Inflammation of the oral mucosa in a child. Children's oral diseases. Treatment of viral warts

Diseases developing in the oral cavity often bring discomfort to the sick person and interfere with his full life. They appear at any age, but more often in weakened people. Diseases that occur in the mouth can be viral and infectious, not dangerous to health and precancerous, but they all require high-quality diagnosis and treatment.

Types of oral diseases with photos

When an infection enters the oral cavity, the mucous membrane is the first to suffer. It becomes inflamed, becomes thinner and becomes a breeding ground for infections. The disease can affect the tongue, gums, inner cheeks and tonsils. All diseases of the oral cavity are conventionally called stomatitis, but stomatitis is not the only ailment that affects the oral mucosa.

Let's look at the most common diseases in the mouth and mucous membranes, their symptoms and causes. General classification and disease statistics oral cavity In adults, you can look at the photo with the names of the diseases:

Stomatitis and thrush

Stomatitis is an inflammatory reaction in the oral mucosa. People with reduced immunity and thinned mucous membranes (infants and the elderly) are susceptible to it.

Stomatitis causes discomfort in the patient, can signal the presence of a pathological process in the body and be a harbinger of oncology. There are many varieties of this disease. More details about the types of stomatitis, possible reasons The occurrence of the disease and symptoms can be found in the table.

Glossitis or inflammation of the tongue

The tongue is called the mirror of human health, because by its condition one can determine the presence of diseases in the body. Inflammatory lesions of the tongue in medicine are called glossitis; it can be acute or chronic.

Based on the causes of the disease, glossitis is divided into primary (an independent disease) and secondary (joined against the background of other diseases). Depending on the form of the lesion, glossitis can be deep or superficial. Glossitis often appears with stomatitis.

General symptoms of glossitis:

At chronic form papillomas and warts may appear. Types of glossitis, its symptoms and causes are described in the table. You can see what kind of rashes and ulcers there are in the photo.

Herpes virus

The well-known “cold rashes” on the lips can also appear in the oral cavity. The cause of such rashes is infection with the herpes virus, which can occur in acute and chronic forms.

The most common type of herpetic rash in the oral cavity is acute herpetic stomatitis. Characterized by rapid spread and sudden development of symptoms. It is most often transmitted by airborne droplets, but there are cases of infection through blood and from mother to child during childbirth.

In the initial stage, herpes infection manifests itself as pain, burning and swelling of the mucous membrane. Light form The disease does not manifest itself with clear symptoms. Severe form of acute herpetic stomatitis manifests itself with severe symptoms:

The main symptoms of the disease are rashes in the form of blisters with a yellowish-white coating, which when ruptured form ulcers. The rash can affect the tongue, gums, cheeks and even tonsils.

Herpetic stomatitis is not dangerous disease, but brings great discomfort to the sick person. With the right and timely treatment, the prognosis for recovery is favorable.

Gingivitis or gingivostomatitis

When we are talking about an inflammatory process localized primarily on the gums, without affecting the periodontal junction, gingivitis can be diagnosed. If the gums are damaged and ulcers appear on the inner surface of the cheeks, gingivostomatitis is diagnosed (more often it affects children).

Gingitis is often a consequence of poor dental care, occurs predominantly in men and depends on lifestyle and general condition body. In the absence of proper treatment, the disease progresses and turns into periodontitis, which threatens tooth loss.

With neglectful care of teeth and oral cavity, microorganisms accumulate, as a result of which dental plaques form and the inflammatory process begins. Gingivitis can be acute, chronic and recurrent. There are several types of gingivitis:

1. Ulcerative - the initial acute form. It is characterized by swelling of the gums, their redness and the appearance of a foreign odor from the mouth.
2. Catarrhal. Severe swelling, pain in the gums and slight bleeding appear. Gum pockets are not affected in this form.
3. Hypertrophic - advanced stage of the disease. At this stage, the gums and gingival papillae thicken and enlarge, and the gum pocket turns red. There are two forms of hypertrophic gingivitis - edematous, characterized by swollen, smooth-red, bleeding gums, and fibrous - with this form the gums are very dense, there is no pain or bleeding (cannot be treated with medication, surgical treatment is used).

Other types of diseases

There are also less common diseases of the oral lining, such as cheilitis, leukoplakia, xerostomia, lichen planus, glossalgia (more details in the article:). Some of them are diagnosed only by experienced doctors.

Diagnosis and symptoms

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If any unpleasant symptoms For oral diseases, you should contact your dentist. It will not be difficult for an experienced doctor to diagnose the disease by examining the oral mucosa. This may be enough to establish the correct diagnosis.

In some cases, examinations may be prescribed:

• scraping from the site of the lesion for examination under a microscope;
• bacterial culture to determine the sensitivity of the fungus to the drug;
• allergy tests;
• general examination of the body to identify a systemic disease.

When should you see a dentist? If any general symptoms of diseases of the mucous membrane and mouth are detected in the oral cavity:

• pain, swelling and burning;
• change in color of the mucous membrane or the appearance of spots on it;
• elevated or reduced work salivary glands;
• the appearance of any rashes, ulcerative lesions and wounds.

Treatment of oral diseases in adults

Due to the wide variety of diseases, there is no single treatment regimen. First of all, the cause of the disease and associated diseases are identified and treated. The treatment regimen is drawn up individually for each patient.

Treatment is prescribed comprehensively and includes medications for internal and local application. Recovery can be long.

Medicines

Folk remedies

• Traditional treatment is effectively complemented folk remedies. For these purposes, herbal decoctions are used, soda rinses and applications with natural oils.
• Rosehip, sea buckthorn or St. John's wort oil is used as an application to the affected areas. Effectively heal wounds and injuries. Use a gauze swab soaked in oil to remove plaque from thrush.
• Calendula and chamomile flowers, oak bark, and eucalyptus leaves are used in the form of decoctions for rinsing. They have antibacterial and wound-healing effects.

Diseases of the oral mucosa in children

Chronic relapsing aphthous stomatitis(HRAS)– one of the most common diseases that can be classified as infectious-allergic. HRAS is characterized by periods of remission and exacerbation and manifests itself in the form of aphthae – superficial painful defects of the mucous membrane. Aphthae have a round or oval shape, covered with fibrinous plaque, red hyperemic rims are visible around the afts. The appearance of aphthae is not preceded by the formation of blisters. HRAS can occur in a mild form (1-2 aphthae) and in a severe form, when recurrent deep scarring aphthae are formed, the period of epithelization of which lasts up to 2-3 weeks. At the same time, relapses of the disease are very frequent (can occur monthly).
The treatment regimen includes a diet with the exclusion of irritating foods, the prescription of immunocorrectors and immunomodulators (after consultation with an immunologist), vitamins B and C, and desensitizing therapy. The child's oral cavity is treated locally with antiseptic solutions, applications of proteolytic enzymes are used, and lubricated with oil solutions of vitamins.

