- Oral pathology and oral surgery - J. G. Meechan
15.1 INTRODUCTION
The incidence of pathological conditions of the mouth and perioral structures differs
between children and adults. For example, mucoceles are more common in the young,
whereas squamous cell carcinomas occur more frequently in older individuals. The
management of pathology in the child differs from that in the adult. Growth and
development may be affected by the disease, or its treatment. On a more practical
basis, anaesthetic considerations for surgical treatment of simple pathological
conditions can make management more complex. This chapter deals with those
conditions that occur exclusively, or more commonly in children. It is not an
exhaustive guide to paediatric oral pathology, for which readers should refer to oral
pathology textbooks. Surgical treatment of the simpler conditions is discussed in the
oral surgery section of this chapter (996HSection 15.5).
15.2 LESIONS OF THE ORAL SOFT TISSUES
15.2.0 Introduction
Conditions affecting the oral mucosa and associated soft tissues can be classified as:
infections, ulcers, vesiculobullous lesions, white lesions, cysts, and tumours.
15.2.1 Infections
Viruses, bacteria, fungi, or protozoa may cause infections of the oral mucosa.
Odontogenic infections will be discussed under 'oral surgery' later in this chapter.
Viral infections
HERPETIC INFECTIONS
PRIMARY HERPES SIMPLEX INFECTION
This condition usually occurs in children between the ages of 6 months and 5 years.
Circulating maternal antibodies usually protects young babies. The symptoms, signs,
and treatment are covered in 997HChapter 11.
SECONDARY HERPES SIMPLEX INFECTION
Secondary infection with herpes simplex usually occurs at the labial mucocutaneous
junction and presents as a vesicular lesion which ruptures and produces crusting
(998HChapter 11).
Herpes varicella-zoster
Shingles, which is caused by the varicella zoster virus, is much commoner in adults
than children. The vesicular lesion develops within the peripheral distribution of a
branch of the trigeminal nerve. Chickenpox, a more common presentation of
varicella-zoster in children, produces a vesicular rash on the skin. The intraoral
lesions of chickenpox resemble those of primary herpetic infection. The condition is
highly contagious.