SOME people may observe a fleshy growth on either the gums or tongue, or even a scaly lesion anywhere on the soft tissues of the mouth. The good news is that most tumours of the gums and tongue are benign (non-cancerous). If the growth is hard, the lesser is the chance of it being serious. Now, the most common growth is an irritation fibroma, which appears as a smooth-surfaced, pink mushroom suspended by a small stalk attached to the lip, tongue or inner cheek. The papilloma is also mushroom-shaped, but with an irregular, white surface.
Irritation fibromas are caused by lip, tongue, or cheek biting or sucking. Frequently, the growth occurs opposite a small space between the teeth, where the tissue can be sucked in. On the other hand, a papilloma is a benign growth that occurs of its own accord.
The patient first becomes aware of the fibroma or papilloma by feeling or observing the irregularity, or by frequent accidental biting of the outgrowth of tissue.        Treatment by excision (cutting out) is the usual cure. Since the diagnosis is obvious, and the entire growth is removed without difficulty, biopsy to check for cancer is not necessary.
Avoidance of lip or tongue “doodling” usually prevents recurrence. If recurrence is due to a space between the teeth, then closure of the space with a small fixed bridge may be indicated. However, once the growth is removed, it seldom recurs, and no further treatment is necessary.
Then there are bony growths, quite common in adults, in the middle of the palate or on the inside lateral or tongue side of the lower jaw. They are called tori, and consist of normal bone substance that in the palate appears as an irregular oval protuberance, and in the mandible, more or less, as a small single or multiple marbles beneath the mucosa.
The cause is unknown, and completely symptomless. Occasionally, they grow so large as to be traumatized by chewing or the wearing of dentures. Most people are unaware of their presence until a dentist or dentex points them out. Unless tori cause a problem, there is no reason to have them removed. If their size becomes annoying or interferes with the placement of a denture, they are removed by simple surgery. Once removed, tori do not recur.
‘Hairy tongue’ is a harmless elongation of the hair-like filiform papillae on the top surface of the tongue. The surface usually appears white, but may be stained brown or black by tobacco or pigments in food. The condition occurs only in adults. A white-coated tongue is common during a dehydration illness, but what causes hairy tongue in the absence of systemic illness is unknown.
The condition is painless, and noted only for its abnormal colour. Since food particles can collect in the hairy filaments, the tongue may emit an unpleasant smell. Both treatment and prevention consist of daily brushing or scraping of the tongue to keep its surface clean.
Leukoplakia, meanwhile, should be taken more seriously. This is observed more frequently among older males, and in persons using tobacco. Although most lesions remain benign, the condition can be viewed as pre-cancerous. Lesions vary in size, from a few millimeters to many centimeters (an inch or more) across. They  may be flat, fissured, or ulcerated, with a somewhat rough and scaly surface, and whitish-yellow, pearly-white, or grayish-white in colour.
Leuoplakia is usually found behind and to the outside of the lower molars, on the inside of the cheeks, and on the floor of the mouth, or the side of the tongue.        Leukoplakia occurs spontaneously, or may be caused by irritation from heavy smoking, chewing tobacco, jagged teeth, ill-fitting dentures, and poor oral hygiene. The disease develops slowly and painlessly, and most times is discovered by a dentist, with the patient being unaware of the condition.
When leukoplakia appears on the tongue or floor of the mouth, there is a very high risk of it developing into invasive cancer, and so complete excision is recommended, with mandatory biopsy. Constant monitoring by the dentist is required.