Periostitis is a purulent inflammation of the periosteum, the tissue covering the bone of the upper or lower jaw. Over time, the inflammation spreads to other tissues of the oral cavity , and a painful and unpleasant abscess can grow on the gum.
Periostitis is of two types: acute and chronic . the acute one , it goes on very quickly. Inflammation is manifested by asymmetric swelling of the cheek on the side of the diseased tooth and enlargement of the lymph nodes, and an increase in temperature is observed. Chronic periostitis can pass without obvious symptoms, while negatively affecting the condition of the child’s teeth, destroying them from the inside. The chronic form often occurs due to untreated acute periodontitis, pulpitis or due to injury.
Causes of stomatitis
The imperfection of local and general defenses of the child’s body makes the mucous membranes of the oral cavity vulnerable to adverse factors. And the healthy curiosity characteristic of every child has made stomatitis one of the most common diseases among children. Sometimes, for the development of an illness, it is enough to taste any less than sterile object. The main causes of the disease include the following:
- insufficiently good oral hygiene;
- minor injuries - cheek biting, scratch, etc.;
- burns, including chemical burns;
- exposure to pathogens from unwashed hands or dirty toys.
Dentists focus on stomatitis associated with biting the inside of the cheek.
This is often associated with recent dental treatment under local anesthesia. For some time after the procedure, there is reduced sensitivity in the area of the lip or cheek, so you need to eat food after treatment very carefully and only after you have waited for the recommended period of time - usually from 1 to 2 hours. The likelihood of developing stomatitis for these reasons increases after infectious diseases, previous interventions, hypothermia and other factors that contribute to a decrease in protective forces.
Types of stomatitis
The treatment regimen for stomatitis in children is based on the type of disease. There are several types of stomatitis:
- bacterial;
- viral, including herpes;
- fungal;
- aphthous;
- angular;
- allergic;
- traumatic.
All types of stomatitis occur in children, but the most common among children under 3 years of age are aphthous, candidal, herpetic and allergic. An increase in the incidence of traumatic stomatitis is usually associated with a period of active growth of primary teeth.
It is important to understand that in some cases, stomatitis is combined with other diseases with similar symptoms and is the first sign of more serious diseases. For example, with cheilitis - inflammation of the mucous membrane and red border of the lips, food allergies, etc.
Real clinical case (baby tooth) –
- In Fig. 4a, you can see that in the projection of the roots of one of the baby teeth of the upper jaw, a purulent lump has formed on the child’s gum. Depending on the degree of filling with pus, the lump can be soft or dense when pressed; in the latter case, pressure will cause acute pain.
- Figure 4c shows an x-ray of the causative tooth that caused inflammation in this case. The area on the radiograph, limited by the white circle, is a zone of purulent inflammation in the area of the roots of the baby tooth. Above this zone we can see the germ of a permanent tooth, which is located almost between the roots of a milk tooth (24stoma.ru).
Important: what to do if the lump bursts...
Sometimes spontaneous opening of a purulent abscess may occur, i.e. the lump can simply burst, and in its place a fistula is formed (Fig. 5). A fistula is usually called a hole in the gum, which through the fistula canal is connected to the source of inflammation at the apex of the root of the “sick” tooth. Purulent discharge will gradually be released from the fistula.
It is important to understand that the opening of a lump and the formation of fistulas does not mean the cessation of purulent inflammation, even if the fistulas also disappeared over time. The purulent inflammation will simply proceed unnoticed, and with the next decrease in the child’s immunity, swelling of the gums with a large amount of pus will appear again.
Symptoms
Common symptoms of stomatitis are pain, burning, swelling of the mucous membrane and redness, and bad breath. Salivation also changes - it can be excessive or insufficient, with dry mouth. In some cases, there may be an increase in temperature and enlargement of the submandibular lymph nodes.
The types of stomatitis in children and treatment methods differ, as do the specific manifestations. For example, with aphthous stomatitis, only one large ulceration may appear, but with viral stomatitis, inflammation almost always takes the form of numerous elements or a rash merging into one focus.
Candidal stomatitis is characterized by the formation of a white or yellowish cheesy coating. It is easier to recognize traumatic stomatitis because it is preceded by damage or the source of injury is nearby - a chipped tooth or a rough filling.
What is periostitis and how does it manifest in children?
The disease is usually a consequence of advanced dental problems, when inflammation descends, spreading to the bone. In children, this process can happen very quickly - sometimes the hours count.
In everyday life, periostitis of the jaw is called gumboil
. It is usually acute in nature and manifests itself with the following symptoms:
- complaints of jaw pain;
- asymmetrical swelling, puffy cheek;
- enlarged lymph nodes in this area;
- increase in general body temperature;
- weakness of the child, signs of general intoxication.
Please note that with periostitis, cooling the inflamed area reduces pain, and heating
increases discomfort.
Look at photos of children with periostitis - you will notice that the face is asymmetrical, the cheek or cheekbone area is swollen and looks painful.
The symptoms listed above (one or more) should be a guide to immediate action - it is necessary to urgently take the child to the dentist. It should be noted that in this case a prior appointment is not required - at the municipal clinic you will be seen immediately with a note of “acute pain”.
