Have you ever decided to be a ‘detective’ when it comes to your child’s dental health? Your child’s mouth could have an infection lurking, and if you find it early you could help to alleviate some discomfort and pain down the road. Infections in the mouth could indicate health problems elsewhere. That’s why, as a pediatric dentist, I always encourage parents to check out their child’s mouth aside from the normal tooth brushing and flossing on a regular basis. You never know what you might find.
Some health conditions show up in the oral cavity before they present themselves in the rest of the body.
Described below are the more common conditions dentists see in this age range.
Mouth ulcers affect about 20% of the population. They are painful and tend to recur either as one or multiple lesions, a few millimeters in size. They can show up anywhere in the mouth and usually heal in 1 to 2 weeks. It is important that if ulcers do not heal after 2 weeks, a medical or dental professional should be consulted.
Treatment for mouth ulcers
Mouth ulcers generally heal of their own accord in 1 to 2 weeks. There is little which can be done to treat them, but you can help reduce the pain by:
- reducing the intake of orange juice and other citrus foods;
- eating fewer salty foods;
- applying topical anesthetic (Baby Orajel) to the affected area, especially before eating;
- using a Benadryl:Lidocaine (Anesthetic):Maalox mix prescribed by your doctor/dentist.
If the mouth ulcers are accompanied by a fever, your child may have a herpes simplex (viral) infection presented as cold sores. This infection is often seen in babies and young children and is usually in the form of primary herpetic gingivostomatitis.
Signs and symptoms include:
- small clusters of vesicles (blisters) that rapidly erupt in the mouth or on gums;
- yellowish ulcers surrounded by a red halo, which develop after the vesicles burst;
- red, swollen gums that bleed when touched;
- fever, malaise (feeling unwell) and irritability.
Herpes/cold sores attacks become less severe over time.
The first attack usually leads to immunity. Any later lesions that the child develops tend to be isolated cold sores. Most viral lesions are spread through direct contact between kids (usually sharing utensils and cups); please make sure not to share items during this time.
Herpes/cold sores treatment involves diet changes.
To treat the symptoms of oral herpes and reduce the pain, the child’s diet should include:
- Adequate fluid intake.
- Bland foods such as yogurt.
- Few or no salty, spicy or acidic foods.
Other Common Mouth Lesions
Other lesions that can develop in your child’s mouth include:
- A tooth abscess – caused by an infection around the root of the tooth, which appears as a pimple on the gum. When the gum is pressed, there may be a discharge of pus. It is important to seek dental advice if you see this.
- Hand, foot and mouth disease – characterized by blister-like (vesicular) lesions in the front of the mouth and sometimes on the hands and feet; sore throat or mouth; and a low grade fever. This disease will heal spontaneously.
- Eruption cysts - for example, a bluish, dome-shaped cyst that appears over the erupting tooth. Treatment is not usually required because the cyst bursts when the tooth erupts.
- Geographic tongue - for example, pink to red smooth patches that appear on the tongue. This condition is not harmful and treatment is not usually required other than reducing acidic and spicy foods, as the tongue may be tender.
- Oral thrush – is common in young babies and infants and is a fungal infection that affects the superficial layers of the mouth surface. It appears as milky white patches in the mouth, which cannot be wiped away as easily as milk curd. A fever and gastrointestinal irritation (this is very rare and may indicate a more general infection) may also be present. Thrush is treated with antifungal agents applied directly to the affected areas.
- Cellulitis – an infection that spreads across a child’s face, causing a rash and fever. It has the same causes as a tooth abscess, but the infection has the ability to spread. Immediate assessment by a dentist or doctor is required.
- Mucocele - a soft, bluish-grey nodular swelling on the lower lip can be caused by trauma to the lower lip, often from lip biting. These will often burst and heal by themselves. If they persist, treatment may be required.
Things To Remember
- Mouth ulcers and thrush are often seen in young babies and infants.
- For many mouth lesions, symptoms can be eased if your child avoids salty, acidic or spicy foods.
- If mouth ulcers don’t heal within 2 weeks, a medical or dental professional should be consulted.
- Tooth abscess and cellulitis require immediate treatment by your dentist or doctor.
Dr. Fazilat’s remarks are meant to be generally educational and should not be construed as direct medical advice. If you are considering medical treatment of a condition, you should seek individual consultation with a Board Certified Professional such as Dr. Fazilat.
Dr. Shahram Fazilat is a Diplomate of the American Board of Pediatric Dentistry and is an active member of the American Academy of Pediatric Dentistry, the American Dental Association, and is also an Assistant Clinical Professor at the University of California, San Francisco. He is heavily involved in children outreach programs and has provided dental care for underprivileged children locally and abroad. His office, Growing Smiles Pediatric Dentistry, is located at 515 South Drive, Suite 17, Mountain View, CA. Dr. Fazilat can be reached at 650-567-9000.
Image provided by Melissa Miller & Vinnie Fernandez, PAMP’s Lead Photographers and co-owners of C’est Jolie Photography