home Adviсe Various oral diseases in children. Bad breath. Requirements for the initial level of knowledge

Various oral diseases in children. Bad breath. Requirements for the initial level of knowledge

Stomatitis is an inflammatory process affecting the mucous membrane in the oral cavity. Translated from Greek stoma means mouth, it means inflammation. Stomatitis in children is the collective name for numerous diseases in the oral cavity, which have the most different reasons and clinical picture.

Most often, the symptoms of this disease appear as echoes of some systemic disease. Usually these are diseases of the gastrointestinal tract, a little less often causative factor damage to the endocrine, cardiovascular, and nervous systems.

Classification of oral diseases

Stomatitis in children is classified according to a group of signs: the causative agent, the course of the disease, morphological changes, the cause of its appearance, and clinical manifestations. By pathogen:

viral – chickenpox, measles, herpetic;
bacterial - tuberculosis, scarlet fever, streptococcal, gonococcal;
fungal – acute or chronic candidiasis;
Fuzospiriples - Vincent's ulcerative-necrotizing stomatitis.

According to the course: acute and chronic.
According to morphological changes: primary and secondary.

Due to appearance:

physical, mechanical and chemical trauma;
allergic reaction– contact, drug allergies;
disorders of the structure of the oral mucosa due to disease certain systems body (liver, stomach, blood, intestines, nervous system).

According to clinical manifestations: catarrhal, aphthous, necrotic.

Types of inflammation of the oral mucosa in children

Having considered the classification given above, it becomes clear that the oral mucosa is susceptible to a huge number of diseases. But the main reason for the appearance of this disease in a baby is precisely the infectious agent (virus, fungus or bacteria).

Normally, the oral cavity is home to a huge amount of flora, which is called opportunistic. Under certain conditions (deterioration of local or general immunity, injury and drying of the mucous membranes, disruption of the symbiotic balance associated with taking a certain group of drugs) it becomes pathogenic. As a result, the microflora multiplies very quickly, and all signs of disease appear in the mouth.

Most often (in 90% of cases) in childhood meet the following types stomatitis:

herpetic (aphthous);
candidiasis (thrush);
bacterial.

Children's stomatitis by age

Scientists and doctors have noted that stomatitis of a certain type is typical for children at a particular age:

from birth to 2 years – thrush is more common;
from one and a half to 3 years - herpetic lesions of the mucous membrane;
from 6 to 15 years – allergic and aphthous stomatitis.

Bacterial stomatitis occurs in any age category as a result of mechanical, chemical, thermal injuries to the mucous membrane in the mouth, as well as during teething, starting from 5-6 months, when the baby puts into his mouth everything that comes into his hands. In older age, the cause of the disease is poor personal hygiene and eating dirty vegetables and fruits.

Stomatitis in children under one year of age occurs so often because the mucous membrane in the oral cavity is very thin and vulnerable, it is easily damaged even with minimal trauma. Adults have a protective enzyme, lysozyme, in their saliva. But in children the enzyme does not have pronounced antiseptic properties, plus the immune system is not developed enough. This leads to the symptoms of the disease appearing very quickly, within a few hours.

Acute herpetic stomatitis in children

Almost every mother knows what stomatitis looks like in children. But this is not always white plaque in the mouth. Acute herpetic stomatitis (AHS), caused by the herpes virus, looks different. Its second name is aphthous. Infection with this virus occurs in 8 out of 10 cases transplacentally (through the placenta from an infected mother), less often by airborne droplets or through direct contact. According to scientists, by the age of 10 years, 70% of children have antibodies to the herpes virus, and by the age of 50, 90% of the population already have this virus in their blood.

OGS occupies a special place among diseases of the oral cavity. It is the herpetic type that accounts for 80% of cases of all childhood stomatitis, the success of treatment of which depends on timely initiation of therapy. Herpetic stomatitis often manifests itself before 3 years of age.

OGS in children has both general (intoxication) and local symptoms (damage to the oral mucosa), expressed to varying degrees. Depending on the symptoms, there are 3 forms of OHS.

Specifics of treatment

It is necessary to treat herpetic (aphthous) stomatitis in a child with both general and local means. Treatment should begin immediately after the first symptoms are detected.

General treatment with local remedies:

gentle nutrition (cereals are neutral in taste and do not irritate the oral mucosa);
drink plenty of water (still water, often in small sips);
antiviral drugs intravenously or orally - acyclovir, Valtrex, Virazol, Famvir;
vitamins – picovit, multi tabs-baby, alphabet;
antihistamines – trexil, suprastin, tavegil, fenkarol, loratadine;
immunocorrective drugs – thymogen, thymostimulin, lykopid, leukogen, thymalin;
antipyretic drugs - ibufen, cefekon D;
painkillers - desensil, kalgel, pyromecaine ointment;
enzymes – terrilitin, solution of chymotrypsin, trypsin, iruksol ointment;
antiseptic drugs - chlorhexidine, orasept, chlorophyllipt, mundisal gel, rotokan, listerine, salvin, tincture of calendula and eucalyptus;
means to accelerate the healing of the mucous membrane - actovegin, solcoseryl, sea buckthorn oil, vinylin, Kalanchoe juice, olazol, methyluracil in ointment;
topical antiviral agents - virolex, acyclovir, herpesin, acigerpin, oxolinic ointment, herpetil, viferon;
astringent medicines - tannin, strong tea leaves, infusion of sage herb.