Diagnostic features
A dentist can detect stomatitis during the first visual examination. But in controversial cases, laboratory tests may be required. Thus, bacterial inflammation may require identification of the causative agent of the disease and its sensitivity to antibiotics. A scraping and/or virological study will help determine the cause of the disease and prescribe appropriate treatment.
If a combination of several ailments with a similar picture is suspected, as well as if the child’s general well-being deteriorates, laboratory tests of blood and urine and consultations with other specialists may be prescribed.
Sometimes stomatitis can be the first manifestation of systemic diseases, general somatic pathology, for example, diabetes mellitus or malignant neoplasms. Therefore, a timely visit to the doctor is extremely important.
Features of treatment
As is often the case with diseases that are at the intersection of several areas of medicine, inflammatory lesions of the oral mucosa are one of the least studied areas of dentistry. Therefore, several specialists can be involved in the treatment of stomatitis in children in the mouth: pediatrician, dentist, dermatologist, immunologist-allergist, otolaryngologist, etc. This is especially convenient when you go to a multidisciplinary clinic.
Self-medication of stomatitis is unacceptable, and although it is now easy to find ready-made treatment regimens and folk recipes, it is important not to experiment with the baby’s health.
Conservative treatment is mainly used, which involves treating the underlying cause of the disease. Your doctor may prescribe the following medications:
- antibacterial drugs (systemic and local in the form of ointments): for bacterial inflammation;
- antiviral agents for herpes and other types of viral stomatitis;
- antifungal drugs for fungal diseases;
- antihistamines - both for allergic origin of stomatitis, and as part of complex therapy to reduce swelling and itching;
- symptomatic drugs - anti-inflammatory, analgesic, antipyretic.
Treatment of candidal stomatitis in infants should be carried out with caution. At the same time, it is important to pay attention to your health; sometimes the cause of such a disease can be insufficient breast hygiene during lactation.
Often, only local remedies are sufficient, but make sure that the entire oral cavity is treated with the rinse - inflammatory agents can be found on the entire surface of the mucous membranes. Healing applications can be used to a limited extent, only on areas of inflammation.
Treatment of stomatitis of any kind in children involves strict adherence to a diet. The diet should be gentle, it is important to avoid salty, spicy, sour foods and drinks, serve the child warm meals, and limit the consumption of sweets.
If traumatic stomatitis occurs, the doctor will prescribe medications to speed up healing. However, it is very important to prevent re-injury. If it was caused by sharp edges of a tooth or filling, this cause should be eliminated. The doctor will suggest grinding off the filling or replacing it, and will also choose the appropriate option for restoring the shape of the crown in case of chips and cracks.
Prevention of stomatitis
You can reduce the risk of developing stomatitis using the following recommendations:
- regular washing of toys, bottles, pacifiers, breast hygiene if the baby is breastfed;
- general strengthening activities: walks, wet cleaning, a balanced diet, moderate hardening, adherence to a daily routine;
- fighting bad habits of biting nails, pencils, etc.;
- regular dental examinations and timely interventions in case of dental injuries.
The dentists of the Family Doctor clinic treat and prevent stomatitis in children.
Advanced equipment allows us to quickly and accurately assess the condition of the oral cavity and perform the necessary studies in a short time. We practice modern approaches to the treatment of inflammatory diseases of the oral cavity and adhere to an individual approach to each small patient. Consultation with a pediatric dentist is carried out by appointment. To make an appointment, call the single contact center or fill out a special online appointment form for a pediatric dentist on the website, or you can also visit the clinic’s reception in person.
Swelling in the cheek area, causes
The most common dental causes of cheek swelling are:
- advanced caries;
- complication of pulpitis;
- complication of gingivitis;
- periostitis, periodontitis and other diseases of teeth and gums.
If you suspect flux, call: 8 (495) 558-88-77
Flux is inflammation of tissues of various origins, for example, periostitis, an inflammatory process in the periodontal gap - periodontium. Such inflammation can occur in acute and chronic forms; the chronic form can periodically enter an exacerbation phase and then subside again.
By origin, periostitis is as follows:
- infectious;
- non-infectious;
- spicy;
- chronic;
The main role in the development of flux of infectious origin belongs to microorganisms, as well as their toxins. Microbes penetrate into the periodontium through the root canal, periodontal pocket, as well as through the blood or lymph flow.
Most often, flux is caused by an infection that enters through the root canal and is a consequence of acute diffuse and chronic gangrenous pulpitis, as well as pulp necrosis.
Microorganisms and their toxins, penetrating into periodontal tissue, cause dangerous acute inflammation
Non-infectious periostitis/periodontitis (fluxes) can develop as a result of trauma (blow, bruise, periodontal trauma after pulp extirpation, sharp, uncomfortable biting on a tooth; cracking nuts, gnawing bones) or chronic microtrauma (smoking pipe, brass band instruments, biting threads, pressing on the tooth with a pencil, pen, etc.); also as a result of the influence of medications - the ingress of potent substances into the periodontium during the expansion of root canals (trilon B, aqua regia), their sterilization (formalin, silver nitrate, etc.) and in the ingestion of arsenic paste.
