Swelling in one or both cheeks can happen for a number of reasons, from a minor facial injury to an infection or a more serious underlying health issue.
In this article, we explore the causes of swollen cheeks and how doctors diagnose and treat them.
The area of swelling can help a doctor identify the problem. For example, an infection may cause swelling in only one cheek.
Below, find more examples of causes of swelling according to the affected area:
Conditions that may lead to swelling in one cheek include:
Inside the cheek
Swelling on the inner lining of the cheek may indicate:
- lymphadenitis, the enlargement of a lymph node, usually due to infection
- a tooth abscess
- Cushing’s syndrome
- Sjogren’s syndrome
Alongside swollen gums
Cheek and gum swelling often indicates an infection of the gums or a tooth abscess.
Pericoronitis, for example, is an infection that occurs around a tooth that has only partially broken through the gums, and it can lead to cheek swelling.
A wide range of issues can cause swelling in one or both cheeks, and some of these causes are more serious than others. For example:
An injury from a fall or blunt force, for example, can damage soft tissue and bones in the face, which can result in facial swelling and pain.
Minor injuries often heal on their own, but anyone who suspects that an injury may be more severe should receive medical attention.
Tooth decay is a common oral health condition that happens when acids break down the enamel coating of a tooth.
Untreated decay can lead to infection around the root of the tooth. If the infection becomes more severe, a pocket of pus, called an abscess, may form, leading to swelling.
Mumps is a contagious viral infection of the salivary glands. Symptoms, including swelling in the jaw and cheeks, may appear 12–25 days after the initial infection.
Other symptoms of mumps include:
- a headache
- a fever
- muscle aches or chills
- a loss of appetite
Salivary stones are calcium deposits that form in the salivary glands. Another name for this issue is sialolithiasis.
Salivary stones most commonly affect people aged 30–60 and are more common in males.
The exact cause of salivary stones remains unknown. However, they can form when bacteria and food particles enter the salivary glands.
If a person does not receive treatment, a salivary stone can block a salivary duct and lead to an infection. of an infected salivary gland can include:
- swelling in one cheek, which may feel warm
- sensitivity or pain in the area
- difficulty or pain when chewing or speaking
- foul-tasting discharge from the infected gland
- a fever
Lymphadenitis occurs when one or more lymph nodes swell in response to an infection in the area.
If the infection is in the head or neck, it may lead to swelling in one or both cheeks.
Cellulitis is a bacterial infection in the fat or soft tissue beneath the skin.
Alongside facial swelling, other symptoms include:
- skin that feels warm
- pain or tenderness in the area
- a fever
Hypothyroidism refers to the thyroid gland not producing enough hormones to meet the body’s demands.
Weight gain and puffiness in the face are common symptoms of hypothyroidism. Other symptoms include:
- muscle and joint pain
- sensitivity to cold temperatures
- reduced sweating
- heavy or irregular menstrual periods
- a slow heart rate
Cushing’s syndrome occurs when the adrenal glands produce too much cortisol.
People with Cushing’s syndrome may experience weight gain and puffiness in the face. Other symptoms include:
- increased fat in or near the base of the neck
- a fatty mass, or hump, between the shoulders
- purple stretch marks on the abdomen, breasts, hips, or underarms
- muscle or bone weakness
People with Sjogren’s syndrome may develop swollen salivary glands, which can make their cheeks appear puffy or swollen. Other symptoms of Sjogren’s syndrome include:
In a child, cheek swelling may result from:
- Cushing’s syndrome
- facial injury
If a doctor cannot identify the cause of the swelling with a physical exam, they may recommend one or more of the following tests:
- CT, MRI, or X-ray imaging tests to evaluate the extent of swelling and identify structural abnormalities
- blood tests to look for signs of an infection or thyroid problems
- urinalysis to check for systemic infections and kidney problems
- biopsy to check for cancerous cells in the mouth or throat
A doctor may prescribe or recommend various treatments to reduce cheek swelling and address the underlying cause. Medication, surgery, or both may be necessary, in some cases.
When swelling in a cheek results from a minor injury, it may help to:
- apply a cold compress to relieve swelling and pain
- keep the head elevate to stimulate blood flow and reduce swelling
- gently massage the cheeks to stimulate blood flow
However, if an injury seems more severe, it is best to receive professional care.
In a small 2019 review, researchers found that antibiotic treatment was effective when lymphadenitis resulted from bacterial infection. In this research, Mycobacterium avium and Mycobacterium intracellulare were the species responsible.
However, antibiotic resistance can cause difficulties. A 2015 retrospective review found that when Staphylococcus aureus bacteria were responsible and resistant to antibiotics, surgery was sometimes required.
Cellulitis and pericoronitis
A dentist or oral surgeon can treat a tooth abscess by surgically draining it and rinsing the area with saline water. They may also prescribe antibiotics.
As with many other viral infections, no specific treatment exists for mumps. However, people can manage symptoms with rest, fluids, and over-the-counter medications.
Vaccination is the most effective way of lowering the risk of mumps. The mumps vaccine comes in two doses and is available for children 1–12 years old.
The right treatment depends on the size and number of stones.
Over-the-counter anti-inflammatory drugs can help reduce swelling and pain, and a doctor may try to free the stone by massaging the affected salivary gland.
If an infection develops, the doctor will likely prescribe antibiotics. If one or more stones are large, they may require surgical removal.
There is no cure for hypothyroidism, but doctors tend to prescribe synthetic hormones to account for the lack.
The dosage will depend on several factors, including current hormone levels.
Cushing’s syndrome responds to medications that lower cortisol production in the adrenal glands or decrease adrenocorticotropic hormone production in the pituitary gland.
A range of medications and lifestyle changes can help manage symptoms of Sjogren’s syndrome, depending on the combination of symptoms and their severity.
For example, corticosteroids may help reduce inflammation and swelling.
Treatment for oral cancer varies, depending on the type, location, and stage of the tumor.
Doctors can surgically remove tumors and affected lymph nodes. Radiation therapy and chemotherapy can help treat advanced forms that have spread to other areas.
A person should receive immediate medical attention if sudden cheek swelling accompanies:
- swelling of the face, lips, or tongue
- a skin rash
- difficulty breathing or swallowing
Swelling in one or both cheeks may result from a minor injury or infection. In other instances, the issue may be a severe infection, autoimmune condition, or oral cancer.
A range of treatments is available. Unless the cause is a minor injury, it is important to receive medical attention, especially if the swelling is sudden or severe.
In some cases, cheek swelling results from poor dental hygiene, which can lead to an infection. It is crucial to brush the teeth twice a day and follow all other dental hygiene recommendations.
If an infection seems to be healing slowly, it is important to consult the doctor or dentist. The sooner the person receives care, the better.
There are many possible causes of swelling in one or both cheeks, and some are more serious than others.
It is a good idea to consult a doctor or dentist, especially is the swelling is sudden, severe, or lasts for longer than a few days.