Parents are often concerned with ‘lumps and bumps’ that appear in the mouths of children. It is important to distinguish the normal clinical appearance of the intraoral tissues in children from gingivitis, periodontal abnormalities, and oral lesions. Recognizing early primary tooth mobility or early primary tooth loss is critical because these dental findings may be indicative of a severe underlying medical illness. Some of the most commonly occurring pathologies are discussed below.
Dental Caries: As one of the most prevalent chronic childhood diseases, dental caries, most manifested as Early Childhood Caries (ECC), is the most frequent cause to seek dental care for a child. The high incidence of Caries in kids is attributed to poor diet habits and oral hygiene, along with the anatomical characteristics of deciduous teeth. Preventive and prophylactic treatments such as topical fluoride applications are recommended shortly after the eruption of permanent teeth. Depending on the extensiveness and severity of the decay, treatment can vary from simple fillings to pulp therapy to extraction.
Pulp Polyp: Chronic Hyperplastic Pulpitis also known as pulp polyp is a vascular condition of the pulp that usually takes place in open carious lesions that is devoid of intrapulpal pressure thereby asserting itself as a mild, non-painful, pulpal condition. It is usually seen more in children than in adults, due to rampant caries occurrence and the wide apices of the roots which bring in ample blood supply. Clinically, it is usually seen as a reddish lobule/mass filling the pulp chamber, the origin of which is not from the surrounding periodontal tissues and is responsive to pulp vitality tests. The treatment plan comprises of extraction of the tooth when it occurs in deciduous dentition or pulp therapy in permanent dentition.
Radicular Cyst: Radicular cyst is an inflammatory jaw cyst originating from epithelial remnants of the periodontal ligament because of inflammation that is generally a consequence of pulpal necrosis. Caries is the primary etiological factor in primary dentition. They also arise from traumatic injuries to the primary teeth. The swellings are usually asymptomatic until secondarily infected. Extraction or endodontic treatment of the affected tooth is required when clinical and radiographic characteristics indicate a periapical inflammatory lesion. The normal treatments for radicular cysts include total enucleation in the case of small lesions, marsupialization for decompression of larger cysts or a combination of the two techniques.
Eruption Cyst: Eruption Cysts are associated with erupting primary and permanent teeth. They present as dome-shaped soft-tissue lesions overlying any erupting tooth in children. The eruption cyst results from fluid accumulation within the follicular space of an erupting tooth. When the fluid in the cyst is mixed with blood, the cyst is referred to as eruption hematoma. No treatment is needed because the tooth erupts through the lesion, which disappears spontaneously.
Ankyloglossia: Ankyloglossia or ‘tongue-tie’ is a common congenital condition characterized by an abnormally short lingual frenum and the inability to extend the tongue. The frenum may lengthen with growth to produce normal function. If the extent of the ankyloglossia is severe, speech may be affected, mandating speech therapy or surgical correction.
If a child can extend his/her tongue sufficiently far enough to the lower lip, then a frenectomy is usually not indicated.
Mucocele: Mucocele is a common lesion of the oral cavity and may be classified as a mucous extravasation cyst or mucous retention cyst. It is seen commonly in children due to constant irritation (like Lip/cheek biting). On clinical presentation, mucocele appears as an asymptomatic nodule, in pink or bluish color, and the size may vary, usually involving the lip, cheek, tongue, palate, and floor of the mouth. Conventional treatment of mucocele is excision by electrosurgery or scalpel, which included the associated overlying mucosa and glandular tissue down to the muscle layer. Vaporization by carbon dioxide (CO2) laser and cryosurgery is also done.
Do visit the Department of Oral Pathology & Microbiology, Yenepoya Dental College under the Yenepoya (Deemed to be University) for a complete oral assessment.
It was established in the year 1992, with its robust alumni of 3000 Undergraduates and 67 Postgraduates students and research scholars have many accolades and achievements to its credit. It strives to provide state of art Oral diagnostics and Molecular Pathology while excelling in research activities and instilling a holistic approach in dental education among students. Department contributes its expertise in fostering interdisciplinary collaboration and providing exemplary education and scientific research.
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