Mole (nevus) on 5 year-old's gum

My five year old daughter has a spot on her gum below one of her lower front teeth. Our pediatric dentist informed us it is a mole and is concerned about its recent growth. She has had the mole as long as we can remember. It currently measures the width of her tooth at the gum line (4mm) and is 1mm in height. What concerns should we have (if any)? What is the recommended procedure for treatment?



Dear Reggie,

A mole can also be called a nevus. A mole is a pigmented lesion composed of nevus cells. The origin of nevus cells is not well-known. While nevi of the skin are fairly common, intraoral nevi are actually quite uncommon. When present, they are usually on the hard palate, but can also be present on the gum tissue and lips.

There are several different subtypes of nevi. In the skin, malignant transformation of a benign nevus is possible. While this relationship may translate to the oral cavity, conclusive evidence is not available because this condition is rare. Other conditions which should be considered include a melanotic macule, amalgam tattoo (does not sound applicable in this case), and melanoma.

Because there might be a slight possibility of malignant transformation of this lesion, it is generally recommended that these lesions be removed and biopsied (examined). Because they are generally not large (under 1 cm), excisional biopsy is recommended. This would require anesthetizing the area with a local anesthetic and removing the lesion. Some soreness may be present in the area for several days after removal, but healing usually occurs uneventfully.

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