Diagnosis and management of oral lesions and conditions in the newborn

Infants frequently present with oral lesions and conditions that may lead to anxiety among parents. The most common lesions and conditions include natal and neonatal teeth, the different oral mucosal cysts of the newborn, ankyloglossia and congenital epulis of the gingiva.

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The diagnostic features and management principles of these lesions are discussed in order for healthcare workers to provide proper care and counselling to patients and parents.

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Introduction: Healthcare workers are faced with a variety of lesions affecting the oral cavities of infants. These may vary from physiological variations linked to development, to tumours. Knowledge of these is important for accurate diagnosis to allow proper counselling and advice on treatment planning. The aim of this paper is to inform healthcare workers about the diagnosis and management of common lesions and conditions affecting the oral cavities of newborns.

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Natal and neonatal teeth
The first deciduous tooth erupts after approximately six months. Natal teeth are teeth present at birth, while neonatal teeth erupt within the first month after birth. The majority of natal teeth form part of the primary dentition, while about 10% represent supernumerary teeth.



WFP Van Heerden & AW Van Zyl (2010) Diagnosis and management of oral lesions and conditions in the newborn, South African Family Practice, 52:6, 489-491, DOI:10.1080/20786204.2010.10874032

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Is there a relationship between headache and temporomandibular disorder?

Headache is one of the most common ills in society, and in some cases it is associated with temporomandibular dysfunction (TMD). The article that we share this time carries out a study of the relationship between headaches and TMD.

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Temporomandibular dysfunction is evidenced by sharp pain in the temporomandibular joint and the chewing muscles. These pains can increase over time if it is not treated in time.

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In conclusion, the findings from this review and the two reported cases suggest that TMD encompasses a collection of clinical entities that are often very painful and disabling, with a major contribution of headache to patient symptoms.

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However, they are self-limiting and generally respond to conservative therapy. Basic management strategies for pain control and restoration of the range of motion can decrease the level of disability and often contribute to relief from primary headaches.



° Abouelhuda, A. M., Kim, H. S., Kim, S. Y., & Kim, Y. K. (2017). Association between headache and temporomandibular disorder. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 43(6), 363–367. https://doi.org/10.5125/jkaoms.2017.43.6.363

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Risk of gum disease for smokers

We all know the effects of tobacco on our body, none positive by the way, and the oral cavity does not escape its harmful effects. It has been shown that smoking increases the risk of periodontitis and also affects the response to periodontal therapies.

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Periodontitis is the destruction of the supporting elements of the teeth (bone and periodontal ligaments), it begins with bleeding and inflammation of the gums, and without treatment it can lead to the total loss of the tooth.

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In conclusion, the job of the dentist is not only to treat periodontal disease, but also to influence the patient to stop smoking.

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Management of Angular Cheilitis in children

Angular Cheilitis occurs more in children and it is caused by children sensitivity against certain contact agents like toys, foods, sunlight, allergy against medicines, cosmetics, and long term antibiotic treatment.

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Disease attacking the corners of the mouth is often cause pain when patients experience dry mouth or xerostomia. This disease can also be caused by vitamin B complex deficiency, blood iron deficiency, denture sore mouth and other factors such as breathing through mouth, wetting lips with tongue, and licking the corner of the mouth with tongue.

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Angular cheilitis also called perleche or angular cheilitis is a lesion marked with fissures, cracks on corner of lip, reddish, ulceration accompanied by burning sensation, pain and dryness on the corner of the mouth. In severe cases, these cracks can bleed when opening the mouth and cause shallow ulcer or krusta.

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Angular cheilitis can be a serious problem if it is not handled properly. This disease progression is so fast. Therefor there should be no delay in treatment if symptoms of angular cheilitis occurred and very clear. Not limited to a certain age, regardless of their sex all can be affected by this disease. Frequently in child aged 4-6 years.



° Fajriani, Fajriani. (2017). Management of Angular Cheilitis in children. Journal of Dentomaxillofacial Science. 2. 1. 10.15562/jdmfs.v2i1.461.

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Riga-Fede Disease (Dentitia Praecox): Report of Two Cases with Literature Review

Riga-Fede disease is a term used to describe traumatic ulceration occurring on the ventral surface of the tongue in neonates and infants. This lesion was first described by Antonio Riga in 1881 and subsequent histological studies were performed by Francesco Fede in 1890, which led to the lesion being termed as Riga-Fede disease.

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It is commonly caused by mechanical trauma from natal, neo-natal or primary lower incisors and rarely may be the initial presentation of a neurological disorder.

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Various terms have been used to describe this lesion, like Riga’s disease, Riga-Fede’s disease, sublingual ulcer, sublingual granuloma, traumatic sublingual ulceration, eosinophilic granuloma, traumatic eosinophilic ulceration of the tongue and oral mucosa, sublingual fibrogranuloma, sublingual growth in infants and traumatic atrophic glossitis.

