Quick Tips to Help Parents Identify Lumps, Bumps, and Lumps in Their Children’s Mouth

Heck, oral health care can be difficult! 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 mucus. When in doubt, you can always call your friendly pediatric dentist.

Normal Things: Normal oral anatomy is usually midline or symmetrical. That little lump behind the upper front teeth is called the incisal papilla, if burned on pizza or poked with a chip it can become inflamed but will heal quickly. Those bright red spots under your tongue are superficial blood vessels called varicose veins – they’re okay mom!

Cold sores: Common cold sores usually occur outside of the mouth on the lips. They are a recurrence of a viral infection called Herpes Simplex. About 90% of children are exposed to the cold sore virus by age four (look what I brought home from preschool mom!), And about 50% become chronic carriers. That means that since the herpes virus infects nerve cells that never die, periodically the virus will reappear to form a cold sore. Before the cold sore forms a scab, the virus spreads and is highly infectious. Fortunately, a whole family of antiviral medications can treat cold sores to limit their size, duration, and discomfort.

Mouth ulcers: For otherwise healthy children, canker sores occur inside the mouth only on mobile tissues. Also called aphthous ulcers or RAS (recurrent aphthous syndrome), they have a concave white center with a bright red border and are very painful to touch. Parents often mistake this lesion for an abscess if it is located near the teeth on the gums. In reality, aphthous ulcers are caused by an exuberant immune system response. That’s right, the immune system gets angry with a micro trauma, cleans the house, and leaves a painful ulcer. Since it is not an infection, the best treatment is to recognize that it will clear up in about a week and medicate with Tylenol or a topical anesthetic agent such as Orajel. Some adults remember burning them with silver nitrate. That is very painful, it will leave a scar and cause a riot!

Mucocele: Unknown to most of us, the lips are filled with minor salivary glands, which consist of a small simple gland that is connected to the oral cavity via a duct. Occasionally, one of these ducts is severed, saliva accumulates in the gland, and a soft lump occurs on the lip. If the gland ruptures, fills up, and breaks open again, a scar can form. This produces a hard blow. Children cannot leave these lumps alone and usually chew on them; Some mucoceles can reach the size of marbles! The best treatment is simply to make a small incision on the inner lip and remove the mucocele. In a pediatric dentist’s office, this involves one point of anesthesia, one stitch, and about five minutes. In your oral surgeon’s office or ENT they start talking about general anesthesia! Remember, children can smell when a doctor has scars.

Popcorn: this is my favorite oral pathology. A child has a swollen gum and slight discoloration. A dental explorer is carefully inserted between the tooth and the gum to capture and deliver a popcorn shell. The pain disappears instantly! Somehow, parents are often blamed, don’t ask me why.

There are many more unusual and always worrying lumps and bumps. If you have a head scratcher and need advice, don’t hesitate to call. Greg Evans, DDS of Big Grins Pediatric Dentistry in Fort Collins is always available to chat.

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