Thrush in children

Candidal stomatitis (candidiasis, thrush, candidiasis) is a disease caused by a fungus of the genus Candida. Even newborns get thrush, becoming infected from the mother through birth, ingesting fungi from the vagina. Healthy children also get candidiasis when personal hygiene rules are violated - through dirty hands, through underwear, toys, if the mother licks the pacifier.

Another one of common reasons candidiasis is the long-term use of hormonal, antibacterial and cytostatic agents by children.

Thrush starts with anxiety. The baby eats poorly and sleeps little. After 2-3 years the child already complains of bad taste in the mouth, burning, coating on the tongue. Body temperature is often normal. Upon careful examination of the child, the mother may see white dots on the palate, tongue, lips, and cheeks. The fungus multiplies and the dots merge to form plaques white, which look like curdled milk. The plaque may be easy or difficult to remove depending on the stage of thrush. IN advanced cases fungi spread through the blood and lymph and lead to generalized stomatitis affecting all systems and organs. The patient must be treated immediately.

When candidal stomatitis is diagnosed in children, treatment should begin with creating an alkaline environment in the mouth. It is this that prevents the proliferation of fungi. To do this, after each feeding you need to use a 1 - 2% solution. baking soda.

Local antiseptics - miramistin, iodinol, hexoral, chlorhexidine. Help cure the disease antifungal agents orally and locally – levorin, nystatin, pimafucin, canisten, nizoral. These drugs are prescribed on average for 7-14 days until the infectious focus is completely eliminated.

Bacterial inflammation of the oral mucosa in children

The appearance of bacterial stomatitis is associated with the introduction of bacteria into microcracks in the oral mucosa. This can be either your own flora that lives in the mouth, or bacteria (streptococci, staphylococci, etc.) from the outside. Infection by one’s own flora is possible with decreased immunity. The age of onset of stomatitis is most often from 6 months to 10 years, but it can also occur in adults.

Any damage to the mucous membrane (mechanical, chemical, etc.) can cause bacterial contamination.

What should a mother do with bacterial stomatitis? Of course, you need to take care of maintaining hygiene rules, show the child to the pediatrician and begin treatment as soon as possible.

Main symptoms: swelling, itching, burning, hyperemia of the mucous membrane, bad breath and hypersalivation (excess saliva). The gums become loose, necrotic, and bleed. Also worrying about signs of intoxication - weakness, headaches.

Treatment of bacterial infection in children:

A bacterial disease must be treated with antibiotics. Most often, pediatricians prescribe chemomycin, lincomycin, ampiox, flemoxin, klacid;
It is mandatory to take pre- and probiotics: acipol, enterol, primadophilus, hilak-forte, linex;
antihistamines - fenistil, suprastin, tavegil, telfast, claritin, zodak;
antiseptics - miramistin, metrogil, hydrogen peroxide, dioxidin, furatsilin;
compliance with the diet, gentle food;
drinking plenty of fluids.

If any strange rashes appear in the child’s mouth, first of all he should be shown to a doctor for an accurate diagnosis and treatment.

Oral diseases in children

Each of us has a lot of functions assigned to the oral cavity. Their implementation can be carried out only in one case - if the oral mucosa is completely healthy. According to statistics, not every child today can boast of such a phenomenon. In some cases, oral diseases in children occur due to pathological abnormalities in the functioning of internal organs, in others – due to a decrease in the body’s defenses. It is also possible Negative influence on the condition of the oral mucosa external factors. In any case, timely consultation pediatric dentist is very important, and well-chosen therapy will help quickly return the child to comfort.

Photo: Consultation with a pediatric dentist

Why do problems arise?

The following factors can provoke oral diseases in childhood:

poor dental condition;
insufficient gum care;
illiterate administration of medications;
the damaging effects of spicy and hot foods;
dehydration;
hormonal imbalance;
avitaminosis.

Photo: Oral diseases

Among the most likely causes of problems in a child’s oral cavity, experts identify various infections. Pathogenic microorganisms, if the environment is favorable for them, begin their activity immediately. Infection occurs when a child puts dirty hands and toys into his mouth.

An equally likely source of infection is another child who already has an oral infection. Some diseases have a fairly long latent period, which means that at the beginning of their development they can escape the attention of parents and doctors. The spread of most infections by contact and airborne droplets significantly aggravates the situation.

