Epulis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Epulis is a tumor or lump that grows on the gums (gingiva). Usually, this condition is marked by the appearance of sores on the patient’s gums.
In general, epulis is caused by hormonal factors, irritation, and physical trauma which is characterized by excessive tissue growth.
There are different types of epilepsy, such as congenital epilepsy or Congenital Granular Cell Tumor (CGCT), fibromatous epilepsy, granulomatous epilepsy, fissured epilepsy, pregnancy-related epilepsy, angiomatous epilepsy, and gigantocellular epilepsy.
What is the difference between each type of epulis? Check out the explanation below.
Epulis
| Medical specialist | Dentist |
| Symptoms | soft lumps on the gums that are pink to dark in color that bleed easily |
| risk factor | Poor oral hygiene, injury, pregnancy, fitting of dentures |
| diagnosis | Medical interview, physical exam, X-ray, biopsy |
| Treatment | Surgery and curettage |
| Complications | Difficulty eating, disruption of the breathing process |
| When to see a doctor? | If experiencing the symptoms of epulis |
Symptoms
Signs and symptoms of epulis can vary, depending on the type. Here are some symptoms that can be recognized according to the type:
1. Congenital Epulis or Congenital Granular Cell Tumor (CGCT)
Usually, congenital epulis looks like a raised lump on a newborn’s gums.
This condition can sometimes hinder the baby’s breathing and food intake.
The epulis bumps are pink and tender to the touch. This lump can shrink spontaneously, with age.
For therapy, tissue cutting can be done if needed.
2. Epulis fibromatosa
The fibromatous epulis lump is pale pink in color and is usually located on the front surface – right between 2 teeth.
The shape looks like a lump that is thin, rubbery, and solid.
Sometimes, a lump can form a sore like a canker sore. Lumps can also be stalked or not, don’t bleed easily, and don’t cause pain.
Generally, this type of epulis is found in adults. The area where fibromatous epulis grows is mainly on the gums (gingiva), lips, cheeks, tongue and gums on the outside of the teeth.
3. Granulomatous epulis
Granulomatous epulis is located on the gums, between the teeth.
This type of epulis lump has an irregular shape, is bluish-red in color, is soft and bleeds easily, and has a stem.
4. Cracked food
This type of epulis lump usually looks like a fold of the gums and does not cause pain, unless it is infected.
In general, this epulis does not cause inflammation.
5. Pregnant women
Epulis gravidarum looks like a gum protrusion with varying colors. Starting from pink, dark red to purple. Epulis is most often found in the gums on the upper teeth.
People with epulis gravidarum generally do not feel sick. However, this epulis bleeds easily when involved in the chewing process and when brushing your teeth.
6. Epulis Angiomatosa (Epulis Telangiectum)
The growth of angiomatous epulis is very fast. The lump has a soft, spongy texture, is bright red in color, and bleeds easily.
This epulis is often mistakenly interpreted as epulis granulomatous and epulis gravidarum.
7. Peripheral Giant Cell Granuloma
This type of epulis mostly attacks women and children. In addition, this epulis can affect the periodontal tissue or gum areas that are not edentulous.
Epulis nodules are dark red to purple in color and broad-stemmed, soft, bleed easily, have a diameter of 0.5–1.5 centimeters or can be larger. Sometimes canker sores occur and are accompanied by pain.
Reason
The causes of epulis vary greatly, depending on the type of epulis itself. Here are some types of epulis and the causes of each:
1. Congenital Epulis or Congenital Granular Cell Tumor (CGCT)
This type of epulis is formed from birth. The cause is still not clearly known to date.
However, congenital epulis is thought to originate from the epithelial cells of the tooth buds and is mostly found in the front area of the maxillary gums.
2. Epulis fibromatosa
This is the most common type of epulis among all other types of epulis.
Fibromatous epulis is caused by irritation or injury to the gums in the same place that occurs repeatedly for a long time.
This then causes tissue overgrowth.
3. Granulomatous epulis
Granulomatous epulis usually occurs in holes where teeth have been extracted or after surgery due to the ingress of food residue after the extraction is complete.
This type of epulis is located on the gums, precisely between the teeth.
4. Cracked food
This type is an epulis which is formed due to the use of bad dentures.
Wounds that arise due to irritation or friction with dentures that are too hard for a long time can cause these epulises.
5. Pregnant women
Epulis Gravidarum is an enlargement of the gums that develops during pregnancy.
As many as 0.2–5 percent of pregnant women experience epulis gravidarum. Hormonal factors are the cause of epulis in this pregnancy.
Risk Factors
Risk factors for epulis include:
- Poor oral hygiene
- Trauma or injury to the gums
- Pregnancy
- Improper use of dentures
- Presence of oral and dental disease
- History of the previous epulis
Diagnosis
To make a diagnosis of epulis, the dentist will conduct a medical interview and direct physical examination.
With a physical examination, the doctor will determine the location, size, area, and also the type of epulis you are suffering from.
Then, the doctor also requires supporting examinations such as dental x-rays and biopsies.
A biopsy is done by taking a small amount of tumor tissue and having it examined in a laboratory to find out whether there is a risk of a malignant or cancerous tumor.
Thus, the doctor can determine the type of epulis suffered and provide the right treatment.
Treatment
Epulis treatment is adjusted to the cause and severity of the gum tumors that appear.
In congenital epulis, most epulis will disappear on their own within the first 8 months of life. Therefore, if the lesion is small, no treatment is required.
Other types of epulis are usually treated with surgery and curettage to remove the epulis from the gums.
After that, the epulis tissue will be examined in the laboratory to test the network further.
Then, the doctor will also look at the cause of the epulis. For example, if the cause is dentures, the dentures must be remodeled to fit the gums to prevent further irritation and prevent recurrence of the epulis.
Prevention
You can prevent the formation of gum tumors or epulis in the following ways:
- Keep your teeth and mouth clean by brushing your teeth twice a day
- Immediately seek treatment to the dentist if you have an injury to your gums or have problems with your teeth and gums such as cavities, cracked teeth, and so on
- Install dentures with an expert and consult with a dentist when there is an installation of dentures that does not fit
- Routine control to the dentist every 6 months for a thorough examination
Complications
If not handled properly, epulis can lead to complications, such as:
- Difficulty eating
- Disruption of the breathing process
When to See a Doctor?
If you feel a lump in your gums that is getting bigger and bleeds easily, immediately consult a dentist for further treatment.