear paler or whiter if the surface has been repeatedly irritated. Oral fibromas are most frequently located along the bite line of the inner cheek, but they can also be found on the lips, tongue, or gums. Most lesions are small, often less than one centimeter in diameter, developing gradually over weeks or months.
Understanding the Sensation: When Oral Fibromas Become Painful
The internal structure of an oral fibroma is dense, scar-like connective tissue containing few nerve endings, which is why the growth itself is typically painless. Pain only begins when the surface layer of the fibroma experiences secondary trauma. The most common mechanism for discomfort is the fibroma’s inconvenient location, which makes it a target for repeated accidental biting.
When the fibroma is repeatedly bitten, the outer layer of tissue can break down, leading to a painful traumatic ulceration. This ulcer, not the underlying fibrous mass, is the source of the discomfort a person feels. Pain can also arise from constant friction against a denture or dental braces, causing inflammation and tenderness on the surface of the growth. While the fibroma is a protective reaction to irritation, its presence often leads to a cycle of re-injury and soreness.
Clinical Assessment and Removal Procedures
A dental professional can suspect an oral fibroma based on a visual and tactile examination combined with a history of chronic irritation. The clinical diagnosis involves assessing the lesion’s size, firm texture, and characteristic location within the mouth. While oral fibromas are benign and do not develop into oral cancer, a biopsy is often performed to confirm the diagnosis and rule out other, potentially more serious, oral conditions.
The treatment for a persistent oral fibroma is surgical excision, as these growths do not resolve. This is a straightforward outpatient procedure, typically performed under local anesthesia in a dental office. The fibroma is removed with a scalpel or a focused laser, which often results in less bleeding and a quicker recovery time. It is necessary to also eliminate the source of the chronic irritation, such as adjusting a dental appliance or addressing habitual biting, to prevent recurrence after the procedure.