Diagnosis and treatment of oral lesions in newborns

Quite often, parents may notice a soft bump that appears on their child’s gum when pressed. What could be the reasons for this phenomenon?

• inflammation of the roots (both baby teeth and molars, permanent ones);
• the beginning of tooth eruption.

Why does an abscess occur?

There can be many reasons for the formation of a lump (fistula, swelling), but the most common of them is undetected or ignored caries. Not all children maintain oral hygiene and eat properly, and not all parents carefully control this, which causes caries to appear on one or several teeth at once.

If caries is not treated, it will develop into pulpitis, extending beyond the tooth area and affecting the upper part of the root. As a rule, a lump appears just near the tooth whose root is inflamed. Typically, a lump can be noticed near a tooth with caries or with a filling that was placed long ago or poorly; Another common reason for its appearance is an injury received from a strong blow or an accidental fall, which can trigger the onset of the inflammatory process.

Stages of development of an abscess:

1. As a result of caries, the infection penetrates into the pulp, affecting the root tip.
2. Pus begins to form near the top of the root.
3. Purulent formations fall under the mucous membrane of the gums.
4. A cyst appears, looking like a small lump from the outside.

The most important symptom of an abscess is a soft and painful swelling, even with slight pressure.

Sometimes, due to an excess of pus, the lump may burst under pressure, and then a fistula appears - a small hole in the gum, which is connected with the source of inflammation located in the upper region of the root. A feature of the fistula is the constant release of purulent formations.

If inflammation decreases for some reason, the fistula may close on its own. However, when the child’s immunity decreases and the inflammatory process begins again, accompanied by pus formation, the appearance of a fistula will not be long in coming.

Stages of development

Due to the ongoing formation of immunity, the child’s cyst has the opportunity to develop. The child's body produces a violent reaction when faced with even minor exposure to a pathogen. The formation of a fibrous capsule can go through three stages:

1. Initial. Pain syndrome is characteristic.
2. Progressive. The swelling becomes noticeable, but the pain subsides. Specialists at the Novostom center suggest that this is due to the death of the nerve.
3. Suppuration. It is not advisable to let things get to this point. Timely removal of a tooth cyst in a child will relieve his body of immune and toxicological overload.

How to treat an abscess on the gum?

If an abscess or fistula appears, then you should not expect that the situation will resolve on its own: you need to make an appointment with a dentist. Treatment of an abscess on a baby tooth and a molar one will be different.

The appearance of an abscess on a baby tooth indicates periodontal inflammation. Such teeth must be removed, since the inflammatory process in the upper part of the root, accompanied by the formation of pus, may well spoil the molar, which will soon erupt in place of the milk tooth. This happens because the roots of temporary teeth are located next to the rudiments of molars. Bad bacteria and infection can also enter the lymph nodes under the jaw, causing them to become inflamed. The occurrence of a fistula means that pus will constantly seep into the mouth, which can cause the development of tonsillitis, since the tonsils will become infected. Various colds in a child are a direct consequence of an abscess on a tooth. Also, do not forget that toxins formed in the area of ​​inflammation will definitely enter the bloodstream: this can result in allergic reactions, asthma and other serious general somatic diseases.

If we are talking about an abscess on a molar, then ordinary treatment is required for adults (provided that the tooth is not fundamentally damaged and can still be saved from removal).

Having discovered an abscess in a child, you should not try to cure it on your own. You can easily find a lot of advice on the Internet on how to relieve inflammation, but no amount of rinsing or even taking powerful antibiotics can eliminate the inflammatory focus located at the root of the tooth. Moreover, it is useless to hope that the tooth ache will stop. A bursting lump (this often happens) indicates only a short respite, during which, meanwhile, bacteria will still continue to enter the bloodstream and spread throughout the body. This situation can turn into a serious problem if the child has diseases of the respiratory system, heart and other internal organs.

Often, dentists suggest leaving teeth near which the inflammatory process is occurring, persuading the parents of a young patient to carry out the silvering procedure. The arguments for refusing removal can be very compelling: possible problems with diction and pain during the removal operation. However, such dentists neglect the information contained in every textbook on dentistry, which clearly states that a baby tooth with a purulent focus must be removed. Silvering will only complicate the situation, and an unresolved inflammatory process can lead to asthma, tonsillitis and even diabetes: in comparison with these diseases, temporary problems with diction will seem like sheer nonsense.

But the formation of an abscess can be prevented, and this is not difficult to do - just teach the child to maintain oral hygiene. At an early age, a child cannot be adequately responsible for his actions, including those related to the care of the oral cavity, teeth and gums, so responsibility for the procedure lies entirely with his parents, who must control how and when the child brushes his gums and teeth . It is the parents who should buy the most effective baby toothpaste that guarantees maximum protection against caries.

If the causative tooth is permanent –

In this case, the tooth is not only possible, but also necessary to be saved.
If permanent teeth in children have already formed roots, then treatment of permanent teeth with periodontitis will be carried out as in adults. However, treating a permanent tooth with incomplete root formation will present some difficulty, because such teeth may have very wide root canals as well as gaping apical foramina (see photo below). And this poses a great difficulty for high-quality filling. Permanent tooth with incomplete root formation –

Currently, in pediatric therapeutic dentistry, there are 2 main approaches to the treatment of periodontitis in permanent teeth with incomplete root formation. The first method is based on temporary filling of root canals with materials based on calcium hydroxide or calcium oxide. This requires a long, months-long exposure of these materials in the root canals (with periodic replacement of the material with fresh portions). This will narrow the width of the apical foramen by creating an osteocement apical barrier, after which it will be possible to perform permanent filling of the root canals.

