Oral mucosal disease is more common in children. They can cause discomfort in mild cases and interfere with eating and crying in severe cases. The main oral mucosal diseases in children are: herpetic stomatitis, thrush, and map tongue.
Herpetic stomatitis
Herpes stomatitis is an infectious disease of the oral mucosa caused by the herpes simplex virus, characterized clinically by the appearance of clusters of small blisters, self-limiting and prone to recurrence.
Causes
Herpes simplex virus infection is transmitted mainly through direct contact with droplets, saliva, and herpes fluid, but can also be transmitted indirectly through eating utensils and clothing, mainly through the respiratory tract, oral cavity, nose, conjunctiva, genital mucosa, or broken skin.
Clinical manifestations
Primary herpetic stomatitis.
(1) Most commonly seen in children under 6 years of age, with the most frequent occurring between 6 months and 2 years of age.
(2) Heavy prodromal symptoms, which may include fever, headache, fatigue, muscle pain, and enlarged lymph nodes.
(3) Any part of the oral mucosa can be involved, with the palate and gingival margin adjacent to the milk molars (adult premolars) being the most obvious, mainly manifesting as clusters of small blisters that break easily and form a large vesicular surface.
(4) The duration of the disease is about 7 to 10 days and is self-limiting.
Treatment principles
(1) Systemic antiviral therapy: nucleoside antivirals and ribavirin.
2, local treatment: oral mucosa local medication, often used preparations are solutions, pastes, dispersions and tablets, such as compound boric acid solution, 0.1% to 0.2% chlorhexidine solution containing gargle, phthalamide ointment, acyclovir ointment local rubbing, tin class powder, nourishing yin raw muscle powder local use, chlorhexidine gluconate tablets containing chemotherapy, etc.; for recurrent herpes labialis can also be used helium-neon laser local irradiation.
3, symptomatic and supportive therapy: bed rest for serious conditions, intravenous infusion for those who have difficulty in eating, supplementation of vitamin B, C, etc.
4.Chinese herbal medicine treatment.
Thrush
Thrush, also known as ciguatera and leucoderma, is infected by fungi and is a common disease of children’s mouth. It forms a white patchy film on the surface of the oral mucosa and is mostly seen in infants and young children.
Etiology
Thrush is caused by Candida albicans, one of the many microorganisms that usually occur in infants with unclean, malnourished mouths, and also in frail adults. Candida albicans can also be found in the mouths of healthy children, but it does not cause disease.
The following conditions can cause infection.
1, the mother’s vagina has mycobacterial infection, the baby was born through the birth canal, contact with the mother’s secretions and infection.
2, bottles, pacifiers are not thoroughly disinfected, breastfeeding, the mother’s nipples are not clean.
3.Contact with food, clothes and toys infected with Candida. In addition, infants and toddlers begin to grow teeth at 6 to 7 months, the dental bed has a mild sense of swelling, infants and toddlers will love to bite fingers, bite toys, so it is easy to bring bacteria, mold into the mouth, causing infection.
4. When living in a group in kindergarten, sometimes thrush can occur due to cross-infection.
5, long-term use of antibiotics, or inappropriate application of hormone therapy, resulting in imbalance of the body’s flora, mold to take advantage of the situation.
Clinical manifestations
Most common in infants and children within 2 years of age.
1. Milky white, slightly elevated plaque film appears on the oral mucosa, with no inflammatory reaction around it, resembling milk lumps. After wiping off the film, a non-bleeding red wound can be seen below. The area of the film varies in size and can appear on the tongue, cheek, palate or inner lip mucosa.
2.It is found on the mucous membrane of the cheek, tongue, soft palate and mouth and lips, and the white plaque is not easily wiped off with cotton swabs or wet gauze.
3.When the infection is mild, the white patches are not easy to find, and there is no obvious pain, or there is only a painful expression when eating. In severe cases, the baby will be irritable, have poor appetite, cry and have difficulty in breastfeeding due to pain, sometimes accompanied by mild fever.
4, damaged mucosa treatment is not timely can continue to expand, spread to the pharynx, tonsils, gums, etc., serious cases can spread to the esophagus, bronchi, causing candidiasis esophagitis or pulmonary candidiasis, respiratory, swallowing difficulties, a few can be complicated by chronic mucosal skin candidiasis, affecting lifelong immune function. It may even cause sepsis secondary to other bacterial infections.
