A critical aspect of every patient intraoral examination is the palpation of the oral soft and hard tissues. The goal with palpation is to identify any changes in anatomy or texture that would not normally be expected. In some cases during palpation it will be noted that there is a lump in a location it would not be expected. Once a lump is detected a process should be initiated to first develop a set of differential diagnoses and ultimately reach a final diagnosis. A lump in the oral tissues is a change that is commonly detected during the oral hard/soft tissue physical examination. There are many different etiologies that can lead to a lump in the oral tissues and identifying the etiology is critical to instituting the appropriate course of clinical intervention. The objective of this presentation is to review different presentations of lumps in the oral soft/hard tissues, the tissue of origin for the lump, the diagnostic steps to identify the etiology, the clinical course typically seen with different lump diagnoses and recommendations for procedures to definitively diagnose and treat a lump. The outcome of the material should help to provide a more comprehensive strategy to evaluate a lump or bump that you detect during your examination and develop a differential diagnosis.

The course will review the different causes of lumps and bumps in the oral tissues. Images from actual clinical cases will be used to present examples and discuss the mechanism of formation of the lump. Specific diagnoses associated with oral lumps will be discussed and different clinical features associated with the specific diagnoses presented. The approaches that can be used in questioning the patient’s chief complaint and history of present illness will be presented to assist in the assignment of potential etiologies and generate a differential diagnosis. Specific diagnostic procedures will be presented to achieve a final diagnosis for the lump/bump leading to a specific recommendation for treatment. There will be an emphasis on the normal physiology of the tissues and the changes that contribute to the signs and symptoms seen in the patient. The importance of developing a differential diagnosis will be stressed and based on the clinical history and physical examination strengths of the oral health professional.

EDUCATIONAL OBJECTIVES
• To recognize changes in oral hard & soft tissues associated with a mass that is presenting as a lump/bump
• To evaluate the clinical history of the lump/bump and identify factors that contribute to either the tissue of origin, etiology or prognosis
• To develop a process to achieve a definitive diagnosis for a lump/bump identified in the oral hard/soft tissues and develop a plan for treatment