A patient has a fractured/missing tooth #14 and a small growth or lump on the buccal mucosa. What could be causing this?

Correct answer: A. Occlusal trauma

• A. Correct (keyed). A small reactive lump on the buccal mucosa adjacent to a damaged tooth is most consistent with chronic mechanical/occlusal trauma (e.g., an irritation fibroma from repeated biting against a sharp/fractured tooth).
• B. Infection would typically present with pain, swelling, or a sinus tract rather than a discrete fibrous lump.
• C. Neoplasia is possible but less likely for a small lump with an obvious local traumatic cause; biopsy confirms if suspicious.
• D. An aphthous ulcer is a painful shallow ulcer, not a raised growth/lump.

Note: Any persistent mucosal lump warrants follow-up/biopsy if it does not resolve after removing the source of trauma.