Photo: Pathogenic microorganisms that cause oral diseases

Let's look at oral diseases that are often diagnosed in childhood.

Stomatitis

Inflammation of the oral mucosa occurs in childhood with disappointing regularity. With stomatitis, redness occurs inner surface cheeks, a white coating and ulcers form on the tongue, bad smell from mouth. The discomfort felt by the child is very high, as is the pain.

Photo: Stomatitis in a child

Stomatitis develops under the influence of pathogenic bacteria. Children with weakened immune systems and untreated teeth are at risk. The development of stomatitis in children whose oral cavity contains microtraumas cannot be ruled out.

Depending on the causes of stomatitis, it happens:

This type of stomatitis is also called herpetic stomatitis. Infection occurs by airborne droplets and contact routes. Children from one to four years old are affected. The disease begins like a cold, but the very next day parents notice small ulcers on the inside of the child’s cheeks and tongue. This stomatitis is very unpleasant, as it is accompanied by severe intoxication of the body.

Photo: Viral stomatitis

Infectious

Most often, preschool and junior children suffer from this form of stomatitis. school age. The disease develops against the background of sinusitis, pneumonia and tonsillitis. The disease is characterized by seasonality: most often children get sick in the autumn-winter period, when immunity is especially weakened.

A distinctive feature of infectious stomatitis is a yellow crust on the lips, which prevents the mouth from fully opening.

Photo: Infectious stomatitis

Also distinguished traumatic stomatitis, in which the oral mucosa is negatively affected by mechanical influences, and allergic, caused by certain types of allergies and the reaction of the child’s body to one or another pharmacological agent.

Any form of stomatitis should be treated in the company of a doctor. Therapy may include several methods of influence, which are selected taking into account the individual characteristics of the little patient’s body and the complexity of the disease. A distinctive feature of infectious stomatitis is a yellow crust on the lips,

Thrush

Oral candidiasis, or thrush, is especially common among infants and children of the first year of life. The disease is caused by yeast fungi of the genus Candida. IN human body they are available in limited quantities. Immunity instability, antibiotic use and dysbacteriosis act as an impetus for their more active reproduction. This, in turn, causes an inflammatory process in the oral mucosa. The disease is expressed in white spots on the tongue, mucous membranes of the mouth and pharynx.

Photo: Oral candidiasis

Infection of a child with thrush occurs during childbirth (if the mother is a carrier of the disease), with insufficient care after birth and disruption of the body's microflora.

To prevent the disease from having an extremely negative impact on the baby’s body, you should visit a pediatrician at its first manifestations. The doctor will assess the extent of the infection and prescribe effective treatment. This mainly involves treating the affected areas of the oral mucosa with a solution of regular baking soda.

Herpetic gingivitis

Infectious gingivitis develops when a virus enters the gum mucosa herpes simplex. Preschool children are considered the most susceptible to it. The cause of the disease, according to doctors, is a violation of the structure of the oral mucosa.

Photo: Herpes virus

If the disease is detected in a child under three years of age, its characteristic signs are:

swelling of the gums, their bleeding;
formation of ulcers on the gums;
changing the contours of the gums.

Photo: Gingivitis

More often, the disease is considered as a separate disease, but in exceptional situations, doctors classify it as accompanying primary stomatitis.

Timely diagnosis and properly selected therapy for gingivitis are very important. Otherwise, the disease may well turn into a more serious disease – periodontitis. This is known to lead to premature tooth loss.

Photo: Periodontitis

How to prevent the problem?

Prevention of diseases of the oral mucosa in children is based on several points. First - strengthening the immune system. Parents should take care of creating the correct rest and wakefulness regime for the child and monitor his diet. It is important to reduce the likelihood of developing acute respiratory viral infections, that is, to prevent the weakening of the body’s defenses. For this purpose, hardening procedures and taking vitamin complexes are recommended.

Photo: Taking vitamin complexes

An important point - timely visits to the pediatric dentist and the fight against existing problems of a corresponding nature. Even a small hole in one of the child’s teeth should serve as an impetus for contacting the clinic.

Basic oral hygiene is also often left undeservedly forgotten. From an early age, a child should learn to regularly clean their teeth with a toothbrush and paste, and rinse their mouth after eating.

Photo: Oral hygiene

Speaking of kids, you should take care of their safety while playing. Parents should ensure that foreign objects do not fall into the child's mouth. If contact occurs, it is recommended to examine the baby’s oral cavity for injuries, and if any, contact a specialist.

Common oral diseases in children

Oral diseases in children: jaw clamps and tongue frenulum

Jaw clamp.

Difficulty opening the mouth indicates inflammation of the jaws, severe inflammation of the tonsils, enlargement of the lymph nodes in the corners of the jaws, excessive enlargement of the auricular salivary gland, and in some cases is also the first sign of tetanus seizures. All these reasons indicate the need for a medical examination. Before a medical examination, if an oral disease is suspected, the child can only be given liquids and thin porridge. In case of inflammation, wet-cold compresses help to alleviate the child’s condition a little.

