Sir, we would like to share with your readers an unusual case of a patient with dental calculus mimicking an oral tumour. An 82-year-old Caucasian woman was referred for diagnosis of an abnormal extensive hard mass in the mouth. Her past medical history included poorly controlled hypertension and type-2 diabetes. The patient was complaining about a growing tumour mass causing swelling and pain in the mandibular region. Examination showed an apparently edentulous mouth with a hard tissue formation of 4 cm covering the left side of the mandibular anterior alveolar ridge extending over the facial and lingual gingiva (Fig. 1). Radiographs revealed deposits completely covering all surfaces of two remaining teeth (Fig. 2). The diagnosis of dental calculus was made and the teeth were extracted. One week later the patient showed complete healing of the alveolus.

Figure 1
figure 1

A hard tissue mass covering the left side of mandibular anterior alveolar ridge

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Figure 2
figure 2

Radiograph evidence of two remaining teeth inside the hard mass

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Diabetes mellitus can lead to marked dysfunction of the secretory capacity of the salivary glands and saliva may be associated with the distribution pattern of supragingival calculus. Dental calculus is mineralised dental plaque permeated with crystals of various calcium phosphates and diabetic patients have an increased salivary calcium and protein concentration compared to non-diabetics.1 Additional studies have shown that various serum antioxidants are decreased in diabetes mellitus patients, including superoxide dismutase (SOD), ascorbic acid (vitamin C), uric acid (UA), and glutathione.2

Although an association between poorly controlled type 2 diabetes mellitus and severe periodontitis has been well documented,3 this clinical presentation is unusual and may have led to unnecessary procedures. A large dental calculus deposit has been previously suspected to be a neoplastic lesion because of its morphological features and exams such as three-dimensional computed tomography, scintigraphy, and pathological biopsy were taken to diagnose the condition.4