Introduction
Children and adolescents are always prone to a wide variety of gingival and soft tissue infections that may arise from multivariate origins. However, they become a matter of extreme concern when these oral manifestations are linked to systemic diseases. Most epidemiological studies indicate that severe gingivitis or soft tissue infections are common findings and may be globally distributed among children and adolescents.
What Are the Types of Hereditary and Congenital Origin Diseases?
1. Gingival Disease or Infection Associated With Heredity and Congenital Origin:
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Gingival Hereditary Fibromatosis: Several syndromes may be, directly or indirectly, related to gingival diseases in children. There is a specific hereditary cause associated with gingival inflammation called hereditary gingival fibromatosis. This condition is hypothesized to occur as a result of a simple inherited Mendelian trait or as part of any chromosomal aberration. It is, however, benign and is characterized by non-inflammatory fibrotic enlargements, with the gingival lesions being very firm and non-hemorrhagic(no bleeding), usually occurring upon the eruption of permanent dentition (6 to 12 years). Although the specific genes for this disease have not been exactly identified, genetic research and analysis suggest that this disease may be inherited because of the presence of two different gene loci instead of one on chromosome 2P.
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Kindler Syndrome: This syndrome is characterized by oral lesions, desquamative gingivitis, and multiple cutaneous manifestations like bullae in the affected child. Photosensitivity and acral atrophy are the other potential changes associated with this syndrome.
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Congenital Epulis of Newborn: This is a congenital condition affecting the newborn child, characterized by gingival tumors, and is not associated with any other dental manifestations, such as teeth abnormalities or any other congenital malformations. Clinically it is a restricted gingival tumor that presents as a smooth yet erythematous mass arising along the alveolar ridge and may interfere with the infant's sucking ability and cause discomfort.
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Congenital Gingival Synechiae: Though relatively rare, this condition is characterized by different congenital adhesions within the oral cavity, and infants suffering from this may frequently have respiratory difficulties soon after birth.
2. Environment Induced or Foreign Body Reaction Induced Gingival or Soft Tissue Disease:
Though uncommon, it is quite possible for a foreign body to trigger immune or allergic reactions, including site-specific gingival inflammation or oral immune response against antigenic agents, certain foods, flavoring agents, and other sensitive materials.
What Are the Soft Tissue Manifestations Associated With Systemic Diseases or Systemic Infections?
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Gingival Lesions Associated With Varicella Herpes Virus
This virus commonly affects children and young adolescents under 15 years and is most commonly characterized by small ulcerations on the gingiva, the palate, or even the buccal mucosa in the oral cavity.
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Gingival Lesions Associated With Infectious Mononucleosis
Infectious Mononucleosis is a result of the Epstein-Barr virus infection typically in children and young adults. The clinical symptoms of this infection are extremely prominent in young adults or children who report typical clinical signs and symptoms like fatigue, generalized weakness, malaise, fever, sore throat, body aches, headaches, enlarged tonsils, localized lymphadenopathy, etc. On the gingival tissue, alterations or ulcerations can be observed that are accompanied by petechiae (pinpoint bleeding spots) over the soft palate. Ulcerations in the buccal mucosa and palatal petechiae are also not uncommon and are observable features in a few children or young adults suffering from infectious mononucleosis.
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Soft Tissue Lesions Associated With Coxsackie Virus
The Coxsackie group A viruses are particularly associated with herpangina disease and very commonly infect young children. This condition, clinically, is characterized by numerous vesicles that subsequently ulcerate, possessing a gray base and inflamed tissue periphery. The oral ulcers may not just appear on the hard & soft palate but also over other sites like the posterior pharyngeal wall, buccal mucosa, or tongue in the oral cavity. However, these ulcers are generally not painful and are self-limiting, resolving within a few days to a maximum of a few weeks.
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Soft Tissue Lesions in Relation to Children With Hand, Foot, and Mouth Disease
Hand, foot, and mouth disease is a very common disease that occurs in children between 6 months to 5 years of age. Both the Coxsackie group A & B are responsible for causing this infection. The hand, foot, and mouth disease may clinically resemble the symptoms of herpangina, but children or young adults frequently complain of difficulty in eating due to sore mouth. This disease is also generally self-limiting and should ideally regress within 1 to 2 weeks.
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Gingival Changes Associated With Wegener’s Granulomatosis
This is a systemic disease that is common in children or young adults resulting in moderate to severe gingival manifestations. In this condition, the gingival tissues appear erythematous or undergo enlargement and are typically like "strawberry gums."
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Gingival Diseases Associated With Blood Dyscrasias
Blood disorders such as lymphoblastic leukemias that usually occur in children below the age group of 10 are characterized by chronic and friable gingival tissue with a tendency for severe oral hemorrhage and irritation alongside gingival enlargement.
Conclusion
Oral and maxillo-facial manifestations of systemic diseases represent an extensive and fascinating study, which is mainly based on the knowledge that many signs and symptoms as numerous systemic disorders may first present as or may be identified by head and neck tissue changes. Thus to conclude, many of the above enlisted common diseases associated with hereditary, congenital as well as systemic diseases that may be sources of severe soft tissue and gingival diseases in children. Timely management and consultation with your dentist or healthcare provider can prove beneficial to relieve oral discomfiture and prevent the spread of oral infections.