A constantly open mouth in young children gives reason to suspect that they have reduced nasal breathing due to an enlarged pharyngeal tonsil (“polyps”). Due to these oral diseases, sleep, appetite and concentration are often disturbed in children.

Tongue frenulum.

The frenulum of the tongue, which runs from the bottom of the mouth to the back of the tongue, acts like a leash that, by lengthening or shortening, controls the movements of the tongue. In children with severe whooping cough, a small abscess forms on the edge of the frenulum, because during a coughing attack, the child’s tongue protrudes far forward, and the edge of the frenulum comes under the pressure of the incisors.

A short frenulum, as popular rumor has it from time immemorial, which almost everyone ineradicably believes, impedes the development of speech, so it must be “trimmed” as early as possible. To a very simple surgical intervention with this disease of the oral cavity in children, they resort, however, only in very short bridle: the doctor literally cuts the slightly bleeding skin fold with one movement of the scissors.

Oral diseases in children: discoloration of the tongue and excessive salivation

Changing the color of the tongue.

Sometimes parents, when examining a child’s oral cavity, may notice changes on the surface of the tongue in the form of a whitish coating, which, in particular, occurs in children with high temperatures (“coated tongue”). In this case, good care is necessary! However, we can talk about something like this childhood disease oral cavity, like thrush.

Dry lips are a sign of dehydration, so you should give your child something to drink, for example, tea.

The so-called “raspberry” tongue, a reddish swelling of the papillae of the tongue, can be a sign of scarlet fever if, in addition, the child has a fever, a sore throat develops and a skin rash appears.

Heavy salivation.

Increased salivation is a common and completely normal phenomenon in many infants in the second half of the first year of life. In some diseases, the secretion of saliva also increases, in particular with inflammation, burns (acid or alkali) and scalding of the mouth and pharynx.

Children's oral diseases: bad odor and toothache

Bad breath.

Bad breath in most cases is caused by carious teeth, as well as chronic inflamed tonsils And maxillary sinuses. All these reasons are symptoms of oral diseases in young children and require a visit to a doctor and subsequent appropriate treatment from an otolaryngologist or dentist.

As for other causes of bad breath and exhaled air, special mention should be made of cases where the smell of acetone appears, reminiscent of the smell of fresh fruit, which is a sign of metabolic disorders.

Toothache.

Toothache and swollen cheek can in most cases be explained by “leaky” teeth (caries), inflammation of the tooth root and inflammation of the periosteum. Only a dentist can help here. Before medical care You can try to moderate the pain by taking painkillers or suppositories, or try applying cold or warm compresses.

If children constantly drink sweetened drinks from a bottle with a pacifier, this can lead to delayed teething and frontal destruction of baby teeth, which is not only unsightly from an aesthetic point of view, but also violates correct position the following, as it leads to deformations.

Oral disease in young children: inflammation of the mucous membrane

Inflammation of the mucous membranes in the oral cavity in a child, even to a small extent, is a serious symptom and a reason to reduce the amount of food taken and pay the most serious attention to this. In most cases, these are inflammations, flat redness (erythema), blisters or ulcers (aphthae) caused by stomatitis. The causative agents are, firstly, bacteria, and secondly, fungi.

Some rashes are only a few millimeters in diameter, but even then they cause discomfort in the child. They are usually located on the inside of the lips, on the edge of the tongue, or under the tongue. With frequent and persistent stomatitis, one may suspect that the child has a decrease in immunity (the body’s general protective ability to resist infections) in general.

The same applies to cases of fungal disease of the oral mucosa in children (thrush), which, first of all, manifests itself in weakened infants and is in the nature of a permanent disease. In the child's mouth back side cheeks, on the palate and tongue, you can see whitish deposits the size of a lentil grain, which cannot be removed, and this is how you can distinguish them from the remains of dairy food. In severe cases, a white coating covers the entire surface of the mucous membrane.

Due to a burn or injury from an acid or alkali, ulcerated areas appear on the mucous membrane, the surface of which may become covered with a whitish-cloudy coating, and blisters or epithelial defects (erosion) may form.

What to do for oral inflammation in children

As for the treatment of inflammation of the oral cavity, parents in mild cases can help their child themselves. What can you do in this case? An analgesic suppository placed half an hour after eating can significantly alleviate the baby’s condition.

Food should be liquid and mushy, but high enough in calories so that children, despite the pain and resulting loss of appetite, still receive enough calories.

What exactly can be eaten in each specific case should be decided depending on individual tolerance. Selected species fruits, such as bananas, cause severe irritation of the mucous membrane and, as a result, pain in some children.