Acute herpetic stomatitis
Much more dangerous and, unfortunately, widespread is another form - acute herpetic stomatitis. Infection of children with the herpes simplex virus is 60% under the age of 5 years, and 90% by the age of 15 years. In addition, acute herpetic stomatitis in children with reduced immunity is very contagious. The disease spreads through airborne droplets and household contact. The older the child, the lower the likelihood of acquiring an acute form of herpetic stomatitis due to acquired immunity.
The disease occurs in mild, moderate and severe forms. The incubation period is up to 17 days (in newborns - up to 3 days). A child with acute herpetic stomatitis may have a fever (up to 37-39o C, depending on the severity of the disease). The mucous membrane of the oral cavity is hyperemic, then single or grouped lesions appear. With more severe forms rashes can appear both in the oral cavity and on the skin in the perioral area. The disease is accompanied by symptoms of catarrhal gingivitis (inflammation and bleeding of the gums
The most reliable method for diagnosing herpes infection is the polymerase chain reaction (PCR diagnosis) method.

Treatment of acute herpetic stomatitis.
The treatment is complex. First of all, it is necessary to provide the child good nutrition, however, excluding all traumatic factors from food (food should not be hard, spicy, salty, hot, etc.). It is important to ensure drinking plenty of fluids. Before each feeding of the child, his mucous membrane must be anesthetized (2-5% oil solution of anesthesin or lidochlor gel). Antiviral therapy involves taking special antiviral drugs (as prescribed by a doctor. For epithelization of affected areas, ointments based on proteolytic enzymes of animal origin are used, as well as oil solutions vitamins Antiviral drugs must be combined with immunomodulators (as prescribed by a doctor). When using a laser, fibrinous plaque is cleansed from the aphthae, and the healing process is accelerated.
To prevent relapses, it is necessary to strengthen the child’s immunity naturally: hardening, swimming, good nutrition, etc. Thorough sanitation of the oral cavity is also important: removal of dental plaque, treatment of caries and its complications.

Pyoderma
Treatment of pyoderma in children
Pyoderma is streptostaphylococcal lesions of the oral mucosa, lips (cracks), and skin of the perioral area. Occurs in weakened children with low immunity, as well as in children who do not receive balanced nutrition. Children suffering from pyoderma are extremely susceptible to diabetes mellitus, which creates a good breeding ground for bacteria. Provoking factors are: hypothermia, overwork, overheating of the body, systemic diseases other organs.
With pyoderma, body temperature can rise to 38-39 degrees. C, lymphadenitis is observed. Blisters-pustules form on the surface of the mucous membrane, the surface around which is hyperemic, and with rashes on the skin, purulent pustules and crusts appear. If left untreated, the infection can easily spread to other parts of the body (eyes, hands, etc.).
Treatment of pyoderma is determined by the nature of the pathogen. Therefore it is necessary to carry out bacteriological culture to determine the causative agent of infection and its sensitivity to certain antibacterial drugs, and only after that the doctor can prescribe adequate treatment. Self-medication without tests can only blur the picture without destroying the causative agent of the infection.

Catarrhal stomatitis in children
Lesions of the oral mucosa caused by taking medications. When taking many medications (antibiotics, serums, vaccines, sulfonamides, novocaine, iodine, phenol, etc.), lesions of the oral mucosa may occur, which can be combined common name « catarrhal stomatitis».
This same group of diseases of the oral mucosa in children also includes an allergic reaction to medications. The mucous membrane is hyperemic, edematous, covered with multiple blisters, after opening of which erosions may remain. The tongue and lips are also swollen. At the same time, the child may experience hives, muscle and joint pain, dyspepsia, and even anaphylactic shock.
Treatment is aimed primarily at identifying the cause of stomatitis. If taking, for example, antibiotics is necessary in the future, it must be combined with antifungal treatment and with antihistamines. Rinses, painkillers, and ointments are used locally to promote healing and epithelization of the mucosa.

Diseases of traumatic origin

IN special group It is necessary to highlight diseases of the oral mucosa in children of traumatic origin. The mucous membrane, due to its physiological characteristics, has a high regenerative ability. However, if it is mechanically damaged, dangerous pathogens can easily enter the wound, which will lead to its inflammation. A child can get injuries to the oral mucosa when brushing teeth, eating solid food, or during dental procedures. This may be trauma from sharp damaged teeth or orthodontic devices in the oral cavity. The child may bite his tongue, lips, or cheek. If you carelessly wipe the mouth of a newborn, you can cause injury, which causes so-called neonatal aphthae.
Treatment traumatic injuries treatment of the oral mucosa begins with eliminating the causes of injury. Then antiseptics that relieve inflammation and agents that promote healing (oils, solcoseryl gel, etc.) are prescribed locally.
In case of chemical damage to the oral mucosa in a child (accidental ingestion of potent chemical substances) the child's mouth must be rinsed immediately big amount water and a neutralizing solution (for example, alkaline for acid burns). In the future, painkillers, antidotes, and agents that stimulate epithelialization are used. The nature of diseases of the oral mucosa in children is largely determined by the age-related characteristics of the structure of the mucosa.

Thrush (acute candidiasis)
In infancy, the epithelium of the oral mucosa is very thin, so a fungal infection, when salivary immunity decreases, very easily attaches to the surface of the mucosa. Symptoms of thrush
At the first stage of the disease, red spots appear. They can be found on the tongue, mucous membrane of the cheeks, lips and gums. After a few days, white cheesy rashes appear in place of the red areas. They look like the remains of cottage cheese or kefir in a child's mouth.
The white plaque is difficult to separate, and the wounds that are opened begin to bleed and bacteria from the oral cavity enter them, which can lead to various complications. Thrush in the mouth is painful. Because of this, children refuse to eat, cannot swallow saliva, and become restless. If you discover a manifestation of the disease, you should consult a doctor and only then begin treatment for oral thrush in children.
In severe cases of the disease, the temperature rises, the baby becomes lethargic, and symptoms of intestinal diseases appear.
Treatment depends on the extent of the disease. It is necessary to treat the baby's cavity regularly. Even if there are visible improvements, it is necessary to continue treatment according to the doctor’s prescription. Since this is a fungal disease, it can appear again and again. Treatment of thrush in children continues until the infection disappears completely, as evidenced by repeated laboratory tests.
If thrush is found in the mother, then the child will definitely have it too.

Prevention of thrush
Follow the rules of hygiene for children: bathe your baby regularly, boil pacifiers, bottles, toys. Strengthen your child's immunity with walks in the fresh air, vitamins from fresh vegetables and fruits, therapeutic massage and, of course, love your baby, give him enough time and attention, and then he will grow up healthy.

The nature of diseases of the oral mucosa in children is largely determined by the age-related characteristics of the structure of the mucous membrane.

