An oral squamous papilloma is a benign, or non-cancerous, growth that develops from the stratified squamous epithelium, the tissue that lines the oral cavity. These growths are common and present as small, wart-like lesions that are generally painless. While their appearance can cause concern, they are considered harmless formations.
Causes and Appearance
The development of an oral squamous papilloma is caused by the Human Papillomavirus (HPV), with low-risk types 6 and 11 being the most common strains. The virus prompts the rapid multiplication of squamous cells, leading to the papilloma’s formation. HPV is transmitted through direct contact with infected skin or mucous membranes.
These growths manifest as a single, slow-growing mass with a cauliflower-like or finger-like appearance. The lesion is usually supported by a stalk-like structure known as a peduncle. Its color can vary from pink or red to white, depending on the amount of keratin on the surface. Growths with less keratin appear pink, while those with a heavy buildup of keratin look white.
Oral squamous papillomas can appear anywhere in the oral cavity but are most commonly found on the soft palate, tongue, and lips. They are diagnosed in individuals between the ages of 30 and 50 but can occur at any age. The growths are solitary and do not spread to other areas of the mouth.
The Diagnostic Process
The diagnostic process is performed by a dentist or doctor and starts with a clinical examination. The healthcare provider will visually inspect the lesion’s size, shape, and location within the mouth. Due to their distinct appearance, a professional can often form a preliminary diagnosis from this assessment.
To definitively confirm the diagnosis and rule out other conditions, an excisional biopsy is performed. This procedure involves the complete removal of the lesion, including its base and a small margin of the surrounding tissue. The removed tissue is then sent to a pathology laboratory for histopathological analysis.
A pathologist examines the tissue sample under a microscope to confirm the presence of benign cell proliferation. This microscopic examination verifies that the growth is non-cancerous and distinguishes the papilloma from other oral lesions that might have a similar appearance.
Common Removal Procedures
The standard treatment for an oral squamous papilloma is conservative surgical excision. This procedure is typically performed by a dentist, oral surgeon, or periodontist in an outpatient setting. Local anesthesia is administered to numb the area, ensuring the patient does not feel any pain during the removal. The goal is to excise the entire lesion, including the stalk and the base where it connects to the oral tissue, which helps prevent it from growing back.
Once the lesion is removed, the small wound may be closed with a few stitches, though this is not always necessary depending on the size and location of the papilloma. The procedure is generally quick and uncomplicated.
While surgical excision is the most common and recommended method, other techniques are sometimes used. Laser ablation, which uses a focused beam of light to vaporize the tissue, is one alternative. Another option is cryosurgery, which involves freezing the lesion with liquid nitrogen to destroy the abnormal cells. However, surgical removal remains the preferred approach because it allows for a tissue sample to be collected for pathological confirmation.
Recovery and Outlook
Following the removal of an oral squamous papilloma, the recovery process is swift and involves minimal discomfort. The small wound in the mouth usually heals within one to two weeks. Patients may experience mild soreness or swelling, which can be managed with over-the-counter pain relievers.
The prognosis for an individual after the complete removal of a squamous papilloma is excellent. Recurrence of the same lesion in the same spot is uncommon, provided the entire base of the growth was successfully excised during the procedure. These growths have an exceedingly low potential to become malignant or cancerous. Regular dental check-ups are sufficient to monitor the site and overall oral health.