For oral care and cleansing, it is recommended to use chamomile tea; some children prefer peppermint tea. In more serious cases of disease of the oral mucosa in children, appropriate care may be required in a hospital setting in order to overcome the difficulties of feeding a child with oral lesions using infusions.

Teething difficulties in children

There is a lot of talk about the difficulties of teething and the painful phenomena that accompany it, namely: “tooth fever”, an increased tendency to diaper rash and even “dental cramps”. In reality, things are somewhat different.

When teeth grow (“eruption” is too strong a word), the bones and gingival margin lying in their path move away, one might say, open up. When baby and molar teeth are cut, sensitive children, due to temporary discomfort, experience anxiety, increased salivation and, at most, a rise in temperature (within the low-grade range). The generally accepted means that supposedly should make teething easier are unnecessary.

High temperature and everything else, including seizure, cannot be explained by teething. A thorough examination almost always reveals a more or less severe infection of the respiratory tract, pharynx, middle ear or urinary tract. Sometimes, and this is the rarest exception, a swelling filled with fluid and a small amount of blood can be seen on top of the growing tooth. In this case it can be expected that infant Complications may occur, slight pain when exerting, slight discomfort. And only in exceptional cases can inflammation occur.

The situation is different when molars appear, if they are located too closely. Complications with wisdom teeth are well known and are sometimes very severe (pain, inflammation in the pockets of the mucous membrane, jaw closing).

The figure shows the sequence of teething based on the child’s age:

Disturbances in the development of teeth can occur both on one tooth (caries, inflammation, consequences of impact, sucking effect), and on all teeth as a whole (constitutional malocclusion, lack of calcium in rickets, discoloration in certain metabolic disorders, translucent spots after an overdose of fluoride). The spaces (slits) between the incisors (diastemal bite) are physiological for baby teeth; the molars should be located closer to each other.

Method of examining the oral cavity in a child

The fear that children experience before the pediatrician is caused in part by his attempts to examine the oral cavity all the way to the wall of the pharynx. Only a few parents manage to examine the oral cavity and tonsils of their children using the handle of a spoon. At the same time, sometimes there is an urgent need to quickly examine the child’s mouth, that is, check the teeth, examine damage on the lips and the inside of the cheeks, as well as blisters or aphthae and tonsils for inflammation or plaque. To do this, parents need to master a technique with which they can achieve the desired goals without a spatula or spoon.

The first step when examining the cavity is to ask the child to open his mouth. First he needs to be shown how it's done, and personal example coupled with slight persistence in most cases lead to success. In this case, it is possible to see a fairly large area of the oral cavity. Using your own little finger, carefully lift the corner of your mouth and calmly examine all the organs of the oral cavity.

As a second step in the oral examination, children are asked to show their tongue, which should be stuck out as far as possible. You can lightly tap the chin with your finger to get the child to reach it with the tip of his tongue. In this position, the soft palate and the anterior vault of the palate become visible.

At the third stage of examining the oral cavity, the child is asked to loudly pronounce the sound:“uh-uh-” (the sound “ah-ah-ah” does not raise the soft palate so well). Thus, the tonsils move apart, and it also becomes visible back wall throats. In some children it can be seen right down to the epiglottic cartilage.

When examining the oral cavity, the tongue should be raised so that its base can be seen.

1 - uvula, 2 - anterior palate, 3 - tonsil, 4 - tip of the tongue (highly raised), 5 - frenulum of the tongue, 6 - duct of the sublingual salivary gland.

How to stop a child from sucking his thumb

Thumb or pacifier sucking may be more beneficial than teething irritation to the gums (jaw). The incorrect position of the front teeth due to intense thumb sucking usually remains until the fifth year of life, so the child should be weaned, at the latest from the third year of life, from the habit of sucking his finger or pacifier.

So that later they do not have to wean their child from sucking their thumb, some parents give their to an infant a special children's ring made of wood or plastic to wean the child from putting in his mouth and “tasting” everything that comes to hand. This may be the reason why many infants do not start thumb sucking.

A baby's ring, like a pacifier, must be spotlessly clean; it must be disinfected daily by boiling or treated with some kind of chemical.

If a child who has developed a persistent thumb sucking habit cannot stop doing so, use an effective psychological advice University Dental Clinic Ulmar. You should draw a face on your finger that asks the child if he likes being in a dark cellar all the time. Almost all children answer this question in the negative. All that remains is to explain to the child that his new playmate (depicted in thumb) I also don’t really like being in the dark in a child’s mouth.

Stomatitis is one of the diseases that is more often diagnosed in children than in adults. This is explained by the fact that babies often taste inappropriate objects, introducing infection or pathogenic bacteria into their mouths. Added to this is an incompletely formed immune system, which is unable to withstand the powerful onslaught of pathogenic microflora. How to recognize stomatitis on early stage so that the disease does not develop into chronic form, - we will consider in our material. We will also talk about possible complications of the disease and methods of its prevention.

