According to Latin translation, a ranula is a "little frog." In the dental world, however, a ranula has little to do with green, hopping creatures. Rather, it is a large swelling in the floor of the mouth. It is a type of mucocele, a cyst that forms when a salivary gland is blocked, and is something that you can bring to the attention of your dentist if one happens to arise between regular cleanings appointments.
Prevalence and Symptoms
Ranulas are rare but typically occur in children, adolescents and young adults, according to a report in the Journal of Dental & Allied Sciences. They may be found in approximately two out of every 10,000 patients.
They often appear translucent blue and dome-shaped, like the stomach of a frog. They tend to arise on the floor of the mouth underneath the tongue. The size varies from 3 to 6 centimeters, with swelling that comes and goes, reports the Malta Medical School Gazette. Occasionally, patients could develop plunging or diving ranulas, where the swelling is in the neck and not necessarily in the mouth.
If large enough, ranulas can displace the tongue and affect swallowing, speech and chewing. They can also become infected, potentially leading to pain, tenderness and fever.
Causes and Diagnosis
Unfortunately, ranulas aren't always preventable. Some ranulas are present from birth, but they often result from injuries in the mouth, such as those related to oral surgery. Most commonly, the injured structure is the sublingual salivary gland — the gland located under your tongue — but the ranula could also be related to another salivary gland or the submandibular duct. When the gland or duct ruptures, saliva accumulates in the tissue and creates swelling.
To differentiate a ranula from another type of cyst, your dentist may order an ultrasound, explains a report published in the Western Journal of Emergency Medicine. If you notice abnormal swelling in your mouth, you should discuss the details of your symptoms with your dentist to determine if testing is necessary.
Small ranulas may not require treatment if they are not causing any symptoms. When larger, they could necessitate oral surgery for the removal of the affected salivary gland. This treatment prevents the problem from recurring, according to a study in the Journal of Clinical & Diagnostic Research.
Marsupialization — the surgical procedure of opening the cyst — can also be used as treatment. While this method preserves the gland, there is greater chance that the cyst will reappear.
Another treatment performed by interventional radiologists is salivary gland ablation, where medications are injected into the salivary gland to cause the tissue to shrivel up. According to Nationwide Children's Hospital, this approach effectively treats 95 percent of pediatric ranula cases and five percent with the removal of the affected salivary gland.
If it is necessary to remove the salivary gland to treat a ranula, the surgeon will close the area with stitches that will dissolve or be removed at another appointment. They will provide detailed information regarding any aftercare instructions, including medication, if necessary. Within a few months, the scar at the floor of your mouth will likely fade and you may not notice any difference in your salivary flow.
Nationwide Children's Hospital reports that patients treated by salivary gland ablation will likely experience swelling for up to 10 days and numbness on the affected side of the tongue for up to four weeks.
While they might be uncomfortable, ranulas can be treated by your medical professional. If you notice a cyst or swelling on the floor of your mouth, show it to your dentist so that you can work together to confirm the diagnosis and come up with the best treatment plan for your oral health.