First-Line Treatment for Mucous Cyst in Buccal Mucosa
Surgical excision is the first-line treatment for a mucous cyst (mucocele) in the buccal mucosa, as it is the most effective strategy with the lowest recurrence rate. 1, 2
Definitive Treatment Approach
- Surgical removal of the mucocele is the treatment of choice for oral mucoceles, including those located in the buccal mucosa 1
- Traditional surgical resection provides the most effective outcomes with low recurrence rates compared to other therapeutic approaches 2
- Complete excision of the entire lesion should be performed, typically under local anesthesia 3
Pre-Treatment Evaluation
Before proceeding with surgical excision, address contributing mechanical factors:
- Have a dental team systematically eliminate all sources of mechanical trauma, including ill-fitting dental prostheses, fractured teeth, or sharp dental restorations 4, 5
- Counsel patients to avoid lip biting habits or cheek biting, as these are common contributing factors to mucocele formation 6, 1
- Inspect the oral mucosa carefully to confirm the diagnosis, as mucoceles typically present as soft, bluish, transparent cystic swellings with a history of bursting and refilling 1
Important Diagnostic Considerations
Be aware that intraoral cystic lesions in the buccal mucosa can mimic other pathology, making accurate diagnosis critical:
- Salivary duct cysts and mucoceles can clinicopathologically mimic salivary gland neoplasms, leading to diagnostic errors 3
- Histopathological examination after excision is essential to confirm the diagnosis and rule out other entities such as salivary duct cysts or epidermoid cysts 7, 3, 2
- The most common location for extravasation mucoceles is the lower lip, but they can occur anywhere in the oral mucosa including the buccal mucosa 1
Post-Surgical Management
After surgical excision, implement rigorous oral hygiene protocols to prevent complications:
- Maintain meticulous oral hygiene to prevent secondary infection and recurrence, as recommended by the American Dental Association 6
- Brush teeth twice daily with a soft toothbrush using the Bass or modified Bass method 4, 5
- Rinse mouth with alcohol-free mouthwash at least four times daily for approximately 1 minute 4, 5
- Maintain adequate hydration by drinking ample fluids to keep the oral mucosa moist 4, 5
Critical Precautions
- Avoid smoking and alcohol consumption, as these impair mucosal healing 5
- Avoid painful stimuli including citrus fruits, hot drinks, and spicy or crusty foods that can irritate the healing surgical site 5
- Address any ongoing lip biting or cheek biting habits to prevent recurrence 6
Common Pitfalls to Avoid
- Do not attempt conservative management as the primary approach—mucoceles may spontaneously rupture and temporarily resolve, but they typically refill and require definitive surgical treatment 1
- Do not confuse mucoceles with other cystic lesions of the buccal mucosa (salivary duct cysts, epidermoid cysts) that may require different management approaches 7, 3
- Ensure complete excision of the lesion and involved minor salivary gland tissue to minimize recurrence risk 2