Orofacial Granulomatosis: Swelling on Orofacial Area

“Orofacial Granulomatosis”- it’s a term that you may or may not have heard. It’s a rare disease and if you care about the way you look, then you definitely don’t want anything to do with it. In this article, we will talk about Orofacial Granulomatosis and some of the things you should know about the disease.


What is Orofacial Granulomatosis(OFG)?

orofacial granulomatosis histology

It a rare condition that is characterized by the swelling of the orofacial area. It means that your mouth, lips will swell up when you are affected by Orofacial Granulomatosis. However, it will not cause you any pain usually.


orofacial granulomatosis symptoms

The symptoms of orofacial granulomatosis are not too difficult to pinpoint. As we have discussed, the orofacial area swells up when it happens and that’s the main symptom.

Here are some of the common symptoms-


recurrent lip swelling

1. Recurrent Lip Swelling

It’s the main symptom and, we have already mentioned that. The lips will start to get bigger and bigger to the point that it will obviously be abnormal. Furthermore, the gums may also start to swell.


 2. Facial nerve paralysis

It’s another sign of orofacial granulomatosis. It is the loss of facial movement and, it happens because of the nerve damage.

fissured tongue


3. Fissured tongue


It means that there will be grooves or some sort of narrow cuts in the tongue. It looks bad and unsettling. But the thing is patients usually do not feel any pain when they are affected by this.


 4. Cervical lymphadenopathy

 There will be large lymph nodes in your neck. For your information, A lymph node is an organ of the lymphatic system. It is a kidney-shaped organ which is present throughout your body and, it is another sign that suggests that you are affected by the disease.


recurrent oral ulceration

5. Oral Ulceration


It’s a common symptom that happens to most of the patients when they are affected by orofacial granulomatosis. There can be small ulcers that may not be too harmful. On the other hand, there can be large ulcers that can be very painful.

These are some of the symptoms of the orofacial granulomatosis. The most common and conspicuous symptom is the swelling of the lips.


Orofacial Granulomatosis treatment

The treatment for orofacial granulomatosis is still uncertain. Many methods have been used to treat this but none of them proved to be sustainable. Some methods did eventually help some of the patients. However, there is no treatment that works for all patients.


Here are some of the methods that can be used-

# Topical therapies

In this case, patients are instructed to apply topical creams that are recommended by doctors.

# Injection-

Local steroid injection has been helpful for some of the patients who have had swelling lips.

# Dietary therapy-

This method has been implemented and the result is somewhat satisfactory (although not 100% effective).

So these are some of the treatments that may help the patients. But again, remember that these are not 100% effective methods.


Orofacial Granulomatosis Diet

Diet for orofacial granulomatosis is a bit complex and, it’s not easy to follow. Even if the patients follow this, their problems will not be solved. But most of them will see a positive result and, their condition will improve.

So the patients have to avoid all types of food that involve cinnamon and benzoate. They have to avoid them for eight to twelve weeks.

There is a study that is worth mentioning. In this case, there were 45 patients. All of them had the same problem. They were affected by orofacial granulomatosis. All of them had one symptom in common. All the patients had swelling lips. Most of them were severe.  Some of them had ulcers and Fissured tongue. As there is no medicine that works for everybody, they were told to follow a diet that did not involve cinnamon and benzoate. As well as they also need to apply some home remedies. there are some home remedies for swollen lips. They had to strictly follow this diet and remedies for a couple of weeks. After 9 weeks, All of them got a good result. Obviously, the Orofacial Granulomatosis did not go away. But their condition improved. The lip swelling was reduced and the oral lesions improved even more.


Orofacial granulomatosis histology

The histology of orofacial granulomatosa is not too different than Crohn’s disease as it causes non-caseating granulomas with acute and chronic inflammation.


Orofacial granulomatosis diagnosis

Doctors tend to go for tissue biopsy when it comes to diagnosis. But there is a problem with it.  It is not capable of distinguishing the granulomas of OFG and Crohn’s disease. Therefore, even the diagnosis is unreliable in this case.

Classification of this OFG

Doctors tend to classify this disease as a type of cheilitis. It is the inflammation of the lips.


Some Common Questions

What causes Orofacial granulomatosis?

Answer: Why it occurs in the first place is unknown still this day. Having said that some of the patients did seem to have food sensitivities to things like chocolate, cinnamon, benzoates. So eating too much of these things can be a possible cause. But it’s impossible to prove this fact with conviction


What is granulomatous cheilitis?

Answer: It is a rare condition where the lumpy swelling of one’s lips occurs. Doctors also recognize it as cheilitis granulomatosa. Basically, it is a part of the spectrum of a disease called OFG (orofacial granulomatosis). There are various reasons for this to happen and they are an allergy and Crohn disease. 

How does Crohn’s disease affect the mouth?

Answer: Crohn’s disease is mainly a bowel disease. However, it does affect the mouth. The most common symptom that you see on a patient’s mouth, who is affected by Crohn’s disease, is that he/she has a sore mouth. Plus, gum inflammation is another symptom of the disease.

orofacial fissured tongue

What are the early signs of lip cancer?


Answer: Even though lip cancer is a deadly disease, it may not show any signs or symptoms. A lot of the times doctors notice it when they are doing a routine dental exam in the mouth. Some of the symptoms may include- jaw swelling; bleeding (on the patient’s lips); lump, ulcer or blister on the mouth. But do remember that having lump or ulcer does not really mean that you are suffering from lip cancer.


Final Verdict

 Orofacial granulomatosis is not a deadly disease. But it is something that can be bothersome. It can hurt your self-esteem as some of the symptoms can ruin your good looks. Most importantly, there is no proper treatment that can cure everyone. Some of the treatments, that do bring a positive outcome, do not resolve the issue completely. So even though it’s not deadly, you don’t want it to happen to you.

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