The lesion initially presents as an ulcerated area on the ventral surface of the tongue and with repeated trauma, it may progress to an enlarged, fibrous mass giving the appearance of an ulcerative granuloma. The pain associated with this oral lesion leads to dehydration and feeding difficulties, which in turn may pose potential risks to infants due to nutritional deficiencies.

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If the child is immunocompromised, then the potential for infection can add to the complications of the disease. In order to be termed as Riga-Fede disease, this lesion should be present in a child less than two years of age. Over the age of two years, the term oral traumatic granuloma is used.



° Mehta A, Chaudhary S, Chaitra TR and Sinha A. Riga-Fede Disease (Dentitia Praecox): Report of Two Cases with Literature Review. Austin J Dent. 2017; 4(3): 1073.

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The Importance of Dental Health During Cancer Treatment

Cancer treatments are aggressive and bring a series of complications in other parts of the body, and the oral cavity is no exception. Before starting chemotherapies or radiotherapies, it is necessary to be evaluated by the dentist, to eliminate existing infections such as cavities and periodontal disease.

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Some of the complications that can occur during chemotherapies are: dry mouth, canker sores and ulcers, spontaneous bleeding from the gums, jaw pain, etc. All complications are preventable and, if they occur, are manageable.

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Knowledge is our best prevention weapon, that's why we share an interesting article that explains in detail the complications that can occur during cancer treatment and how we can prevent it.

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What is tooth sensitivity?

Exposure of dentin is the cause of tooth sensitivity, and can be caused by fractures, bruxism, cavities, maladjusted restorations, aggressive brushing, gingival recession, etc.

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Tooth sensitivity is evident when you consume a hot or cold food or drink. The pain is sharp and short-lived. There may also be pain from pressure and from chewing food.



The intervention of the dentist is important because tooth sensitivity could mean the existence of other types of pathologies. The dentist must find out what the reason for the dentin exposure is to prevent it from happening again.

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Bruxism: A medical or dental issue?

Bruxism is a parafunctional habit characterized by teeth grinding or clenching, usually at night. This activity generates a series of problems in the teeth, chewing muscles and jaw joint.

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Bruxism is often seen in the dental office and is listed as the “third most common form of sleep disorders after sleep talking and snoring.” This parafunctional habit (or parasomnia in medical terms) of grinding or gnashing the teeth and clenching the jaw has two different subdisorders—awake (diurnal) bruxism and sleep (nocturnal) bruxism—and is encompassed by a complex web of supposed causes and variables.

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Sleep bruxism (SB) exists in 8% to 31.4% of the population, while awake bruxism has a higher prevalence exhibited in 22.1% to 31% of the general population.

Unfortunately, both conditions have the same deleterious effects on the patient’s mouth and jaw, causing a cascade of destructive symptoms in the mouth, head, and neck. The parafunctional activities of bruxism cause hypersensitivity in teeth, headaches, painful muscles of the jaw and temporomandibular joint (TMJ), occlusal wear, and often, damage dental restorations, even dental implants.

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Indeed, 13% of failed implants are attributed to bruxism, making recognition of the disorder essential before commencing implantation work.

Without question, bruxism is a constant symptom in the dental office, at least in its presenting symptoms. However, there is more to this complex and perplexing disorder than meets the eye, as any dental professional who has been in the field for more than a few years can tell you. Beyond the local effects, the syndrome is correlated with a host of other medical and lifestyle issues. This leads us to the question: Is bruxism a medical or dental issue?

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Souce: https://www.rdhmag.com/pathology/oral-systemic/article/14169169/medical-problems-dental-solutions-bruxism-a-medical-or-dental-issue
Image: Vocal

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What Are The Causes Of TMJ Related Headaches?

The articulation of the jaw with the skull base is known as TMJ, and it can suffer a series of alterations, these are known as temporomandibular dysfunction (TMD).

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The chewing muscles and the joint are affected by TMD, and it prevents various actions such as: talking, yawning, eating and even breathing. Headache is another symptom of TMD.

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Treatment for TMD may consist of medication, massage to the affected area, and use of occlusal splints. Go to your trusted dentist for an evaluation and treatment.

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Pediatric oral RANULA: Clinical cases and follow-up

Oral ranulas are cystic lesions located on the floor of the mouth that arise from obstruction of the excretory duct of the sublingual gland. This causes an accumulation of mucoid material, leading to a well-circumscribed swelling in the oral mucosa of the floor of the mouth.

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Oral ranula is an infrequent pathology, appearing more frequently in children. A review of articles published on oral ranula between 2000 and 2009, found only 12 series, of which eight were specific to the pediatric population.

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The largest series corresponded to Chidzonga et al who analyzed 61 oral ranulas in children younger than 10 years. Some authors discuss ranulas in the general population and other authors have published isolated clinical cases.