Complications
Babies may refuse to take milk due to pain, resulting in reduced food intake and slow weight gain. If thrush spreads to the back of the mouth, it may “affect” the esophagus. Once involved, babies may feel uncomfortable swallowing and may even refuse to drink for fear of pain, possibly resulting in dehydration. If left untreated, yeast can also spread to other parts of the body. Of course, diffuse yeast infections are very rare.
Treatment
Wash with a weak alkaline solution, such as 2% to 5% sodium bicarbonate (baking soda), and rub ice boron oil (traditional Chinese medicine ice boraxan made into a paste-like honey) and mycophenolate suspension with good effect. Strengthen nutrition, especially the appropriate amount of vitamin B2 and vitamin C. Infant room should pay attention to isolation and disinfection of breastfeeding to prevent transmission.
Prevention
1, maternal vaginal mycosis should be actively treated to cut off the route of infection.
2, infants and children eating dishes cleaned and then steamed for 10 to 15 minutes.
3, lactating mothers should wash the areola and nipples with warm water before breastfeeding; and should always bathe, change underwear, cut nails, and wash hands every time you hold your child.
4, for infants and children’s bedding and toys should be regularly unwashed and dried; baby’s toiletries should be separated from parents’ as much as possible and disinfected regularly.
5.The infant room should pay attention to the disinfection of isolation and breastfeeding to prevent transmission.
6.Children should regularly engage in some outdoor activities to increase the resistance of the organism.
7.For children who live in a group in kindergarten, utensils should not be mixed.
Map tongue
Map tongue is a chronic marginal exfoliative linguitis that occurs in the superficial layer of the tongue mucosa. Because its lesions appear in different parts of the tongue, and can change size and shape, with the characteristics of wandering, so also known as wandering linguitis.
Etiology
The cause is not very clear, it may be related to intestinal parasites or gastrointestinal dysfunction; some people think that it is related to the incomplete development of the child’s nervous system and mood swings; there are some children’s parents have also suffered from map tongue, so the performance has a certain genetic tendency. In general, map tongue is most often seen in children, especially in infants and young children who are weak.
Clinical manifestations
1, the lesions are usually found on the tip of the tongue, the center of the tongue and the edge of the tongue.
2, the lesions are round or oval erythematous, single or multiple, can be enlarged or fused, often resembling a “map border” after fusion, surrounded by a slightly elevated white-yellow curved edge, the center of the fiery red filiform papillae exfoliation area, but the fungal papillae are not changed.
3. The lesion is wandering and can change its original shape and position over the course of the day and night.
4. The lesion area may have a mild paresthesia.
Treatment
Map tongue is a common disease in infancy and childhood, and the incidence of children is reported to be about 15%. This disease may be related to factors such as indigestion, nutritional deficiency and poor physical fitness. It is usually asymptomatic and the tongue feels a little numb when eating irritating foods. For children with map tongue these methods can be used.
1, rest and diet
Ensure rest and avoid overexertion. Diet should be nutritious, timely addition of complementary foods. Prevent partiality, picky eating, so as to avoid gastrointestinal disorders and malnutrition.
2.Eliminate the foci of infection
Certain bacteria in the oral cavity may cause map tongue. Therefore, we should carefully check the teeth, tonsils and buccal mucosa for infections, and treat them as soon as they are found.
3.Find the cause of the disease
Detailed history of the onset of the disease should be understood, and the damage to the mucosa should be observed, and vitamin B complex or zinc sulfate preparations can be taken. Children with iron deficiency anemia should take iron supplements. Children with too little gastric acid can take dilute hydrochloric acid orally. In short, symptomatic treatment should be given.
4.Clean oral cavity
The oral cavity should be kept clean and hygienic. Every morning, a soft brush can be used to gently brush from the back of the tongue outward for one to two times to remove the exfoliated epithelium, and then gargle with 0.5% sodium bicarbonate solution, which can receive remarkable results.
Prevention
Daily life should pay attention to exclude and avoid stimulating factors that may induce map tongue, such as not to eat spicy irritating food, remove oral lesions, maintain oral hygiene, brush teeth with soft-bristled toothbrush. At the same time should do a reasonable diet, pay attention to eat more vitamin-rich food, if necessary, you can take vitamin B complex directly.