A mucocele (MYOO-koh-seal) is a swelling in your mouth. It can happen when a salivary gland is injured or blocked.

It occurs in about 1 out of 500 adults. You have many salivary glands in your mouth. They produce saliva. Saliva is made of water, mucus and enzymes. Saliva moves from a gland into your mouth through tiny tubes called ducts. Sometimes, one of these tubes is cut. The saliva pools at the cut spot and causes a swelling, or mucocele. These swellings commonly occur inside the lower lip. They also can be found in other places inside the mouth, including the roof of the mouth (palate) and the floor of the mouth. Swelling also can occur if one of these tubes is blocked and saliva backs up in the tube. If swelling occurs because the submandibular duct is blocked, the mucocele is called a ranula. A ranula is quite large and appears under the tongue. Mucocele is a common lesion of the oral mucosa that results from an alteration of minor salivary glands due to a mucous accumulation. Mucocele involves mucin accumulation causing limited swelling. Two types of mucocele can appear - extravasation and retention. Extravasation mucocele results from a broken salivary glands duct and the consequent spillage into the soft tissues around this gland. Extravasation mucoceles are caused by a leaking of fluid from surrounding tissue ducts or acini. This type of mucocele is commonly found on the minor salivary glands. Physical trauma can cause a leakage of salivary secretion into surrounding submucosal tissue. Inflammation becomes obvious due to stagnant mucous resulting from extravasation. Extravasation mucoceles appear frequently on the lower lip whereas retention mucoceles appear at any other location of the oral cavity. Occasionally mucoceles can involve the glands of Blandin-Nuhn. These glands are located on the muscle of the ventral side of the tongue; the histological diagnosis is always extravasation type, and normally affecting young patients

Retention mucocele appears due to a decrease or absence of glandular secretion produced by blockage of the salivary gland ducts . Retention mucoceles are formed by dilation of the duct secondary to its obstruction or caused by a sialolith or dense mucosa. The majority of retention cysts develop in the ducts of the major salivary glands.

There is no clinical difference between extravasation and retention mucoceles. Mucoceles present a bluish, soft and transparent cystic swelling which frequently resolves spontaneously. The blue colour is caused by vascular congestion, and tissular cyanosis of the tissue above and the accumulation of fluid below. Coloration can also vary depending on the size of the lesion, proximity to the surface and upper tissue elasticity

When located on the floor of the mouth these lesions are called ranulas because the inflammation resembles the cheeks of a frog. Diagnosis : Palpation can be helpful for a correct differential diagnosis. Mucoceles are mobile lesions with soft and elastic consistency depending on how much tissue is present over the lesion Despite this fluctuation, a drained mucocele would not fluctuate and a chronic mucocele with a developed fibrosis would have less fluctuation. A simple technique known as fine needle aspiration biopsy (FNAB) is very helpful, especially when differential diagnosis of angiomatous lesions is involved. Abundant mucosa without epithelial components is found within mucoceles as well as many inflammatory cells, especially histiocytes. A histopathologic study is crucial to confirm the diagnosis and to ensure that glandular tissue is completely removed. Two types of mucoceles exist: retention mucoceles and extravasation mucoceles. In the case of retention mucoceles a cyst cavity can be found, this is generally well defined with an epithelial wall covered with a row of cuboidal or flat cells produced from the excretory duct of the salivary glands (3). Compared to extravasation mucoceles, retention mucoceles show no inflammatory reaction and are true cysts with an epithelial covering (5). Extravasation mucoceles are pseudocysts without defined walls. The extravasated mucous is surrounded by a layer of inflammatory cells and then by a reactive granulation tissue made up of fibroblasts caused by an immune reaction. Even though there is no epithelial covering around the mucosa, this is well encapsulated by the granulation tissue A mucocele can be described as a painless cyst, which is usually seen on the inner side of a persons lip. Also known as a mucous retention cyst, mucoceles are quite common, and fortunately, harmless. These cysts usually occur because of the accumulation of clear fluid on the surface of the inner lip. In several people, these cysts heal on their own, but a person may face the problem of recurrent mucoceles. If these cysts are recurrent, they have the ability to leave permanent scars on the area that they form on. Mucoceles are common in both men, as well as women, of all ages. Studies reveal that it is mostly the younger people, who are below the age group of 20, that are affected the most by this affliction. In people who are above the age of 30, the formation of the mucoceles is mainly superficial. In general, a mucocele looks like a clear, bluish bubble, which has been filled with a liquid. Some of them may also seem to have a rubbery appearance. While they do not really hurt, they could cause a bit of discomfort, if any pressure is applied on them. Although these cysts are mainly harmless, they could interfere with usual mastication process, depending on their size and location. Though this is rare, in certain instances a few types of mucocele formations could lead to complications, which require medical assistance. Hence, in such instances,mucocele treatment may be required. However, in order to use the appropriatetreatment for mucocele problems, it is important to identify the exact factors that could be causing them.

