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Quick Tips to Help Parents Identify the Lumps, Bumps, and Owies in Their Child’s Mouth
Wow, oral health care can be challenging! How do you know what is normal and what is not in a child’s mouth? Here are some quick tips to identify lumps, bumps and eyes. When in doubt, you can always call your friendly pediatric dentist.
Normal stuff: Normal mouth anatomy is usually average or symmetrical. That little bump behind the front upper teeth is called the incisal papilla, if burned on a pizza or poked with a chip it can become inflamed but heals quickly. Those bright red spots under the tongue are superficial blood vessels called varicose veins, they are ok mom!
Cold sores: Common cold sores usually occur outside the mouth on the lips. They are a recurrence of a viral infection called Herpes Simplex. About 90% of children are exposed to the herpes simplex virus by age four (look what I brought home from preschool mom!) and about 50% become chronic carriers. This means that because the herpes virus infects nerve cells that never die, the virus periodically reappears to form a cold sore. Before herpes spreads, it sheds the virus and is highly infectious. Fortunately, a family of antiviral medications can treat cold sores to limit their size, duration, and discomfort.
Ulcers: In otherwise healthy children, ulcers occur only on the inside of the mouth on mobile tissues. Also called aphthous ulcers or RAS (recurrent aphthous syndrome), they have a white, cup-shaped center with a bright red border and are very painful to the touch. Parents often mistake this lesion for an abscess if it is located near the teeth on the gums. In fact, canker sores are caused by an overactive immune system response. That’s right, the immune system gets pissed off about some micro-trauma, cleans house, and leaves a painful ulcer. Since it’s not an infection, the best treatment is to find that it goes away in about a week and medicate with Tylenol or a topical numbing agent like Orajel. Some adults remember burning them with silver nitrate. This is very painful, will leave a scar and cause a riot!
Mucocele: Unknown to most of us, the lips are full of smaller salivary glands that consist of a simple small gland connected to the oral cavity by a tube. Sometimes one of these tubes is cut, saliva builds up in the gland and a soft bump appears on the lip. If the gland ruptures, refills, and ruptures again, a scar may form. This creates a hard impact. Children absolutely cannot leave these bumps alone and usually chew them; some mucoceles can reach the size of marbles! The best treatment is to simply make a small incision on the inside of the lip and pull out the mucocele. At a pediatric dentist’s office, this involves a local anesthetic, one stitch, and about five minutes. At your oral surgeon or ENT office, they will start talking about general anesthesia! Remember that children can sense when the doctor is scarred!
Popcornoma: This is my favorite oral pathology. The child presents with swollen gums and slight discoloration. A dental probe is carefully inserted between the tooth and gum to capture and deliver the popcorn husks. The pain will disappear immediately! Fathers are usually blamed somehow, don’t ask me why.
There are many more unusual and always disturbing lumps and bumps. If you have a scratcher and need advice, don’t hesitate to call. Greg Evans, DDS at Big Grins Pediatric Dentistry in Fort Collins is always available for an interview.
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