Nasopalatine Duct Cyst

A nasopalatine duct cyst is a fluid-filled bump on the roof of your mouth, behind your front teeth. It’s the most common type of nonodontogenic cyst that forms in your upper jaw (maxilla). “Nonodontogenic” just means these cysts don’t arise from tissue that forms teeth.

Like most cysts, nasopalatine duct cysts are benign (not cancerous). But you should still see a dental care provider if you have one. They can remove it so it doesn’t grow so big that it causes issues with your teeth.

Symptoms of a nasopalatine duct cyst

Often, these cysts don’t cause symptoms. You may not know you have one until a healthcare provider finds it during routine imaging, like a dental X-ray. But sometimes, a nasopalatine duct cyst causes symptoms like:

• A swollen bump in the roof of your mouth, behind your two front teeth
• Burning pain that radiates from the swollen area to the bridge of your nose
• Nasal obstruction
• Drainage (pus) that may taste salty

Pain and drainage are often signs of infection. Be sure to mention these symptoms when you call a healthcare provider.

Nasopalatine duct cyst causes

Doctors don’t know for sure what causes nasopalatine duct cysts. But they most likely arise from leftover tissue from the nasopalatine duct. This is where the condition gets its name. The nasopalatine duct is a structure that’s present before birth. During embryonic development, it disappears.

To find this area, place your tongue on the roof of your mouth, far enough behind your two front teeth so there’s no contact. This is the general area where your nasopalatine duct once was. It’s also where the roof of your mouth and your nasal cavities meet.

Sometimes, tissue from your early nasopalatine duct remains. When this happens, the leftover tissue can give rise to cysts.

Risk factors

Most people diagnosed with these cysts are males in their 40s. But anyone can get a nasopalatine duct cyst. Sometimes, they appear out of the blue. Often, symptomatic cysts occur after events like:

• Dental procedures (like getting implants)
• Infections (like a cold or flu)
• Mouth injuries

Complications of this condition

A nasopalatine duct cyst can grow so big that it impacts the bones and tissue that support your teeth. It can cause them to become loose or displaced.

This is why it’s important to see a dental care provider if you suspect an issue. Removing the cyst can spare you from having to deal with dental issues on top of having a cyst.

How doctors diagnose this condition

Your healthcare provider will ask about your symptoms and examine your mouth. As various types of cysts and tumors can form in the roof of your mouth, you’ll need tests to confirm that you have a nasopalatine duct cyst.

You may need an X-ray or CT scan. Imaging can show if the growth is mostly fluid-filled (a cyst) or solid (a tumor). Your provider will also check the growth’s shape and size. Most nasopalatine duct cysts appear round, oval, pear-shaped or heart-shaped on imaging. The average diameter is about 1.5 centimeters (a little more than half an inch).

A biopsy can confirm that the material inside the cyst isn’t cancerous.

How are nasopalatine duct cysts treated?

Treatment involves surgery to remove the cyst. You may need to see a specialist called an oral and maxillofacial surgeon to have it removed. After the cyst is gone, any bone involved in the roof of your mouth usually grows back.

Your provider may fill the hole with safe substances, like fibrin, to encourage healing. Fibrin is a protein that helps stop bleeding and promotes tissue repair.

When should I see my healthcare provider?

Contact your dental care provider if you notice signs of an infection after surgery to remove the cyst. Signs to look out for include:

• Fever
• Pus
• Redness or warmth in the area

Let your provider know if you’re noticing new swelling in the area after you’ve healed. It’s extremely rare for these cysts to grow back, but it can happen. Have your provider take a look.

What can I expect if I have this condition?

Nasopalatine duct cysts are curable with surgery. Cysts can grow back, but this is rare. There are a few instances where a benign nasopalatine cyst has transformed into cancer. But this is even rarer.

Typically, surgery to remove the cyst gets rid of it for good.