Causes and risk factors:
Trauma is one of the main contributing factors seen. Rubbing of the teeth, particularly the lower ones, on the tongue can lead to injury and ulcer formation. Repeated thrusting habits contribute to the same. Studies have shown that this condition can also be associated with certain diseases like cerebral palsy, Tourette syndrome, microcephaly, or macroglossia, etc.
Clinical presentations:
The patient presents with ulcer formation on the ventral surface of the tongue. The other common locations are on either side of the inner aspect of cheeks or on the lips or gums. They either erupt singularly or can be in multiple numbers. On examination, small oval or round ulcers are seen in which there is a yellow base and white edge. The surrounding area of the ulcer shows congestion. Pain may occur which can cause difficulty in sucking and this leads to irritation and crankiness among children. This all affect the diet intake of the child, resulting in nutritional deficiency and dehydration. In some cases, these ulcers can grow in size and form a large fibrous mass.
Diagnosis and investigations:
The symptoms narrated by the parents and the local examination carried out by pediatric doctor might help in diagnosing the case. Investigations are usually advised if the complaints persist for 2 weeks or more. Histological examination, along with skin biopsy and certain neurological examinations can be done to rule out other causes. Certain other investigations can also be done.
Treatment:
Usually the ulcers heal spontaneously and hence no treatment is required. If needed, soothing agents or topical cortisone applications are advised. Change in feeding habits should be implemented. If other underlying cause is confirmed, appropriate conservative or surgical care needs to be done.
Other modes of treatment:
The other modes of treatment can also be effective in treating the pain. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivatives can also be beneficial in combating the complaints.