Thrush (acute candidiasis)

In infancy, the epithelium of the oral mucosa is very thin, so a fungal infection, when salivary immunity decreases, very easily attaches to the surface of the mucosa. Therefore, acute candidiasis (thrush) is very common in newborns.

Stomatitis in children

Stomatitis in children: chronic recurrent aphthous

Chronic recurrent aphthous stomatitis(HRAS) is one of the most common diseases that can be classified as infectious-allergic. HRAS is characterized by periods of remission and exacerbation and manifests itself in the form of aphthae - superficial painful defects of the mucous membrane. Aphthae have a round or oval shape, are covered with a fibrinous coating, and red hyperemic rims are visible around the afta. The appearance of aphthae is not preceded by the formation of blisters. HRAS can occur in a mild form (1-2 aphthae) and in a severe form, when recurrent deep scarring aphthae are formed, the period of epithelization of which lasts up to 2-3 weeks. At the same time, relapses of the disease are very frequent (can occur monthly).

Treatment regimen includes a diet with the exclusion of irritating foods, the prescription of immunocorrectors and immunomodulators (after consultation with an immunologist), vitamins B and C, and desensitizing therapy. Locally treat the child's oral cavity with antiseptic solutions, use applications of proteolytic enzymes (trypsin, chymotrypsin), lubricate with oil solutions of vitamin A, sea buckthorn, and rose hips.

Stomatitis in children: acute herpetic stomatitis

Much more dangerous and, unfortunately, widespread is another form of stomatitis - acute herpetic stomatitis. According to the World Health Organization, diseases caused by the herpes simplex virus rank second in the world after viral influenza. General morbidity herpes infection ranges from 50 to 100%, so herpes infections are considered socially significant diseases. Infection of children with the herpes simplex virus is 60% under the age of 5 years, and 90% by the age of 15 years. This statement is also true for dentistry. In addition, acute herpetic stomatitis in children with reduced immunity is highly contagious, that is, very contagious. The disease spreads through airborne droplets and household contact. The older the child, the lower the likelihood of acquiring an acute form of herpetic stomatitis due to acquired immunity.

The disease occurs in mild, moderate and severe forms. The incubation period is up to 17 days (in newborns - up to 3 days). A child with acute herpetic stomatitis may have a fever (up to 37-39o C, depending on the severity of the disease). The mucous membrane of the oral cavity is hyperemic, then single or grouped lesions appear. In more severe forms, rashes can appear both in the oral cavity and on the skin in the perioral area. The disease is accompanied by symptoms of catarrhal gingivitis (inflammation and bleeding of the gums). Changes in the blood appear in moderate and severe forms of the disease (ESR up to 20 mmh, leukocytosis, lymphocytosis).

The most reliable diagnostic method herpes infection is a method of polymerase chain reaction (PCR diagnostics). The material for research is smears and scrapings from the oral mucosa.

Stomatitis in children: acute herpetic stomatitis, treatment

The treatment is complex. First of all, it is necessary to provide the child with adequate nutrition, however, eliminating all traumatic factors from the food (food should not be hard, spicy, salty, hot, etc.). It is important to ensure you drink plenty of fluids. Before each feeding of the child, his mucous membrane must be anesthetized (2-5% oil solution of anesthesin or lidochlor gel). Antiviral therapy involves taking special antiviral drugs (as prescribed by a doctor). These include: interferon, ointments “Bonafton”, “Tebrofen”, “Oxolin”, drugs “Acyclovir”, “Alpizarin”, “Panavir”, etc.

For epithelization of affected areas, ointments based on proteolytic enzymes of animal origin (trypsin and chymotrypsin), as well as oil solutions of vitamin A, carotoline, Vitaon oil, rosehip oil, and Solcoseryl dental paste are used. Recent studies have shown the high effectiveness of the Super Lysine drug +" (ointment, tablets, USA) and laser therapy. The drug "Super Lysine +" accelerates the healing of herpetic ulcers, the rate of epithelization, the cleansing of ulcers from fibrin plaque, and has a high analgesic effect.

Antiviral drugs must be combined with immunomodulators (imudon, lykopid, immunal, etc. - as prescribed by a doctor).

To prevent relapses, it is necessary to strengthen the child’s immunity naturally: hardening, swimming, good nutrition, etc. Thorough sanitation of the oral cavity is also important: removal of dental plaque, treatment of caries and its complications, periodontitis in order to remove all foci of infection.

Pyoderma in children

Pyoderma- these are streptostaphylococcal lesions of the mucous membrane of the oral cavity, lips (cracks), and skin of the perioral area. They are found in weakened children, with low immunity, as well as in children who do not receive a balanced diet. Children with diabetes are extremely susceptible to pyoderma, which creates a good breeding ground for bacteria. Provoking factors are: hypothermia, fatigue, overheating of the body, systemic diseases of other organs.

Taking medications and damage to the oral mucosa

Lesions of the oral mucosa caused by taking medications. When taking many medications, lesions of the oral mucosa can occur, which can be combined under the general name “catarrhal stomatitis.” This same group of diseases of the oral mucosa in children also includes an allergic reaction to medications.

Diseases of the oral mucosa of traumatic origin

A special group includes diseases of the oral mucosa in children of traumatic origin. At mechanical damage of the mucous membrane, dangerous pathogens can easily enter the wound, which will lead to its inflammation. A child can get injuries to the oral mucosa when brushing teeth, eating solid food, during dental procedures, etc. Rubbing the mouth carelessly can cause injury to a newborn, causing so-called neonatal aphthae.

Treatment of pyoderma is determined the nature of the pathogen. Therefore, it is necessary to carry out bacteriological culture to determine the causative agent of the infection and its sensitivity to certain antibacterial drugs, and only after this the doctor can prescribe adequate treatment. Self-medication without tests can only blur the picture without destroying the causative agent of the infection.

Catarrhal stomatitis in children

Lesions of the oral mucosa caused by taking medications. When taking many medications (antibiotics, serums, vaccines, sulfonamides, novocaine, iodine, phenol, etc.), lesions of the oral mucosa may occur, which can be combined under the general name “ catarrhal stomatitis."

This same group of diseases of the oral mucosa in children also includes an allergic reaction to medications. The mucous membrane is hyperemic, edematous, covered with multiple blisters, after opening of which erosions may remain. The tongue and lips are also swollen. At the same time, the child may experience hives, muscle and joint pain, dyspepsia, and even anaphylactic shock.

Treatment is aimed primarily at identifying the cause of stomatitis. If taking, for example, antibiotics is necessary in the future, it must be combined with antifungal treatment and antihistamines. Rinses, painkillers, and ointments are used locally to promote healing and epithelization of the mucosa.