Stomatitis is an inflammation of the mucous membrane in the mouth, more common in children than in adults.

What is stomatitis?

Stomatitis is an inflammation of the oral mucosa, accompanied by painful sensations when swallowing, talking. Since the disease has many varieties, its manifestations may vary. As a rule, a plaque appears in the mouth that looks quite dense, and swelling, ulcers, blisters with liquid, or small cracks may also form. Let's look at how the disease progresses and what are the routes of infection.

Course of the disease

Stomatitis in children usually begins with mild discomfort in the mouth. At first, the patient thinks that he simply bit his tongue or the inside of his cheek, or tasted too hot tea. However, instead of gradual improvement, he notices that the number of areas in the mouth in which soreness is felt becomes more numerous.

The first symptoms of stomatitis may be accompanied by fever - up to 38°C, as well as general weakness. Viral stomatitis causes fever up to 40°C. As a rule, these signs gradually disappear, giving way to painful sores and plaque in the mouth. If stomatitis in a child is not treated, it can degenerate into an ulcerative-necrotic, purulent or chronic form. Symptoms, as shown in the photo below, may occur several times a year.

Is stomatitis contagious?

It is possible to clarify whether stomatitis is contagious or not after identifying the causes that provoked the disease

The contagiousness of the disease depends on its causative agent, and we will talk about the types of stomatitis below. Viral, bacterial and fungal diseases can be contagious. Stomatitis caused by injury or a reaction to any allergen is not covered. Infectious species stomatitis is transmitted by airborne droplets, and fungal stomatitis is transmitted from mother to child during childbirth or from an infected baby to a healthy one through toys and pacifiers.

Causes of stomatitis in a child

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Most often, stomatitis occurs in children due to bacteria entering the mucous membranes of the oral cavity or infection with yeast-like fungi. Unwashed hands and dirty toys that get into the baby's mouth can cause painful rashes. The offspring can also become infected kindergarten from one of his comrades.

It is worth understanding that young children have weaker immunity than adults, so they get sick (including stomatitis) more often. Wherein healthy baby A person who regularly walks in the fresh air, eats rationally and sleeps enough is less likely to get sick.

What do different types of stomatitis look like in the photo?

Stomatitis may have different nature, and the choice of therapy depends on the diagnosis. In children, the disease is most often provoked by a bacterial infection, as well as fungi of the genus Candida. This does not mean that the baby cannot be diagnosed with viral or allergic stomatitis. Let's look at the types of the disease and the symptoms that accompany each of them.

Viral stomatitis

Viral stomatitis refers to a condition caused by the herpes virus. It manifests itself in the same way as a herpes cold on the lips, only the localization of the bubbles is found on the mucous membranes of the mouth. Fluid blisters appear on the tongue, inner cheeks and lips, and rarely on the gums or palate. Over time, the blisters burst, forming ulcers that are difficult to treat.

Herpetic or viral stomatitis

Viral stomatitis has several features that distinguish it from other types of disease:

The onset of the disease is usually accompanied by high temperature(39-40°C), which gradually decreases over several days.
Herpetic stomatitis can recur over time. As a rule, the appearance of bubbles with liquid is observed in the same place that they occupied previously.
This type of disease is characterized by particularly unpleasant symptoms - the pain is quite pronounced, the baby has difficulty eating, and experiences pain when swallowing.

Bacterial damage

Bacterial stomatitis

The bacterial form is one of the most common in children. Signs of stomatitis in a child:

Swelling and redness of the mucous membrane of the cheeks, tongue, inner surface of the lips and palate. Cracks and ulcers may form on it.
Bad breath appears, the temperature may rise slightly, and weakness may occur (see also:).

It is difficult to diagnose the bacterial type on your own; a doctor can do this based on clinical manifestations or laboratory results. A baby can become infected from a playmate, since his local mucosal immunity is not yet sufficiently developed. If one of the parents has damage and cracks on the tongue, palate and gums, the baby has high probability catch an infection.

Traumatic form

Traumatic stomatitis is not such a rare occurrence. It is not difficult to injure the oral mucosa - you can easily get a burn when tasting a hot dish, bite your tongue while eating, scratch your cheek with a splintered tooth, etc. Usually such injuries heal quickly, but when immunity is reduced for some reason, the wound can become the beginning of the development of inflammation. The disease starts and permanent injuries resulting from wearing braces, dentures or a broken tooth.

Traumatic stomatitis

Why does the disease occur in children? This condition can be triggered by a fall or hitting the lips with a toy. This type of stomatitis is not transmitted to others, but requires treatment.

Inflammation due to allergies

It happens that the patient is allergic to some product, but the parents have no idea about it. The allergen accumulates in the blood and tissues, resulting in a reaction in the body in the form of stomatitis. However, more often this type of disease develops as a result of an allergy to dentures. According to statistics, the majority of patients with such stomatitis are women over 50 years of age.