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It was therefore interesting to analyze oral ranulas in a large sample of pediatric patients of the Oral and Maxi-llofacial Surgery Department of the La Fe University Children’s Hospital, Valencia. The aim is to analyze the clinical characteristics, treatment and outcome of oral ranulas in pediatric patients.



° Bonet-Coloma C, Minguez-Martinez I, Aloy-Prósper A, Galán-Gil S, Peñarrocha-Diago M, Mínguez-Sanz JM. Pediatric oral ranula: Clinical follow-up study of 57 cases. Med Oral Patol Oral Cir Bucal. 2011 Mar 1;16 (2):e158-62. http://www.medicinaoral.com/medoralfree01/v16i2/medoralv16i2p158.pdf

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Diagnosis of temporomandibular joint (TMJ) ankylosis in children

Temporomandibular joint (TMJ) ankylosis is a disabling condition of mastication in which the condylar movement is limited by a mechanical problem in the joint (true ankylosis) or a mechanical cause not related to the joint components (false ankylosis).

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In children, trauma is identifi ed as the main cause of TMJ ankylosis (57-63%). The other etiological factors are infections, rheumatoid arthritis, hypoparathyroidism, psoriasis, and burns.

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Ankylosis in children can have a tremendous effect on physical and psychological well-being due to restricted mouth opening, inability to chew food, and poor oral hygiene. Due to growth deformity, the child may become shy and reclusive and have a low self-esteem. Trauma to TMJ in early childhood can affect the growth potential of the mandible.

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Any traumatic injury to the joint, if left unnoticed and untreated immediately can cause loss of growth and function resulting in muscle and bone atrophy and subsequently micrognathia, microgenia, and retrognathia.



Shetty, Priya & Thomas, Ann & Sowmya, Bhykani. (2014). Diagnosis of temporomandibular joint (TMJ) ankylosis in children. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 32. 266-70. 10.4103/0970-4388.135848.

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What are the symptoms of clenched teeth and how can we fix it?

Grinding and grinding of the teeth is called bruxism. This activity is nocturnal and in states of unconsciousness. The consequences of bruxism is varied, since it affects teeth, muscles and bones.

The teeth wear out quickly and may have some fissure or fracture of the enamel. In the case of muscles, they become inflamed and generate great pain when chewing or talking.

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If you want to know more information about bruxism and its consequences on our health, we invite you to watch the following video.

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What is Trismus and what causes it?

Trismus has a number of potential causes, which range from the simple and non-progressive to those that are potentially life-threatening. Kazanjian divided ankylosis of the temporomandibular joint into true and false.

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The true type of ankylosis was attributed to pathological conditions of the joint, and false ankylosis was applied to restrictions of movement resulting from extra-articular joint abnormalities.

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This latter type of ankylosis is what most clinicians know as trismus. In a busy practice, it is not unusual to see several patients each month with a complaint of trismus. This condition may impair eating, impede oral hygiene, restrict access for dental procedures and adversely affect speech and facial appearance.

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What is Normal Opening of the Mouth?

The normal range of mouth opening varies from patient to patient, within a range of 40– 60 mm, although some authors place the lower limit at 35 mm. The width of the index finger at the nail bed is between 17 and 19 mm.



° Dent Update 2002; 29: 88–94 / P.J. DHANRAJANI AND O. JONAIDEL

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3 Reasons for the White Coating on Your Tongue

A healthy tongue is a clear demonstration of good general health. The color and shape of the tongue can be the manifestation of an ongoing disease or poor oral hygiene.

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A white tongue can be the product of dead debris, bacteria and cell phones that remain on the surface of the tongue.

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But a white tongue reveals some disease such as: candidiasis, leukoplakia, geographic tongue. We have more information about white tongue thanks to the BiteawayTV International channel.

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What is Mandibular Tori? What causes it?

The mandibular torus is an indeterminate bone growth that appears in the jaw. It generally appears on the inside of the jaw at the level of the premolars.

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When the torus appears in the upper jaw, it is called the Torus Palatinus, and it is usually found in the midline of the palate. This malformation is usually suffered by men.

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Among the factors that contribute to the formation of the torus, we have the genetic factor, stress and bruxism. See with us this interesting video where they explain what a mandibular torus is.

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How to Reduce a TMJ Dislocation?

The temporomandibular joint (TMJ) is a joint between the mandible and the temporal bone of the skull. The condyle of the mandible articulates bilaterally in a concavity known as the glenoid fossa or mandibular fossa.

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Dislocation of the temporomandibular joint is a painful condition that occurs when the mandibular condyle becomes fixed in the anterosuperior aspect of the articular eminence.

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Dislocations of the temporomandibular joint (TMJ) are common and occur in as many as 7% of the entire population, at some point in their lives . They can occur at any age but are most common between 20-40 years of age.

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