Diseases of traumatic origin

Diseases of the oral mucosa in children should be included in a special group. Tratic origin. The mucous membrane, due to its physiological characteristics, has a high regenerative ability. However, if it is mechanically damaged, dangerous pathogens can easily enter the wound, which will lead to its inflammation. A child can get injuries to the oral mucosa when brushing teeth, eating solid food, or during dental procedures. This may be trauma from sharp damaged teeth or orthodontic devices in the oral cavity. The child may bite his tongue, lips, or cheek. A newborn, if he carelessly wipes his mouth, can cause injury, which causes so-called aphthae of newborns.

Treatment of traumatic lesions of the oral mucosa begin with eliminating the causes of injury. Then antiseptics that relieve inflammation and agents that promote healing (oils, solcoseryl gel, etc.) are prescribed locally.

In case of chemical damage to the child’s oral mucosa (accidental exposure of strong chemicals to the mouth), it is necessary to immediately rinse the child’s mouth with plenty of water and a neutralizing solution (for example, alkaline for an acid burn). In the future, painkillers, antidotes, and agents that stimulate epithelialization are used.

Oral diseases in children are associated with pathological processes, occurring in internal organs, weakening of the immune system, adverse effects of external factors. The causes are dental pathologies, lack of oral hygiene, unsystematic use of medications, trauma to the mucous membrane due to eating spicy or too hot food, and dehydration.

The disease can also be triggered by hormonal disorders, deficiency of vitamins and minerals, infections of the ENT organs (whooping cough, scarlet fever, influenza, whooping cough, sinusitis), various viruses, and fungi.

Types of inflammation of the oral mucosa in children

Oral diseases, depending on the reasons that caused their development, are divided into:

1. infectious;
2. viral or bacterial;
3. traumatic;
4. allergic;
5. fungal;
6. caused by concomitant diseases Gastrointestinal tract, ENT organs, cardiovascular and endocrine systems;
7. hereditary.

Stomatitis

Stomatitis of the oral mucosa is common in children. The disease is accompanied by redness of the oral cavity, a whitish coating on the tongue, the inner surface of the cheeks, gums, unpleasant smell from the mouth, increased temperature. The child experiences pain and discomfort, refuses to eat, and becomes capricious and whiny.

General symptoms of diseases:

• bleeding ulcers yellowish white on the mucous tissues of the tongue, lips, cheeks, gums;
• swelling and bleeding of the gums;
• increased secretion of salivary fluid;
• dry tongue;
• enlarged The lymph nodes on the neck;
• painful sensations;
• loss of appetite;
• moodiness and tearfulness.

To relieve the inflammatory process and disinfect the affected areas, you need to rinse your mouth with antiseptic agents - a warm decoction of chamomile or sage, a solution of furatsilin, soda or hydrogen peroxide.

Herpetic stomatitis

The most common type of stomatitis is caused by the herpes virus. Acute form Herpetic stomatitis is a contagious disease. Children from 6 months to 3 years are especially susceptible to the disease. weak immunity. With age protective functions the body is strengthened and the likelihood of infection is reduced.

Symptoms of the disease in acute form:

1. body temperature often rises to 41ºС;
2. signs of general malaise - impotence, fatigue, headaches, pallor, increased painful sensitivity muscles and skin;
3. lack of appetite;
4. nausea and vomiting;
5. swollen lymph nodes under the jaw and in the neck;
6. severe swelling and redness of the mucous tissues in the oral cavity;
7. a large number of sores on inside lips, cheeks, gums and tongue;
8. in moderate and severe forms of the disease, the rash affects the external skin around the mouth earlobes and eyelids;
9. increased salivation;
10. bad breath;
11. bleeding gums;
12. dry and cracked lips;
13. in rare cases - nose bleed due to a blood clotting disorder caused by herpesvirus.

For treatment, drug and local therapy are prescribed. Recommended medications to improve immunity (gamma globulin injections, Lysozyme, Prodigiosan, herpetic immunoglobulin, etc.); means of general therapy - Diphenhydramine, Suprastin, Pipolfen, calcium gluconate, etc.

Local therapy for the disease consists of treating the oral cavity with agents that relieve painful sensations, preventing the spread of rashes, stimulating the processes of regeneration of damaged tissues.

Prescribed to destroy viruses various ointments(Oxolinic, Florenal, Heliomycin, Interferon, etc.). For antiseptic treatment, solutions of furatsilin, Etonium, Ethacridine, rosehip oil, Karatolin, Solcoseryl are used.

All dishes for feeding a child should be liquid or porridge-like (soups, broths, purees). To relieve intoxication, drinking plenty of fluids is recommended. Before eating, the oral cavity must be treated with an anesthetic (5% anesthetic emulsion), and after eating, rinse the mouth.

Aphthous stomatitis

Aphthous stomatitis can be of an allergic or infectious nature, alternating between periods of remission and exacerbation. The first symptoms of the disease are fever (+39… +40ºС), restlessness and moodiness of the child, lethargy, dry mouth.

Gradually, the oral mucosa swells, turns red, and hyperemia of the mucous tissues increases. Aphthae appear on days 3-4 in the form of round or oval erosive formations ranging in size from 1 to 5 mm with a yellow or gray coating, surrounded by a red rim. They affect the tongue, lips, cheeks, and can be single or multiple. The disease is accompanied by pain in the mouth, migraine, loss of appetite, bowel dysfunction, and swollen lymph nodes. The duration of the disease is 2-3 weeks.

Candidal stomatitis

Candidal stomatitis is an inflammation of the oral mucosa caused by Candida fungi. The disease begins with redness and swelling of the tongue, then a white cheesy coating appears on the mucous surface of the cheeks and lips. Under the plaque, ulcers and erosions form, which bleed and hurt.

The cause is a weakened immune system, and the development of the disease and the spread of fungi is provoked by the milk feeding of infants. For treatment, immunomodulatory drugs are prescribed, and the mouth is regularly treated soda solution. Good for removing Candida fungi 2% solution boric acid, which is used to treat the oral mucosa 3 times a day.

Gingivitis or gingivostomatitis

Gingivitis is a disease associated with inflammatory processes occurring in the gums. It is a consequence of dental damage (caries, plaque or tartar). Often factors that provoke gingivitis may be vitamin deficiency, weakened immunity, hormonal imbalance, infections (herpes).

The disease is accompanied by pain that intensifies during eating and brushing teeth. The gums turn red, swell, become loose and bleeding. If the nature of the disease is infectious, then ulcerative or erosive formations may appear on the gums. Characteristic signs– bad breath, copious discharge salivary secretion. Without proper treatment, the disease can be complicated by the development of periodontitis and tooth loss.

To prevent the disease, it is necessary to carefully care for the oral cavity (teeth, gums) - regular hygiene, timely removal of tartar. For treatment, mouth irrigation is prescribed with infusions of medicinal herbs - chamomile, sage, plantain. In order to exclude various pathologies internal organs, you should be examined by a pediatrician.

