Holes in gums of a child are a relatively rare presentation of stomatological pathologies that requires immediate medicinal or sometimes even surgical treatment. Fortunately, this symptom does not always indicate a problem of such a serious magnitude.
Causes and Symptoms
When there is a hole in the gums of a baby, it is necessary before everything else to exclude possibility of an active teeth growth. During this time period, such a symptom may be a part of a natural process, a growing tooth cutsthe gum and the consequence is a small gap in gum’s mucosa. A signature in this case will be
a single wound with uneven edges and with underlying more or less apparent edema of the gum;
no signs of infection or inflammation (the gum is uniformly dense and elastic, its color may be slightly brighter than in other areas or the same with no pellicle, aphthaes or hives, and with no signs of fetid breath).
If teething is the reason and the baby is very uncomfortable with it, it may be advisable to apply some ice packs on the area or even administer painkillers like Paracetamol to the child. Sometimes dentists also advise to apply a small bit of Lidocaine gel over the swollen area. But one should be very careful with the amount of the solution and it is necessary to make the child spit out the remains of the medicine and not to swallow it.
If the pain does not go away or at least subside, an X-ray scanning may be prescribed.
But some cases may indicate development of certain pathologies that require special attention. These include:
Fistula is a hollow alveus in soft tissues that is formed due to an infection process that proceeds in the dental root or in a juxtahilar area. It serves as a ‘safety mechanism’ of a sort: pus from a suppurative focus is released through the gap outward, which otherwise could have spread to internal tissues and provoke constitutional infection.
Fistula is characterized by a certain sequence of symptoms:
First, a dense, painful nub is formed on the gum, in conjunction with this symptom body temperature may rise.
Within 1-2 days after the onset of initial symptoms, the nub becomes softer, a white or yellowish head forms on its top.
A spontaneous rupture of the apostem along with ample pyorrhoea ensues. Almost immediately, pain and tension in the gums disappear, and body temperature returns to normal.
Pyorrhea and serosanguinous fluid emanation may continue for several hours or up to several days, it depends on the suppurative focus size in deep tissues, and the particular characteristics of the causative microorganism.
The hole in the gums of a baby will heal without any treatment after the pus has ceased to effuse. But this does not mean that the recovery will be permanent – without timely treatment, the pathological focus still remains in the dental root or in a juxtahilar area, and in case of an unlucky train of events (a cracked tooth, colds, hypothermia, etc.), the whole cycle may repeat again.
Stomatitis is the most common reason for the appearance of big holes on the gums of a baby. Ulcerative areas on the mucosa or wounds are often mistaken for holes in gums. Those are left after spontaneous rupture of follicles filled with the infected contents. A specific distinction of stomatitis that makes it even more dangerous than fistulous formations is the presence of multiple gapes existing “without reference” to a particular tooth or a certain area of the oral cavity.
Such foci could be found not only on the gums, but also on the cheek and lip mucous, on the surface of the tongue and even in the throat. Given that there is a large number of varieties of stomatitis (aphthous, traumatic, allergic, fungal, etc.), the accompanying symptoms may vary greatly.
As a possible way of treatment a draining system can be installed in the fistulous passage to ensure an immediate drainage of pus and to prevent its insertion into nearby structures (maxillary antrum, periosteum, etc.)
Possible Methods of Treatment
As it may be already obvious, therapy alternatives in case of such dental diseases that damage gums mucous, hinges on the causes and nature of the existing pathology. Those may be:
If stomatitis has been diagnosticated, local treatment with agents that are active against certain types of pathogens with anti-inflammatory effect or other actions can be recommended as the most effective. In additio0n to the main therapy course, immunostimulatory, antihistamines and other oral medications may be prescribed.
When fistula formation is the problem, the dentist should first detect a pathological focus (or several foci), which is the source of the infection. To accomplish this, an x-ray examination or a hysteroscopy may be prescribed. After the results are analyzed, the treatment for the etiological disease (periodontitis, granuloma, dental cyst, periodontal abscess, etc.) can be successfully administered.
If a hole in the child’s gum has been found and you do not have the opportunity to have an immediate consultation with a dentist and do necessary tests, preventive care should be taken. The main aim in this situation is to take steps that can minimize the likelihood of complicating disease development. With this end in view, make sure that your child
has a thorough cleaning of the teeth;
does not eat any type of food that may irritate even more the already damaged mucous membrane;
gets regular oral treatment with locally acting solutions.