Lesions seen in the mouth of children can be scary for parents. Some lesions in children are harmless and can even be a part of their normal anatomy, but look as if they are infectious. Some lesions in the mouth can be signs of systemic diseases or infections going on elsewhere in the body. Some can be signs of active infection in the mouth. The purpose of this blog is to go over common lesions we see here at the office to help inform parents about them. It is always important to call your dentist if you see a suspicious lesion in your child’s mouth.  Although we do soft tissue exams at your child’s regular dental checkup, it’s a good idea to let us know if something is concerning you.

  • Geographic Tongue

Geographic tongue is a common medical condition of the tongue. It can appear as large, red, smooth patches on the tongue. Sometimes the red patches have a white border. The lesions can look irregularly shaped. It can look like an infection which can cause parents to worry. Another interesting fact about geographic tongue is that the lesions can move around; it may look like 3 red patches toward the back of the tongue and then the next day the lesions can migrate to the front or to the sides of the tongue! Geographic tongue can be genetic and more common in children who are sensitive to environmental factors.  (Oral Surgery, Oral Medicine, and Oral Pathology, Aug 1984). Geographic tongue is usually painless but can cause burning sensations in the mouth. The good news of geographic tongue is that no treatment is recommended and it can heal on its own.

  • Hand Foot and Mouth Disease

Hand Foot and Mouth disease is a very contagious disease that can be spread fecal-oral or oral-oral. It usually occurs in the summer and fall months and is caused by a virus (Coxsackie A16 is the most common). Children are most affected. Symptoms include fever and sore throat and outbreak of red bumps in the mouth, hands, feet, and bottom area. Just like most viruses, this has to run its course. Treatment includes plenty of rest and fluids. Since the virus is contagious it is better to keep your child home during the course of the illness as to not infect others.

  • Apthous Ulcers AKA Cankersores

Apthous ulcers have an unknown cause but may be associated with stress, hormones, the immune system, infections, and food sensitivity. They are more common in children, and genetics may play a role in these. Apthous ulcers look grayish in the center and are surrounded by a red border. They can be found on the tissue inside the mouth (such as lip or cheek). They can be very painful and last one to two weeks. There is no treatment except letting it run its course; Orabase and other ointments may be applied to help with the pain. It is also wise to stay away from citrus and spicy foods while your child has these, as these kinds of foods may agitate the sores and cause more pain.

  • Candida Albicans AKA Oral Thrush

Oral thrush is caused by the fungus called Candida Albicans which is a normal organism in the mouth. The infection occurs when it overgrows. Oral thrush looks like a white plaque and can be found inside the cheek, on the roof of the mouth, on the tongue, and sometimes on the tonsils and on the gums. When the white plaque is wiped off, it often leaves a painful and red surface below. It can affect everyone but most often affects babies and people with weakened immune systems. Treatment commonly includes Nystatin or oral fluconazole which are antifungal medications. It is important to see your physician if your child has oral thrush.

  • Cheek/Lip/Tongue Bite After Anesthetic

We sometimes get calls from parents who are worried about their children after they notice puffy lips, cheeks, and tongues post restorative treatment appointments. Like this picture shows, cheek, lip, and tongue bites can look frightening and resemble a range of problems (allergic reaction, infection, other lesions, etc.) There is no treatment for cheek/lip bites so that’s why it’s very important to watch your child closely post op appointments to make sure they are not chewing on their lip. Children bite their cheeks and lips because the area feels “funny” due to the local anesthetic . Sometimes they are not aware they are biting their cheek/lip/tongue and causing a sore because the area is numb and they can’t feel pain.  We send kids home with cotton rolls and gauze in the cheek to prevent bites. Prevention is key.  However, sometimes we recommended Glyoxide antiseptic oral cleanser to help keep the area clean which you can buy over the counter.




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