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Author: Dr Delwyn Dyall-Smith FACD, Dermatologist, 2010.
Retrocuspid papilla is a swelling on the inside of the lower gums regarded as a normal anatomical variant seen most commonly in children. It is sometimes also called a retrocuspid papule.
Retrocuspid papilla is very common, especially in children. It is seen in up to 75% of young children less than 5 years of age, although often persists in adults (approximately 10%). Many surveys report a female predominance. When looked for, it has been found in all races. It may be present at birth.
A retrocuspid papilla is a smooth, soft, well defined round or oval swelling on the inside of the lower gums covering the jaw or floor of mouth near the cuspid or canine teeth. Usually it is about 1mm below the free gum margin. Retrocuspid papillae are found most commonly on both left and right sides but are sometimes just on one side. The lesion is usually a normal pink colour but can be red. The size and height is 1-3mm. It may be raised on a short stalk like a mushroom (pedunculated).
As it is a common normal anatomical variant, retrocuspid papilla can usually be recognised clinically. It is sometimes biopsied to exclude other conditions such as gingival abscess or draining dental sinus especially if red. The histology may show elongated blunt rete ridges overlying loose vascular connective tissue. Large fibroblasts with multiple nuclei may be present.
Treatment is not required. It appears to flatten or disappear with age.
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