Symptoms of allergic stomatitis:

burning sensation, dry mouth;
saliva often becomes viscous;
Clinically, the disease is expressed by redness of certain areas of the mucosa.

Candidal stomatitis

The candidal form of stomatitis occurs more often in infants. It is caused by fungi of the genus Candida, which are normally present on the mucous membrane of a healthy person. The active growth of microorganisms is provoked by a decrease in the body’s defenses due to the use of antibiotics, long-term illness, vitamin deficiency, etc. For adults, this type of stomatitis is practically not contagious if they do not share the same utensils with the sick person. Babies have weaker immunity, so children are often exposed to infection.

Candidal stomatitis

How to determine that a baby has thrush (the popular name for candidal stomatitis):

This condition manifests itself as a white coating on the tongue, inner surface of the cheeks, and palate.
Under the plaque, reddened tissue and the appearance of blood are found. There may be slight swelling and soreness of the mucous membrane.
If stomatitis is not treated, cracks and ulcers appear, the plaque becomes denser, and the top turns a little yellow.

General symptoms of the disease

You can tell that a child has stomatitis based on various symptoms. If the baby is an infant, he may refuse the breast or pacifier, experiencing pain during feeding. You should evaluate the color of the mucous membrane, check whether there is swelling or a white coating on the cheeks and tongue.

An older child can explain to his parents what is bothering him. The initial symptoms of stomatitis may be mild (the exception is the herpetic form), and may be accompanied by fever, tearfulness of the child, and refusal to eat.

To make sure that your baby has stomatitis, you should carefully examine his oral cavity. Redness of certain areas of the mucous membrane and a white coating may indicate the development of the disease. In this case, it is advisable to show the child to a pediatrician or dentist.

How can stomatitis be cured?

Stomatitis can be cured, and today there are a lot of drugs for this. We will tell you how to deal with the manifestations of the disease - to help the child get rid of discomfort and severe pain, as well as relieve inflammation. Let's consider traditional methods of treating the disease and folk remedies. In addition, we will tell you how to feed your baby during illness.

Use of painkillers

Is stomatitis accompanied by pain and the child refuses to eat? You should try to reduce the discomfort. For this, it is advisable to use painkillers. Paracetamol and Ibuprofen show excellent results. However, these drugs should not be abused; they are given only at the beginning of treatment in case of significant pain accompanied by elevated temperature.

For local anesthesia, you can treat the affected areas with special gels, including: Kamistad Baby, Cholisal, Lidochlor, Metrogyl Denta, etc.

The use of medications depending on the form of stomatitis

Before prescribing medications for treatment, you should find out the nature of the disease. Let's consider the main methods of therapy depending on the pathogen. Treatment of any type of stomatitis in children should be comprehensive - they use both drugs for local anesthesia and internal use.

For viral stomatitis, oxolinic ointment is often prescribed

Type of stomatitis	Therapy methods	Drugs
Viral (herpetic)	Antiviral agents, antipyretics and analgesics, antihistamines, local anesthesia	Lidochlor gel, Oxolinic ointment, Acyclovir
Bacterial	Antibiotics, local treatment	Lincomycin, Gentomycin (antibiotics), Metrogyl Denta (local anesthesia, antiseptic), Chlorophyllipt (antiseptic)
Candidiasis (thrush)	Antifungals, local anesthesia, antiseptics	Cholisal (antiseptic), methylene blue, Candida solution, Nystatin ointment
Allergic	Antihistamines, painkillers and antiseptic gels	Finistil or Zodak (anti-allergic drugs), Kamistad Baby
Traumatic	Elimination of the cause of mucosal damage, antiseptics, anti-inflammatory drugs	Chlorophyllipt, Metrogil Denta, Kamistad Baby, Lugol, Hexalize (children over 6 years old) (see also:)

Folk remedies

There are a lot folk remedies for the treatment of stomatitis. The most commonly used are tinctures of herbs that have antiseptic, anti-inflammatory and healing properties. Chamomile, sage, yarrow, and oak bark are used separately or in equal proportions. You should rinse your mouth several times a day herbal infusion.

It is possible to treat stomatitis at home with an infusion of sage, chamomile, yarrow and oak bark

Other treatments:

Stomatitis is fought with garlic. To do this, chop the clove and mix with yogurt or yogurt, then apply to the affected areas of the mucous membrane. This method is only suitable for adults and children over 12 years old.
Raw potatoes have good pain-relieving properties. Rubbed onto fine grater The paste is applied to ulcers and wounds.
Traditional recipes recommend using honey. To anesthetize the oral cavity and remove symptoms of inflammation, just put a small portion of honey under your tongue and hold it on your tongue until it gradually dissolves. The method is not suitable for small children and those who are allergic to this product.
Rinse your mouth with carrot juice. You can also make juice from cabbage leaves and dilute it half with water.
Aloe juice helps remove swelling and inflammation - a cut leaf of the plant is applied to the affected areas of the mucous membrane.

