Page 6 of 73 DISEASES OF LIPS AND LANGUAGE
Diseases of lips
The increased bridle. The bridle of an upper lip is sometimes thickened and eminates. Its fibers can pass between the central cutters, discrepancy (diastem) of milk or second teeth is a consequence of what.
Between milk upper cutters there is often free space. If it remains after a prorezyvaniye of constant canines, it is possible to assume that the attachment of considerable part of a bridle to a lingual surface of an alveolar bone is the reason of a diastem. In most cases growth of an alveolar bone recovers a normal attachment of a bridle, and lateral forces which are created at a prorezyvaniye of canines liquidate a diastem. In necessary cases carry out surgical correction, and for rapprochement of cutters use simple plates.
Cheilitis. At children the dryness of lips which is followed by their peeling, cracking and a characteristic burning sensation is often observed. This state is usually connected with hypersensitivity to some substances which are a part of toys or food and also to a sunlight. A habit to lick lips, drying of lips on wind, especially in a cold nogoda, aggravate the specified signs. The cheilitis often arises at feverish states. The softening ointments have medical and preventive effect.
Angular stomatitis. Maceration and cracks in corners of a mouth are often caused by Candida albicans infection. Process can pass into an oral cavity, without being followed by any characteristic symptoms or pains. The disease is successfully treated by easy antiseptic agents.
If angular stomatitis arises owing to insufficiency of food, such state call a cheilosis. A cheilosis — a precursory symptom of deficit of Riboflavinum, it is often combined with a moniliasis. Cracks are also observed at mentally retarded children with hypersalivation (for example, at a Down syndrome).
Herpes simplex (herpes of lips, fever herpetic). The herpes simplex is shown in the form of a conglomerate of small transparent vesicles on the inflammatory basis; is followed by an itch or burning. Usually defeat arises on border of skin and mucous membrane, but can be localized only on which? e persons or only on a mucous membrane of a mouth. Self-healing comes in 8 — 14 days.
Allergic rashes. Some substances (which are a part of toothpastes and lipstick) at contact with lips cause allergic rashes. They are shown by vesicles, the raised ring-shaped rash (urticaria) and can be combined with a glossitis. As a rule, at children with such type of an allergy also other forms of allergic reactions are observed.
Quincke's disease. It is a kind of the small tortoiseshell at which the child with tendency to allergic reactions suddenly has a diffusion hypostasis lasting 1 — 3 day. It often is followed by an itch, but seldom causes pain; there is no erythema, fabric of normal color, dense, when pressing a pole is not formed.
Mucoid retentsioniy cysts. These are the single mastoidal protrusions covered with the thinned mucous membrane and filled with transparent contents. Cysts are formed at obstruction of lip or buccal mucous glands owing to what in them the secret accumulates.
Injury after anesthesia. The local anesthesia at treatment of forelocks or small surgical interventions causes a temporary anesthesia in lips. Children of younger age can injure lips at this moment; the hypostasis which is often followed by an ulceration results. Usually spontaneous recovery comes in 2 — 3 days, but sometimes it is necessary to apply antibiotics to prevent secondary infection.
In some cases language takes an unusual form, but it is not followed by any clinical manifestations and does not cause to the child disturbance.
Ankyloglossia (language increment). Sometimes the bridle of language reaches almost its tip, limiting mobility. If the place of an attachment of a bridle is on a front surface of language, on it visible deepening appears. It is undesirable to dissect an abnormal bridle at the birth as, first, there is a danger of bleeding and infection and, in - the second, over time the bridle can stretch. In those exceptional cases when surgical correction nevertheless is necessary, it should be seen off in 8 — 10-month age.
Folded language. The surface of language reminds leaves of plants or gyruses. Language is a little increased, prints of teeth are at the edges visible. Such form of language usually inborn, but maybe acquired, in particular at a Down syndrome. Sometimes the skladchatost appears after scarlet fever, syphilis and a typhoid.
Black "hairy" language (Lingua nigra). This state is characterized by lengthening of the threadlike nipples taking a form of hairs 1 — 2,5 cm long. Such nipples are observed mainly in a triangular zone of a kpereda from the V-shaped line of valikoobrazny nipples; in them food microparticles accumulate. Color of the changed part of language varies from brown to black. The illness usually proceeds chronically, but sometimes recovers at regular cleaning of a back of the tongue. Language takes the same form at the chronic bleedings in an oral cavity arising against hemorrhagic purpura or hemophilia. At the same time threadlike nipples hypertrophy and painted in dark brown color by blood pigments. Availability of blood in a mouth causes characteristic fetor ex ore.
