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 Vol. 28 No. 1, January 2007
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(Pediatrics in Review. 2007;28:15-22.)
© 2007 American Academy of Pediatrics

Oral Conditions


David M. Krol, MD, MPH*
Martha Ann Keels, DDS, PhD{dagger}
 * Chair, Department of Pediatrics, University of Toledo, Health Sciences Campus, Toledo, Ohio
{dagger} Assistant Clinical Professor, Department of Pediatrics and Surgery, Duke University Medical Center, Durham, NC

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Describe the appropriate treatment of a ranula.
  2. List the conditions that predispose to persistent or recurrent candidiasis of the oral cavity in an infant younger than 6 months of age.
  3. List the conditions that predispose to persistent or recurrent candidiasis of the oral cavity in children older than 6 months of age.
  4. Distinguish clinically among hand, foot, and mouth disease, herpangina, acute herpetic gingivostomatitis, and aphthous ulceration.
  5. Discuss the therapy for children who have a short lingual frenulum.


   Introduction
 
This review addresses a variety of oral conditions that clinicians likely encounter in their practices, some more often than others. Recognition of normal and abnormal features of a child’s mouth is an important part of the physical examination because oral health is an integral part of a child’s overall health.


   Oral Candidiasis
 
Candidiasis is the most common oral fungal infection of infants and children. Although this infection can lead to serious complications when systemic, invasive, or manifested in immunocompromised individuals, it is encountered more commonly by the primary care pediatrician in a more benign presentation.

     Causes and Epidemiology
A variety of species of the genus Candida can lead to oral disease in humans, including C albicans, C glabrata, and C tropicalis. C albicans is the species associated most commonly with oral candidiasis, accounting for 70% to 80% of the oral isolates. Candida is a dimorphic fungus that can exist in both a yeast phase (blastospore) and a hyphal phase. This ability to exist in two forms contributes to its ability to spread, survive, and cause disease.

Even in the absence of disease, as many as 60% of healthy individuals may harbor Candida in their oropharyngeal region, not to mention on the skin and in the intestinal tract and vaginal area. Most commonly, infants acquire Candida during . . . [Full Text of this Article]






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