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Section 3 Oral Conditions Affecting Infants and Children Copyright © 2017 Wolters Kluwer · All Rights Reserved Objectives • Define and describe the clinical appearance of common oral conditions of infants and children. • Recognize the causes and clinical features of these conditions. • Use the diagnostic process to distinguish similarappearing oral anomalies of infants and children. • Describe the consequences of disease progression with respect to these conditions. Copyright © 2017 Wolters Kluwer · All Rights Reserved Objectives (cont.) • Be knowledgeable of appropriate treatments for common oral conditions of infants and children. • Identify conditions discussed in this section that require the attention of the dentist and/or affect the delivery of dental care. Copyright © 2017 Wolters Kluwer · All Rights Reserved Oral Conditions Affecting Infants and Children 1. Commissural lip pits 8. Dental lamina cysts 2. Paramedian lip pits 9. Natal teeth 3. Cleft lip 10. Eruption cyst 4. Cleft palate 11. Lymphangioma 5. Bifid uvula 12. Thrush 6. Congenital epulis 13. Parulis 7. Melanotic neuroectodermal tumor of infancy Copyright © 2017 Wolters Kluwer · All Rights Reserved 1. Commissural Lip Pits • Dimplelike invaginations • Corner of the lips • Unilateral or bilateral • Failure of fusion of the embryonic maxillary and mandibular processes Copyright © 2017 Wolters Kluwer · All Rights Reserved 2. Paramedian Lip Pits • Congenital depressions that occur in the mandibular lip • Develop when lateral sulci of the embryonic mandibular arch fail to regress during the 6th week in utero Copyright © 2017 Wolters Kluwer · All Rights Reserved 3. Cleft Lip • Results when the medial nasal process fails to fuse with lateral portions of the maxillary process of the first branchial (pharyngeal) arch • Upper lip is most commonly affected Copyright © 2017 Wolters Kluwer · All Rights Reserved 4. Cleft Palate • The palate develops from the primary and secondary palate • Palatal fusion is initiated during the 8th week in utero • Generally completed by the 12th week of gestation Copyright © 2017 Wolters Kluwer · All Rights Reserved 5. Bifid Uvula • Minor cleft of the posterior soft palate • Asian and Native American • A submucosal palatal cleft may occur with bifid uvula Copyright © 2017 Wolters Kluwer · All Rights Reserved 5. Bifid Uvula (cont.) • Develops when the muscles of the soft palate are clefted, but the surface mucosa is intact • Clefted region is notched • Incomplete cleft • Complete cleft Copyright © 2017 Wolters Kluwer · All Rights Reserved 6. Congenital Epulis • Benign, soft tissue growth arising exclusively in newborns from the edentulous alveolar ridge or palate • Most commonly in the anterior maxilla Copyright © 2017 Wolters Kluwer · All Rights Reserved 7. Melanotic Neuroectodermal Tumor of Infancy • Rare benign tumor of neural crest cell origin • Rapidly growing mass in the anterior maxilla during the first year of life Copyright © 2017 Wolters Kluwer · All Rights Reserved 8. Dental Lamina Cysts • Remnants of the dental lamina that do not develop into a tooth bud • May degenerate to form dental lamina (inclusion) cysts • Tiny keratin-filled cysts Copyright © 2017 Wolters Kluwer · All Rights Reserved 9. Natal Teeth • Teeth that are present at birth or erupt within 30 days of birth • Cornified and calcific material • Represent premature eruption of the primary teeth Copyright © 2017 Wolters Kluwer · All Rights Reserved 10. Eruption Cyst • AKA: Gingival Eruption Cyst, Eruption Hematoma • Variant of the dentigerous cyst • Lined by odontogenic epithelium Copyright © 2017 Wolters Kluwer · All Rights Reserved 11. Lymphangioma • Benign malformation of lymphatic vessels • Tongue, alveolar ridge, and labial mucosa Copyright © 2017 Wolters Kluwer · All Rights Reserved 12. Thrush • AKA: Candidiasis, moniliasis • Fungal • Milky white curds • Easily wiped off • Tx: antifungal agents Copyright © 2017 Wolters Kluwer · All Rights Reserved 13. Parulis (Gum Boil) • Inflammatory response to a chronic bacterial infection of a nonvital tooth • Pulpal infection spreads beyond the furcation of a posterior tooth • Drains through sinus tract Copyright © 2017 Wolters Kluwer · All Rights Reserved Lip Pits • Congenital depressions or dimplelike invaginations • Inherited pattern often • Commissural lip pits (corner of the lips) – Failure to fuse • Paramedian lip pits (mandibular lip) – Either side of the midline – If with cleft lip or palate + hypodontia = van der Woude syndrome • Treatment is not required unless for cosmetic reasons Copyright © 2017 Wolters Kluwer · All Rights Reserved Review • Define and describe the clinical appearance of common oral conditions of infants and children. • Recognize the causes and clinical features of these conditions. • Use the diagnostic process to distinguish similarappearing oral anomalies of infants and children. • Describe the consequences of disease progression with respect to these conditions. Copyright © 2017 Wolters Kluwer · All Rights Reserved Review (cont.) • Be knowledgeable of appropriate treatments for common oral conditions of infants and children. • Identify conditions discussed in this section that require the attention of the dentist and/or affect the delivery of dental care. Copyright © 2017 Wolters Kluwer · All Rights Reserved