"Hairy" language is sometimes observed at long reception of antibiotics, especially in the tableted look. An essential role is also played by disturbance of normal microflora of an oral cavity.
"Geographical" language (the wandering rash). Emergence on a back of the tongue of smooth bright red spots with yellowish, grayish or whitish edges against not changed mucous membrane is characteristic of this high-quality state. Spots are visible in those places where threadlike nipples deskvamirutsya completely, leaving a smooth brilliant surface. Such sites can be single or multiple, discrete or merged like a map. They change the configuration, as if "travel" around language in process of desquamation of nipples at one edge and their regeneration on another. This state usually proceeds chronically, the periods of an aggravation last from 2 to 7 days.
The brilliant red spots on a back of the tongue reminding "geographical" language can temporarily appear at the subfebrile temperature accompanying cold or a persistent system infection. Treatment is contraindicated.
Macroglossia. At children of chest age language is sometimes disproportionately increased in relation to other parts of a mouth as it grows rather quicker and not limited to teeth. In some cases at children of a hypersthenic structure language is so increased that falls out of a mouth; this state can be regarded mistakenly as manifestation of a hypothyroidism. With growth of the child other structures of a mouth increase in sizes so the relative sizes of language decrease.
The true hypertrophy of language meets seldom; it can be display of such inborn diseases as a diffusion lymphangioma or a muscular hypertrophy (rhabdomyoma). Language at the same time sometimes reaches such sizes that does not find room in a mouth, meal, and later the speech as a result is at a loss; under the influence of the increased language malocclusion forms.
Treatment is surgical; it should be noted that in process of growth of the child there comes relative improvement.
Diffusion or limited increase in language can be caused by cysts and hemangiomas. Besides, the macroglossia is observed at cretinism, an acromegalia, Bekvit's syndrome and sometimes at a gargoilizm.
White coated tongue. The wet language covered with a white plaque — a consequence of accumulation of the remains of food and bacteria between threadlike nipples. Approximately to 5-year age threadlike nipples are much shorter fungoid therefore language looks smooth. If children more young in language have than 5 years a plaque, it is necessary to think of its reason.
The dry coated tongue (hypertrophied threadlike nipples) is observed in an early stage of slight dehydration of an organism and at a subfebrile temperature.
The transition phase from a white coated tongue to red varnished is known as white crimson language as its surface looks as unripe berry of raspberry. The hyperemic and increased fungoid nipples act over the white exfoliated threadlike nipples. Such picture is observed in an initial stage of scarlet fever and other acute feverish states.
The varnished language (glossitis). Language takes such form when threadlike nipples completely of a deskvamirovana and over a smooth "naked" surface of language tower only congestive fungoid nipples. Such language sometimes call red crimson or red strawberry; it is observed in late stages of feverish states, and also on 6 — the 7th day of scarlet fever.
If nipples are flattened and edematous, but are not atrophied and are not desquamated, then language reminds a pebble-leather. Purple-red color (color of fuchsin) is characteristic of it. Language is edematous, in it prints of teeth are visible; edges "are peeled", burning and pain is felt; often there are cracks. Such changes in combination with a cheilosis, photophobia and lachrymation are observed at an ariboflavinosis.
At a full atrophy of both threadlike, and fungoid nipples there is a picture of the atrophic polished language. Deskvamirovanny surface usually dry and extremely sensitive (glazed language). The atrophic glossitis with bright-red color of language is typical for a pellagra, especially at a combination of deficit of niacin to an infection. The atrophic glossitis with pale salmoncolored coloring of language (a gupterovsky glossitis) is characteristic of pernicious anemia, to a spr, an achlorhydria and hypochromia anemia.
Flavoring receptors are not numerous or in general are absent at Riley's syndrome — Dai (family vegetative dysfunction).
Injury. Children often have accidental nadkusyvaniye of language, irritation his carious teeth, damage by the sharp objects which are in a mouth, burns by hot food. As a result there can be a bubble or an ulcer which disappear in several days; but even superficial ulcers are very painful. In hard cases there is a paraglossa. Apply ice to reduction of hypostasis. The food has to be cold and liquid; babies sometimes should be fed through a nasal probe. 1% iodine tincture in normal saline solution are useful an oral cavity irrigation weak antiseptic agents, for example.
Damages and burns owing to hit in a mouth of toxics are frequent. Character of urgent measures depends on a type of poison and extent of defeat.
In hard cases special attention has to be paid on passability of respiratory tracts; sometimes according to vital indications resort to a tracheostomy.
Defeats of a bridle and edges of language usually have character of aphthous ulcers; the ulcers localized only on a bridle can be caused prikusyvanny language during a fit of coughing at whooping cough. Similar ulcers are observed at Riley's syndrome — Dai.