Thrush in children

Thrush is caused by the pathogenic proliferation of fungi of the genus Candida, caused by weakened immunity due to various diseases, dysbacteriosis due to long-term use of antibiotics. The disease most often occurs in infants and children under 1 year of age. The pathology appears in the form of a white cheesy coating in the mouth and throat.

A baby can become infected with a fungus during childbirth if the mother has vaginal candidiasis or due to poor hygiene during subsequent care, if the intestinal microflora is disrupted, which is often found in babies in the first six months of life.

Treatment of the disease consists of treating the oral cavity with a solution baking soda. If thrush is antibacterial in nature, Nystatin or Levorin is prescribed. To increase the level of immunity and normalize the intestinal flora, the child is prescribed a nutritious diet with high content vitamins (groups B, C, A, nicotinic acid).

Treatment and causes of cheilitis in children

Cheilitis is an inflammation of the lips caused by infection of a wound on the lips resulting from injury (cut, burn, mechanical damage from an impact, fall, etc.). Also, the causative agents of the pathology can be herpes viruses, erysipelas or eczema. Oral disease can also be caused by vitamin B2 deficiency.

The disease is accompanied by swelling of the lip and impaired mobility; the mucous membrane of the oral cavity becomes red and painfully sensitive. Sometimes symptoms appear general intoxication– weakness, headaches and muscle pain.

Zaeda or angular cheilitis is a subtype of cheilitis. The causative agents of the disease are streptococci or fungi. When caught, the corners of the mouth are affected by small but painful erosions, which crack and bleed when the mouth is opened, then become covered with crusts.

Antibiotics are prescribed to eliminate the infection. If an abscess forms, it must be opened and treated antiseptic. In case of inflammation of the labial glands, opening, drainage and cleaning of the infected areas are also indicated.

To treat a fungal infection, nystatin ointment is used, and a viral infection is treated with synthomycin emulsion or penicillin ointment. Vitamin B2 deficiency can be compensated for by consuming riboflavin. It is necessary to regularly clean the mouth, dishes and children's toys, and use individual hygiene products (towel, washcloth, toothbrush, dishes).

Traumatic lesions of the oral mucosa

Traumatic stomatitis can be caused by various one-time injuries or constant mechanical irritation of the oral mucosa. In children, injuries occur due to toys, when falling or biting the tongue or cheek, due to wearing braces; In infants, gum damage may be caused by tooth growth. As a result, pustules, abscesses, ulcers or erosions form at the site of violation of the integrity of the mucous membrane. If it doesn't hit the wound external infection, it heals quickly without side effects.

Treatment consists of eliminating the cause of the injury (the tooth fragment is removed or ground, tartar is removed, incorrect braces or dentures are corrected); wounds are treated with an antiseptic. If infection is present, anti-inflammatory drugs are additionally prescribed.

Glossitis or inflammation of the tongue

Glossitis is inflammatory lesion tongue, expressed in peeling of the skin layer and the formation of a whitish thickening in the form of a narrow strip. The affected surfaces are in the form of rings or semi-rings of a light red hue, sometimes merging into more large spots. This condition is called “geographical” tongue due to the loss of uniformity of the surface of the organ and its resemblance to a geographical map. There are no other signs in the form of pain or discomfort, redness or swelling; in rare cases, a slight burning sensation of the tongue is felt.

The causes of the disease are unknown, treatment is not prescribed. It is recommended to rinse the mouth with soda solution or Citral.

Other types of diseases

There are many diseases of the oral cavity, the most common of which are discussed above. Also described in medicine are such pathologies of the oral mucosa as infectious mononucleosis and viral warts.

Infectious mononucleosis is a viral disease. It manifests itself as enlargement (to the size of a walnut) and soreness of the lymph nodes in the neck and under the jaw, the development of sore throat, stomatitis and changes in blood composition.

Infection occurs through the pharynx or nasopharynx and quickly spreads throughout lymphatic system and blood. The disease is accompanied by fever, headaches, drowsiness, lethargy and fatigue, nausea and vomiting. In young children, an increase in the size of the liver and spleen may be observed. The analysis shows an increase in leukocytes, lymphocytes and monocytes; atypical mononuclear cells also appear in the blood (15-30%).

Treatment of mononucleosis is aimed at relieving symptoms - prescribing painkillers and antipyretics, NSAIDs, vitamin and mineral complexes to boost immunity. As local therapy diseases, it is recommended to rinse the oral cavity with a solution of furatsilin. The patient is prescribed bed rest, isolation, high-calorie diet and plenty of fluids.

Viral warts in the oral cavity are neoplasms of benign etiology. There are flat and pointed ones. Most often they strike inner corners mouth and sides of the tongue, and less commonly may appear on the gums, lips, or outside of the mouth. In most cases, they accompany warts on the hands or genitals.

Treatment viral warts carried out with Oxolinic ointment (3%), Bonafton (0.5%), Florenal (0.5%) and others antiviral ointments. Before applying the product, it is necessary to thoroughly rinse the mouth and brush the teeth.

Prevention of oral diseases

In order to avoid the development of various diseases of the oral cavity, a child should be taught from early childhood to follow the rules of care and hygiene - regularly brush his teeth, limit the consumption of sweets. Subsequently, children can be taught to use dental floss and rinse after each meal.

It is necessary to regularly, at least 2 times a year, visit the dentist with your child, treat caries in a timely manner, remove plaque and stones. Children's immunity should be strengthened by hardening, physical exercise, swimming.

The child needs to be provided with adequate nutrition, rich in various vitamins and minerals. In winter, as prescribed by the pediatrician, the baby should be given various vitamins. It is important to remember that it is always easier to prevent the development of a disease than to treat its consequences.

The tooth consists mainly of hard tissues (dentin, enamel, cement) and is located in the alveoli of the jaws. Dental development begins in the embryonic period and ends at 18-20 years of age. The formation and formation of baby teeth in humans begins at the 6-8th week of embryonic life.

Teething

A CT is physiological and cannot cause any diseases. Signs of correct eruption are the paired eruption of symmetrical teeth in a certain sequence - first on the lower jaw, then on the upper jaw. Teething is an indicator proper development child.

In the second half of the 1st year of life, the child’s teeth erupt and he gradually learns to chew.

A child is born, as a rule, without teeth; cases of intrauterine eruption are rare. Teething begins with the formation of dense protrusions on the gum of the lower jaw, the so-called mounds, corresponding in size and shape to the future crowns of baby teeth. At 6-8 months of a child’s life, the cutting edges of two central incisors appear on the surface of the gums: first the lower incisor, then the upper. Next, the lateral incisors of the lower jaw erupt, followed by the lateral incisors upper jaw. Thus, by the beginning of the 2nd year of life, the child should have 8 teeth. After a short break of 2-3 months, the first primary molars erupt, followed by the canines and lastly the second primary molars. By the age of 2-3 years, the eruption of all 20 baby teeth ends, which are indicated by a formula using Roman numerals:

V IV III II I I II III IV V
V IV III II I I II III IV V

Timing of baby teeth eruption

I incisor - 6-8th month

II incisor - 8-12th month

III incisor - 16-20th month

IV first molar - 12-16th month

V second molar - 20-30th month.

