Dental Health Article by Dr Emma - "Variations on Normal"

Dental Health

We're all a bit weird in our own way. Did you know there are several things that could be going on in your mouth that make you special? I'm not talking about diseases like tooth decay, but rather about conditions which are considered to be a "variation on normal". Not necessarily anything wrong, but simply little physical quirks that not everyone has. I've had a few patients present to me panicking when they've found a lump or a spot in their mouth, only for me to tell them it's probably been there their whole life and it's nothing to worry about. Having said that, it's always a good idea to get any new lesion or anything that worries you checked by your dentist. Most of the time it's nothing to worry about, but you definitely want to rule out anything nasty.


Pronounced "tor-eye", these are hard, bony lumps which are usually found in the middle of the hard palate, or either side of inside of the bottom jaw. A single one on its own is called a torus. They rarely cause problems, but can be a nuisance if they are large and you need to have a denture made. There's little point in surgically removing them unless it's absolutely necessary, because they often regrow.

Geographic tongue

This condition has a very exotic name, but simple refers to the surface of the tongue looking a bit like a map. It's characterised by various shaped patches on the tongue which are smooth in the centre with white edges. The patches can change shape and size over time. Most people have no symptoms, but a small percentage can experience a burning sensation on their tongue which is difficult to treat effectively.

Fissured tongue

Staying with the tongue, around 2-5% of the population has this condition. It rarely causes any problems, and presents as the surface of the tongue having a pattern of deep grooves in it. It's a favourite for dental students to find on each other when first learning to examine people, as another term for fissured tongue is "scrotal tongue" due to its appearance.

Fordyce granules

A warning first, do not do an Internet image search for this while in public, as a similar condition occurs on the genitals. In the mouth, however, it presents as slightly raised, white-yellowish spots on the lips or inside of the cheeks. They are actually oil glands which are usually associated with hair follicles, but they've gotten lost and appeared in a place where they're not needed. People can have only one or two, or they may have hundreds. They are of very little consequence other than looking interesting.

Bigger than most

There are several lumps and bumps that everyone has in their mouth as part of normal anatomy, but in some people they are bigger than others. Salivary ducts are often associated with a flappy "papilla" where they open into the mouth. The common areas for people to notice this are in the middle of the inside of the cheek, where the parotid ducts open, and underneath the tongue, where the sublingual ducts open. If they are not painful or red, it's likely you just have a bigger papilla than the person next door.

Occasionally I'll also see someone with a larger than usual incisive papilla. This is the bump behind your upper front teeth which is prone to being burnt when you eat hot pizza. Again, if there's no pain or redness, you've probably just got a big one.

So, next time you have a dental examination, ask your dentist if there's anything in your mouth that sets you apart from the crowd. You might be more special than you think.

Dr Emma

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Important: This article is general advice only. For further advice or information on this topic, please consult your health professional.


Category: Dental Health

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