There could be several factors that lead to the formation of mucoceles in the body. One of the most common causes of this problem is a blocked or a damaged salivary gland. A rupture or even a ductal

obstruction of the salivary glands could lead to oral mucoceles. Another common cause of mucoceles in most people is the habitual and the excessive sucking of the lower lip area. This increases the pressure placed on the membranes on the inner lip, which increases the collection of clear liquid in the area, leading to a mucous cyst. It is also possible to get a mucocele on the upper lip due to the same reason. Some of the other common health conditions and occurrences that lead to mucoceles include: Biting an area on the inner lip repeatedly Trauma, in the form of a burn, inflammation, mouth infection or an injury A disease or a disorder known as oral lichen planus Taking drugs that could cause the saliva to thicken A piercing in the tongue or the lower lip

Most mucoceles, which are shallow, rupture on their own, without leading to any pain, bleeding, pus or anything else like that. Hence, in most people, the treatment of mucoceleis not required. However, though it is not very common, in some cases the mucocele may go on for a longer period of time, without bursting or getting drained. In such instances, a person may need to seek mucoceles treatment or even go through a mucocele removal surgery, to prevent the cyst from turning into a permanent nodular scar.

Mucocele treatment Before suggesting any form of treatment, mucocele home remedy or a mucocele removalprocedure, a medical health care giver needs to confirm the diagnosis of the mucocele, by examining the area visually. At times, it could be continued trauma that is causing a delay in the healing of the mucocele. Hence after identifying the main cause of the problem, a doctor may suggest various options, right from home remedies for mucocele to mucocele treatment with laser. For longer lasting cysts, some of the common procedures that are usually suggested by doctors are drainage, aspiration, cryotherapy, surgical removal and laser treatment. Mucocele home treatment Several people swear by the home treatment options for oral mucous retention cysts. Many health experts too, recommend mucocele treatment with alum, since it causes the cyst to grow rapidly and then pop on its own. Moreover, alum reduces the possibilities of any infections or inflammations in the area. For best results, it is suggested that a small amount of alum should be applied on the mucocele for around 10 to 15 minutes and then, rinsed off using a good mouthwash. Another common home remedy in mucocele treatment is salt therapy. Around a teaspoon of sea salt should be added to a glass of warm water and used as a mouth rinse, twice or three times each day. After about four or five days, the size of the cyst should have reduced considerably. However, it is important to regulate the size of the mucocele on a daily basis and continue with this remedy, only if the size seems to have reduced within a day or two.

Primrose oil can also be applied directly on to the cyst, in order to help it heal faster. This home remedy also reduces the chances of an infection. Some people use castor oil combined with honey too, in place of primrose oil. In case the home remedies for mucocele mentioned above are not very effective in treating the condition, it is best to check with a doctor, for other medical treatment options. The doctor should also be consulted about mucocele treatment cost, effectiveness, side effects as well as the chances of the cysts recurring, before taking any decision. Mucocele removal surgery In case the home remedies or other treatment options for getting rid of mucoceles do not yield the desired result, it may be best to consider mucocele removal options. However, there is no guarantee that a mucocele will not return even after a surgical or a laser procedure. This is just a chance that several people decide to take and hope that they will not be bothered with mucoceles in the future. Since most of the procedures are as good as non invasive, mucocele removal care is minimal. However, mucocele removal recovery time could take up to a week, where a person may need to eat soft foods for about two days. Mucocele removal cost could range from a few dollars, to a few hundreds, depending on the doctor and the medical facility. It is important to discuss these aspects with a doctor carefully.