Frequently ill children may experience so-called difficult teething, accompanied by general malaise, anxiety, insomnia, a short-term increase in body temperature, the appearance of mild dyspeptic symptoms, delayed weight gain, and increased or onset of skin rashes.

The teeth are arranged so that their crowns form an arch, or row, on the upper and lower jaws. The relationship between the dentition of the upper and lower jaws with the most complete closure of the antagonist teeth is called “bite”. There are primary (temporary), removable and permanent bites. After 6 years the shift begins milk bite permanent. This is preceded by the growth of primordia permanent teeth and physiological resorption (resorption) of the roots of baby teeth, which look shortened and eaten away.

Period of resorption of the roots of baby teeth

Following the loss baby tooth eruption of the permanent tooth begins, part of the cutting edge or the cusps of the crown of which are visible after the loss of a baby tooth (Table 28).

Table 28. Timing of eruption of permanent teeth

Anomalies of the dental system manifest themselves in the form of disturbances in the development of teeth, dentition or jaws.

Anomalies in the number of teeth: primary adentia - absence of teeth, can be complete or partial; observed in both primary and permanent dentition. Secondary adentia occurs after tooth extraction.

Tooth retention- delayed eruption of a fully formed tooth, the position in the jaw is revealed by x-ray.

Supernumerary teeth- teeth located outside the dentition, and sometimes in the dentition, without disturbing its shape.

Anomalies in the shape and size of tooth crowns- increase in the size of all teeth in the arch (“gigantism”). The presence of small crowns of teeth leads to large gaps between teeth. The gap between the central incisors is called diastema.

Anomalies in the position of individual teeth: distinguish between palatal, lingual, vestibular, distal position, rotation of teeth, etc.

Anomalies in the development of hard dental tissues manifest as hypoplasia.

Enamel hypoplasia- a malformation of enamel, manifested in the form of chalky spots, pits, grooves without compromising the integrity of the enamel.

The presence of enamel hypoplasia indicates that during the period of tooth formation, the metabolism in the growing body was sharply disrupted.

The development of hypoplasia of milk teeth refers to the uterine and neonatal periods, and of permanent teeth - to early childhood. Hypoplasia occurs after childhood rickets, severe infectious diseases, dyspepsia, insufficiency endocrine glands. The severity of hypoplasia depends on the severity of the disease suffered by the child. With weakly expressed substance disorders, only chalky spots can form on the entire shiny surface of the enamel.

Enamel hypoplasia is divided into systemic(symmetrically located white spots on the teeth of the same name) and local(changes in the enamel of 1-2 permanent teeth). One type of systemic hypoplasia is “tetracycline” teeth. These are teeth that have a changed color as a result of taking tetracycline during the formation and mineralization of dental tissues. Taking tetracycline by a pregnant woman leads to staining of the incisors of a child's baby teeth, and administration of tetracycline drugs to children aged 6 months to 12 years leads to staining of permanent teeth. With age, the color changes, but does not disappear completely.

Fluorosis- disease associated with fluoride intoxication; occurs as a result of increased fluoride content in drinking water. This disease is endemic. The permanent teeth of children living in areas of endemic fluorosis or who settled there at the age of 3-4 years are more often affected. The maximum permissible concentration of fluorine in drinking water is 1 mg/l. Treatment and prevention of fluorosis are carried out by a dentist.

Malocclusions- violation of the relationship of the jaws in the sagittal, vertical or transversal direction. Anomalies are reflected in appearance child, are accompanied by dysfunction of chewing, swallowing, speech, and breathing. Anomalies can be congenital or acquired. Progenic bite - The teeth of the lower jaw are located in front of the corresponding teeth of the upper jaw due to the displacement of the lower jaw or its larger size compared to the upper jaw. Open bite - when closing teeth between separate groups There is no contact between the teeth of the upper and lower jaws. Prognathic bite - The incisors and canines of the upper jaw are located in front of the corresponding teeth of the lower jaw.

Causes of malocclusion: hereditary predisposition, endocrine disorders, disorder intrauterine development jaws, improper artificial feeding, bad habits (sucking fingers, lower lip), etc.

Treatment. The treatment is carried out by an orthodontist.

Prophylactic A. When artificial feeding, it is necessary to provide conditions for active sucking (use of an elastic nipple, shaped like a breast nipple, with a small hole). A pacifier is given to the child after feeding, if satiety with food has occurred and the sucking reflex has not subsided.

At 4-8 months, it is necessary to organize proper complementary feeding, eliminating the formation of bad habits.

At 7-8 months, the consistency of food consumed is changed; It is necessary to include pureed and porridge-like foods with a thick consistency in the diet; teach eating with a spoon, at night you can feed through a pacifier.

By the end of the first year, you need to teach your child to chew food correctly with his mouth closed. After one year, the child should be fed only with a spoon and watered from a cup; completely eliminate pacifiers and pacifiers.

If, when the jaws are closed, the teeth of the lower row are located behind the teeth of the upper jaw, the baby’s head should be placed on a higher pillow while sleeping. If the lower jaw protrudes above the upper jaw, then during sleep the child’s head should be placed on a flatter pillow. Eliminate the habit of sleeping with your head on the handle.

Viral diseases of the oral mucosa

Viral diseases today- the most frequent illnesses person. They can occur acutely, chronically and latently. Many viral infections manifest clinically in the oral cavity. The most common viral disease is common herpes. Diseases of the oral mucosa caused by various viruses (common herpes viruses, chickenpox, herpes zoster, Coxsackie A, foot and mouth disease), have similar clinical manifestations. The main morphological element of damage to the oral mucosa is a vesicle, which turns into erosion - aphtha.

Clinical picture. Viral hemorrhagic fevers manifest themselves in the oral cavity in the form of a “flaming” pharynx, catarrhal gingivitis, enanthema on soft palate, hyperemia of the lips, seizures, hemorrhagic rashes. Changes in the pharynx and soft palate are also observed in many other viral infections: influenza, parainfluenza, rhinovirus and adenoviral diseases, rubella. Specific changes occur in the oral mucosa during measles and scarlet fever. Clinically, herpetic infection in the oral cavity manifests itself in two forms: primary herpetic infection - acute herpetic stomatitis (primary herpes) and chronic recurrent herpes (recurrent herpetic stomatitis).

Gingivitis

Inflammation of the gums, caused by the adverse effects of local and general factors and occurring without compromising the integrity of the dentogingival junction. Gingivitis can appear as an independent disease or be a symptom of other diseases. According to clinical manifestation, gingivitis is divided into acute and chronic.