The duration of such treatment usually ranges from 0.5 to 1.5 years. If a water-based material with calcium hydroxide is used, then it needs to be changed in the root canals monthly, but if it is oil-based - only once every few months. The disadvantage of this method is the need for frequent repeat visits, and the effectiveness is only about 70-90%, because the emerging osteocement barrier has a loose porous structure and does not guarantee 100% reliable sealing of the root canal lumen.

The second method is a one-step technique for forming a barrier in the area of ​​the apical foramen using materials from the MTA group (mineral trioxide aggregate). An example of such material is “Pro Root”. The method assumes that the apical part of the root canal for 3-4 mm will be permanently sealed with MTA. Thus, in this case, only 1 visit is required, but it is best to use this method only in the last stages of root formation (otherwise, it will be best to combine temporary filling with calcium hydroxide-based material for 1-2 months + subsequent permanent filling with MTA) .

A lump on an area of ​​the gum where there is no tooth yet: what to do in this case?

A couple of weeks before the tooth erupts, a cyst may appear on the gum, looking like a lump filled with a clear or bluish liquid. Such bumps are by no means common: dentists do not consider such formations to be a pathology requiring treatment. In addition, such formations on the gums in no way indicate an inflammatory process.

According to statistics, a small percentage of children are affected by the appearance of such a cyst. The child may not even suspect that he has a lump in his mouth, because if he touches it, there is no pain. However, a dental examination is still necessary, because the inflammatory process may still begin, in which case intervention will be required. The presence of inflammation is indicated by such signs as increased body temperature, pain when touching the lump, and swelling of the mucous membrane.

Most parents do not like the fact that their child has a lump in his mouth: in this case, you can ask the dentist to make an incision under anesthesia, as a result of which the fluid inside the cyst will come out. As a rule, when part of the cyst is removed, the crown of the tooth about to erupt is visible.

Cyst treatment

A dental cyst is treated either with therapeutic methods or with surgical intervention. The first ones are used in simple cases.

Surgery involves two types of operations - cystotomy and cystectomy. In both cases, local anesthesia is used. With cystomy, only the anterior wall of the cyst is removed. This is a less traumatic option, as it allows you to preserve the rudiments of permanent teeth during surgery on milk teeth.

Cystectomy is performed if the size of the cyst does not exceed 1.5 cm. This operation is more difficult, but postoperative recovery is much faster.

No matter how small and insignificant the swelling may seem to you, contact your dentist. This will avoid complications. And the problem will be resolved more easily and in a short time. Remember that no rinses, infusions or other folk remedies can guarantee recovery.

How to help a child at home with suppuration?

If suppuration and the formation of a lump on the gum appear, it is recommended to contact a dentist as soon as possible, but, unfortunately, for various reasons this is not always possible.

If an adult can endure pain (although, of course, situations are different), then it is much more difficult for a child to endure painful sensations, and it is not easy for parents to watch their child suffer. There are ways to alleviate the baby's condition. Naturally, they will not replace full-fledged treatment, so you can resort to them only in situations where going to the doctor is impossible right now.

These include:

• take as much warm liquid as possible, which reduces intoxication of the body;
• eat liquid food (moderately warm, but not hot!), as it injures already damaged gums;
• If the pain becomes severe, you can use painkillers. For example, Nurofen or Paracetamol - the exact dosage depends on the age of the child, so before use you should carefully read the instructions for the drug;
• to reduce swelling, you can resort to cold - any frozen product from the freezer compartment of the refrigerator is wrapped in a soft cloth and applied to the cheek;
• use rinsing solutions that temporarily relieve pain - chamomile decoction or the drug chlorhexidine, which reduces irritation.

Symptoms and diagnosis

At the initial stage of development, the only symptom of the disease can be pain. Obvious symptoms can be noted at the progressive stage:

• biting is accompanied by complaints of pain;
• swelling and hyperemia are visible on the gums. The formed characteristic tubercle with noticeable spots (pus) may have a bluish tint;
• when you press on the gum, pus will come out - this is evidence of the formation of a fistula.

When a child’s dental cyst is mature, it manifests itself:

• painful sensations when palpating enlarged submandibular and cervical lymph nodes;
• headache;
• loss of appetite;
• general weakness;
• increased temperature in the evenings.

A dental cyst at the Novostom clinic is diagnosed:

• when the dentist conducts the initial examination;
• using extended radiography to determine its type;

Preventive measures to prevent the formation of lumps on the gums

To reduce the likelihood of an abscess to a minimum, a child from childhood should be taught to carefully observe oral hygiene.

The list of the most effective measures includes:

• Brushing your child's teeth twice a day. First, parents should brush their child’s teeth themselves, showing how to do it correctly, gradually giving the child more independence in this matter;
• rinsing your mouth after every meal;
• minimizing sweets in the diet - it is important to ensure that the child keeps caramel and candies in his mouth as little as possible;
• Do not introduce your child to chewing gum (the product is especially harmful if it contains sugar).