The discovery of a lump or swelling beneath the tongue, known as the floor of the mouth, can cause immediate concern. This sublingual region contains major blood vessels, nerves, and salivary glands, making any change noticeable. While a sudden bump can be worrying, the majority of such lesions are harmless, temporary, and have benign causes. Understanding the common sources of these growths provides clarity on what might be causing the unexpected change.
Causes Related to Salivary Gland Blockages
A specific cause of a bump under the tongue involves the sublingual and submandibular salivary glands. A blockage or injury to the small ducts that drain saliva can lead to a fluid-filled cyst called a ranula. A ranula appears as a soft, painless, and often translucent or bluish bubble-like swelling on the floor of the mouth.
The ranula forms when saliva leaks from a damaged gland into the surrounding connective tissue. While generally not serious, a large ranula can occasionally interfere with swallowing or speaking. Another cause of obstruction is sialolithiasis, which is the formation of hardened mineral deposits, often called salivary stones.
These stones, primarily composed of calcium, most commonly affect the submandibular gland duct. A salivary stone may present as a painful lump that often swells or causes dull pain during mealtimes. This pain is triggered because eating stimulates saliva production, and the stone prevents proper drainage. Symptoms usually subside within an hour or two after the meal as the swelling temporarily decreases.
Inflammatory Lesions and Minor Infections
Bumps in the sublingual area can stem from localized inflammation, minor injury, or common sores. A frequent cause of painful lesions is the aphthous ulcer, commonly known as a canker sore. These ulcers typically present as a shallow, round sore with a white or yellowish center and a distinct red border.
Canker sores are not contagious and often form under the tongue due to factors like stress, minor trauma, or nutritional deficiencies. Another type of bump is a mucocele, which involves the minor salivary glands. A mucocele forms when trauma causes the duct of a minor gland to rupture, leading to a collection of mucus in the tissue.
Traumatic fibromas are firm, painless, dome-shaped nodules resulting from chronic irritation or injury. They are scar-like tissue overgrowths that develop in response to repeated biting, sharp teeth, or irritation from dental appliances. Although they can occur anywhere, they are often found on the tongue or inner cheek where trauma is common.
Benign Tissue Growths and Vascular Bumps
Some bumps under the tongue are structural variations or vascular changes that are generally harmless. Lingual varicosities, sometimes referred to as “caviar tongue,” involve the veins on the underside of the tongue. These are dilated, tortuous vessels that appear dark blue or purplish, becoming more common with advancing age due to the weakening of vein walls.
These vascular bumps are asymptomatic and do not require treatment, representing a physiological change. Other growths include papillomas and fibromas, which are small, non-cancerous tissue overgrowths. A squamous papilloma is often painless and may have an irregular, wart-like surface texture.
These benign growths are slow-growing and usually pose no threat to health. They may be removed if they become irritated or interfere with daily functions. They are differentiated from other lesions by their solid, often firm consistency and slow development, though professional examination is often required for distinction.
Signs That Require Medical Evaluation
While most sublingual bumps are benign, certain signs indicate the need for prompt medical or dental evaluation. A persistent lesion that does not show signs of healing within a two-week period should be examined by a healthcare professional. This duration is a standard benchmark, as most minor sores and traumatic injuries resolve quickly.
Any change in the appearance of the bump, particularly a rapid increase in size, new bleeding, or a shift in color to red or white patches, is a significant warning sign. Patches of mixed red and white tissue are concerning, as is any lump that develops a rough or hardened texture. These visual changes may suggest a more serious condition requiring a definitive diagnosis.
Immediate consultation is also necessary if you experience persistent pain not related to an ulcer, or difficulty with speaking or swallowing. Furthermore, unexplained numbness in the mouth or face, or a lump in your neck or throat area, warrants professional evaluation. Diagnosis typically involves a thorough visual exam, and sometimes a biopsy or imaging is necessary to determine the exact nature of the lesion.