Clinical picture. Acute gingivitis is characterized by swelling, hyperemia of the gums, bleeding, and sometimes ulceration. In chronic gingivitis, inflammation of a productive nature predominates, when the gum becomes hyperplastic and partially or completely covers the crown of the tooth. Gingivitis is very common among schoolchildren as a result of unhygienic maintenance of the oral cavity, many untreated carious teeth. Gingivitis is common in children suffering from general diseases: rheumatism, tuberculosis, diabetes mellitus, hepatocholecystitis, nephropathies, etc.

Treatment. The basis of treatment is to eliminate the causes that provoked the development of gingivitis. For blood diseases and diseases of the gastrointestinal tract, treatment of gingivitis comes down to sanitation of the oral cavity. You should protect your gums from injury. The teeth are treated conservatively: wipe with swabs soaked in hydrogen peroxide, rinse the mouth with solutions of furatsilin and lysozyme. In case of increased bleeding, the gums are treated with a 5% solution of potassium permanganate. In case of diabetes, curettage of periodontal pockets is carried out only under anesthesia in combination with novocaine blockade. Add 1 ml of 5% vitamin B1 solution to the novocaine solution. The course of treatment consists of 20 blockades. Chronic gingivitis, in addition to traditional sanitation, is treated by injecting a 40% glucose solution into the apex of the papilla - 0.1-0.2 ml 3 to 8 times into each papilla with a break of 1-2 days. Corticosteroids are used in the form of ointments or injections into the papillae - 0.1-0.2 ml of hydrocortisone.

Fungal diseases of the oral mucosa

Etiology. The disease is caused yeast-like mushrooms candida, which are normally saprophytes of the oral cavity and are found in 40% healthy people. When the reactivity of the child’s body decreases, especially in early age, these fungi acquire pathogenic properties.

Clinical picture. Candidiasis develops - thrush. It occurs in mild, moderate and severe forms. The disease begins asymptomatically. Later, children become restless, sleep poorly, and suck the breast sluggishly. Older children complain of an unpleasant taste in the mouth, a burning sensation, and then pain appears when eating, especially spicy and hot food. Regional submandibular and mental lymph nodes may be slightly enlarged and painful. Body temperature is within normal limits or low-grade. When examined, groups of pearly white spots ranging in size from fractions of a millimeter to 1-1.5 mm are found on the unchanged or hyperemic mucous membrane of the tongue, lips, cheeks, and palate. round shape, having the appearance of semolina. As the fungus multiplies, the affected areas slowly increase in size; merging with each other to form white film, rising above the level of the mucous membrane and resembling curdled milk. Sometimes the plaque is coarser, curdled, crumbly or foamy, and cracks (jams) form in the corner of the mouth.

Treatment. It is important to create an alkaline reaction in the oral fluid, which prevents the growth of the fungus. After each feeding of the child, the oral cavity should be washed with a 1-2% solution of baking soda or boric acid. A suspension of nystatin (1 tablet - 500,000 units) in 5 ml of breast milk is also successfully used. In addition, older children are prescribed rinsing with iodine water 5-6 times a day (5-10 drops of iodine tincture in half a glass of water) and lubricate the affected areas with 0.5-1% alcohol solution aniline dyes, and also use antifungal antibiotics.

Dental caries

A pathological process that occurs after teething, during which demineralization and softening of the hard tissues of the tooth occur, followed by the formation of a defect in the form of a cavity. The first signs of damage may appear during the eruption of primary and permanent teeth. With age, dental caries increases. Caries of primary teeth is found in children aged 2-3 years, the greatest damage is observed at 6 years, permanent teeth - during puberty.

The number of carious teeth in one child, as well as the number of carious cavities in one tooth, varies and determines the degree of caries activity. With a compensated course of caries, a 10-12 year old child in the oral cavity has no more than 4 teeth affected by caries, with subcompensated - up to 8-9 teeth. The decompensated form of caries is characterized not only by a large number of affected teeth (more than half of the teeth), but also a large number carious cavities. Children have many decayed teeth, devoid of pulp. When treating such teeth, it is difficult to achieve good fixation of fillings; the teeth do not maintain optimal physical activity, quickly collapse (crumple).

Pathogenesis. Factors contributing to the development of caries in younger age, are disturbances in the structure of dental tissues that arose during embryogenesis, in the antenatal period, under the influence extragenital diseases mother.

Dental caries- it's long lasting chronic process, which is the focus and source of infection and allergization of the child’s body, since with food the child constantly swallows a large number of microorganisms and decomposition products of tooth tissue and food that lingers in the carious cavity. In addition, these same microorganisms, their toxins and waste products are absorbed into the blood through the mucous membrane of the mouth and at the points of contact between the tooth and the jaw. Such constant infection of the body and its sensitization contribute to the development of chronic tonsillitis, rheumatism, kidney diseases, joint diseases, gastrointestinal tract and weakened vision in children.

Prevention. Caries prevention should begin in the prenatal period and continue throughout life. A pregnant woman's diet should include a wide range of proteins (primarily plant origin), carbohydrates, fats (milk, cheese, butter). The most valuable nutrition for a newborn is breast milk, as it contains the optimal set of essential nutrients. During lactation, nursing mothers have a need for mineral salts, microelements, and vitamins. This need can be met by consuming cottage cheese, cheese, milk (at least 500 g per day), eggs (1-2 pcs.), vegetables (fresh cucumbers, carrots, radishes, etc. in an amount of at least 800 g per day). It is advisable to include fruits, berries, fresh herbs (sorrel, lettuce, etc.) in the diet of nursing mothers. It is better to eat bread made from wholemeal flour. Fluid intake should be limited to 2 liters per day.

IN daily ration a child aged 1-3 years should include milk (at least 700 g), cottage cheese (35-40 g), vegetables (at least 150 g, in addition to potatoes), and fruits (at least 100 g). The amount of sugar should not exceed 60 g, and sweets - no more than 100 g per day. Sometimes, even if all these conditions are met, children with multiple dental caries occur. In these cases, it is necessary to identify the presence of factors contributing to its development: past infectious and other serious illnesses, impaired metabolism or impaired absorption and assimilation of certain nutrients, which is often observed in disorders of the gastrointestinal tract. In every special case Appropriate measures should be taken aimed at treating existing diseases, rationalizing nutrition, additionally introducing calcium and phosphorus into the body in the form of calcium gluconate, calcium glycerophosphate with fish oil, vitamins BI, D, E, if they enter the body in insufficient quantities. Additional administration of vitamin BI reduces the incidence of dental caries. Vitamin BI is prescribed 2 times a day in doses containing as many milligrams per dose as the child is old, but not more than 10 mg per dose.

Limiting carbohydrates in the diet of both infants and older children and replacing sugar with non-cariogenic products (sorbitol, xylitol) in infant formula and confectionery- promising directions in the prevention of caries in children of preschool and school age. The most common method of preventing dental caries currently is artificial fluoridation. drinking water(up to a concentration of 1 mg/l), which ensures a reduction in the incidence of caries by 30-50%. IN preschool institutions and schools practice rinsing the mouth with a sodium fluoride solution, as well as ingesting fluoride tablets and a fluoride solution with vitamins (vitaftor) as prescribed by the dentist. Fluorine-containing varnishes and gels are also used to coat tooth enamel. Fluoride-containing toothpastes “Ftorodent”, “Cheburashka”, “Signal”, “Lockout”, etc. have proven themselves well.

Treatment. Performed by a dentist. In organized groups of children, oral sanitation is carried out for children with a compensated form of caries once a year, with a subcompensated form - twice a year, and with a decompensated form - three times a year.

Periodontal disease

Periodontium refers to the complex of tissues surrounding the tooth and closely related to each other genetically, morphologically, and functionally. This morphofunctional complex includes the gum, bone tissue alveoli, periodontium and tooth tissue.

Periodontal disease- inflammation of periodontal tissues, characterized by progressive destruction of the periodontium and bone of the alveolar processes of the jaws. Periodontal disease is a dystrophic lesion of the periodontium. Inflammatory diseases periodontal disease occurs in children over 10 years of age and does not exceed 20 % from all inflammatory diseases.

Allergic stomatitis

Exudative erythema multiforme. This is a recurrent disease that occurs with damage to the mucous membrane of the mouth and skin.

Etiology and pathogenesis. The etiology is unclear. In the pathogenesis, various intoxications play an important role, as well as the action of a number of unfavorable factors: biological, physical, chemical, which are allergens for the body.

Clinical picture. The disease often begins acutely, with a rise in body temperature to 38 C, and is accompanied by severe intoxication. Manifests itself in various ways morphological elements: erythematous spots, papules, blisters, etc. In children, not only the oral mucosa can be affected. Patients feel severe pain and burning of the mucous membrane of the lips, cheeks, and tongue, which interfere with food intake and make speech difficult. When examined on the reddened and swollen mucous membrane of the lips, cheeks, transitional fold of the tongue, sublingual area in the initial stage of the disease, single or grouped papules, vesicles and blisters can be seen different sizes. The blisters quickly burst, and the mucous membrane eroded in this area is covered with a thin fibrinous film of whitish-yellow color, which is usually located in the plane of the surrounding mucous membrane. The lips are often affected, especially the lower lip. Injury to blisters on the red border of the lips leads to the formation of massive dark brown crusts. With secondary infection, ulceration of eroded areas is possible. Skin rashes are localized on the back of the hands, forearms, legs, face and have the appearance of bluish-red spots with round outlines. In the center of the spot there is an infiltrate, which turns into a vesicle. Blisters may immediately appear on the skin, surrounded by a bright red or bluish-red rim. The disease lasts 2-4 weeks and is very difficult for children to tolerate.

Treatment. Locally apply mouth rinse with antiseptic solutions (lysozyme, methenamine with novocaine, fortified mixtures for oil based). Canker sores are extinguished with 1% solutions of aniline dyes or powdered with a mixture of antibiotics and vitamin BI. For the purpose of desensitization, calcium supplements, diphenhydramine, pipolfen, and large doses of multivitamins are prescribed. In severe condition of children, these drugs are administered parenterally.

Herpetic stomatitis (aphthous stomatitis)

Etiology. Acute infection, caused by the herpes simplex virus in children aged 6 months to 3 years.

Clinical picture. The disease occurs in mild, moderate and severe forms. The incubation period lasts on average 4 days. The disease begins acutely, as a rule, with an increase in body temperature to 37-41 ° C and general malaise. After 1-2 days, pain occurs in the oral cavity, aggravated by eating and talking. The mucous membrane of the mouth is hyperemic, swollen, then small vesicles appear on it, individually or in groups. They quickly turn into erosion - aphtha. Afta - erosion of a round, oval or slit-like shape with smooth edges, smooth bottom covered with a grayish-white coating. Erosion can turn into superficial ulcers, and when attached secondary infection- into deeper necrotic ulcers. Aphthae are localized mainly on the palate, tongue, cheeks, lips, and transitional folds.

Characteristic is diffuse damage to the gums - acute catarrhal gingivitis, more pronounced on the palate. Necrotic areas of the gums are yellowish-white in color and are not removed during treatment. The process involves only a narrow border along the edge of the gum, which is covered with purulent plaque. The gum contours are preserved. Gingivitis in acute herpetic lesions lasts for some time after disappearance general phenomena and epithelization of aphthae. The tongue is usually heavily coated. Salivation reflexively increases.

Regional lymphadenitis precedes the appearance of afts, accompanies the disease and persists for another 5-10 days after epithelization of the afts. The red border of the lips and surrounding areas of the skin are often affected; the skin of the hands may be involved in the process. Other mucous membranes also change, primarily the gastrointestinal tract.

The disease has a favorable prognosis, clinical recovery occurs in 1-3 weeks, aphthae heal without scars, and the gum edges retain their shape.

Complication of pyococcal infection leads to impetiginization of the red border of the lips and surrounding areas of the skin, which in children is macerated due to increased salivation. The addition of fusospirillosis leads to the development of necrotizing ulcerative stomatitis.

Treatment. General treatment: the antiviral drug bonafton is prescribed 0.1 g 3-5 times a day in cycles of 5 days with breaks of 1-2 days. For the purpose of detoxification, hyposensitization and increase protective forces the body uses sodium nucleinate, antihistamines (diphenhydramine, suprastin, diazolin, etc.) in medium therapeutic doses, calcium gluconate 0.5-1 g 3 times a day, vitamins, especially C and P. In severe forms of the disease, if it complicated by fusospirillosis, oral metronidazole or antibiotics are prescribed wide range actions (children should not be given tetracycline antibiotics). Cardiovascular drugs are prescribed according to indications. Mandatory diet: crushed high-calorie fortified food, drinking plenty of fluids.

Local treatment: in the first days of the rash, antiviral drugs are prescribed - interferon in the form of a solution or ointment (interferon 1 ampoule, anhydrous lanolin 5 g, peach oil 1 g, anesthesin 0.5 g), 0.5 % bonaftone, 1-2% florenal or 2% tebrofen ointment. These drugs are applied to the entire mucous membrane after pre-treatment with proteolytic enzymes, a 0.2% solution of deoxyribonuclease, characterized by an antiviral and cleansing effect from necrotic tissue, as well as antiseptics or herbal decoctions (chamomile, sage, tea).

Prevention. Avoiding contact of a sick child with healthy ones. In children's groups, children are examined daily to identify initial signs diseases (lymphadenitis, catarrhal gingivitis). For children who have been in contact, the mucous membranes of the mouth and nose are lubricated with antiviral agents for 6-10 days.