Nutrition and diet

Despite the fact that during stomatitis a child cannot eat many foods, the diet must be balanced. It is important to ensure that your baby’s diet includes carbohydrates, proteins and fats. Dishes should not be hot, but not cold, and in a processed form (without large solid particles).

Mashed potatoes with cutlets

Carbohydrates on the menu can be presented:

mashed potatoes;
boiled porridge with milk;
puree soups.

Meat and fish should also be present on the child’s table. It is advisable to cook him meatballs, steam cutlets, and not chops or steaks. Steam the fish or stew it with vegetables. At first, you should avoid sour fruits, try to salt your dishes less, and do not use spices. Do not buy your baby crackers, bagels, or hard cookies.

Fermented milk products can cause pain while eating, so they can be offered after pain relief.

The baby's nutrition remains unchanged. You just have to try to treat the oral mucosa after feeding and periodically offer him water.

Features of therapy for children of different ages

Therapy for a child is selected according to age. Many drugs are not recommended for children under one or two years of age. Special attention treatment of stomatitis should be given to parents of infants, since Small child may respond inadequately to a particular drug. Let's consider what to do with an infant or an older child who has a coating on the tongue and sores.

Treatment of infants

The most common natural remedy against stomatitis, which works reliably, is baking soda.

It is better to use for the treatment of infants natural remedies, familiar to our grandmothers:

Candidal stomatitis responds well to treatment soda solution. You need to stir a teaspoon of baking soda in a glass of water and, moistening a piece of bandage in the liquid, treat the mucous membranes. Among the approved medications are Candide and Nystatin.
Herpetic stomatitis can be treated with oxolinic ointment. Lubricate the wounds, trying not to go beyond their boundaries.
Shostakovsky ointment can be used as a healing agent - it is applied up to 5 times a day. Solcoseryl is applied once, after which the wounds are periodically moistened with water.

Treatment of children 1-2 years old and older

Therapy for children older than one year can be the same as for infants. Cholisal gel and Fluconazole are added to the list of approved drugs.

Rotokan is an effective antiseptic and anti-inflammatory agent that is used to treat the oral cavity for stomatitis.

Older children who can rinse their mouths on their own can prepare such solutions.

Oral diseases in children are associated with pathological processes occurring in internal organs, weakened immunity, and adverse effects of external factors. The causes are dental pathologies, lack of oral hygiene, unsystematic use of medications, trauma to the mucous membrane due to eating spicy or too hot food, and dehydration.

The disease can also be triggered by hormonal disorders, deficiency of vitamins and minerals, infections of the ENT organs (whooping cough, scarlet fever, influenza, whooping cough, sinusitis), various viruses, and fungi.

Types of inflammation of the oral mucosa in children

Oral diseases, depending on the reasons that caused their development, are divided into:

infectious;
viral or bacterial;
traumatic;
allergic;
fungal;
caused by concomitant diseases Gastrointestinal tract, ENT organs, cardiovascular and endocrine systems;
hereditary.

Stomatitis

Stomatitis of the oral mucosa is common in children. The disease is accompanied by redness of the mouth, a whitish coating on the tongue, the inner surface of the cheeks, gums, bad breath, and fever. The child experiences pain and discomfort, refuses to eat, and becomes capricious and whiny.

General symptoms of diseases:

bleeding yellow-white ulcers on the mucous tissues of the tongue, lips, cheeks, and gums;
swelling and bleeding of the gums;
increased secretion of salivary fluid;
dry tongue;
enlarged lymph nodes in the neck;
painful sensations;
loss of appetite;
moodiness and tearfulness.

To relieve the inflammatory process and disinfect the affected areas, you need to rinse your mouth with antiseptic agents - a warm decoction of chamomile or sage, a solution of furatsilin, soda or hydrogen peroxide.

Herpetic stomatitis

The most common type of stomatitis is caused by the herpes virus. The acute form of herpetic stomatitis is a contagious disease. Children from 6 months to 3 years with weak immunity are especially susceptible to the disease. With age protective functions the body is strengthened and the likelihood of infection is reduced.

Symptoms of the disease in acute form:

body temperature often rises to 41ºС;
signs of general malaise - impotence, fatigue, headaches, pallor, increased painful sensitivity of muscles and skin;
lack of appetite;
nausea and vomiting;
swollen lymph nodes under the jaw and in the neck;
severe swelling and redness of the mucous tissues in the oral cavity;
a large number of ulcers on the inside of the lips, cheeks, gums and tongue;
in moderate and severe forms of the disease, the rash affects the external skin around the mouth earlobes and eyelids;
increased salivation;
bad breath;
bleeding gums;
dry and cracked lips;
in rare cases, nosebleeds due to a blood clotting disorder caused by herpesvirus.

For treatment, drug and local therapy are prescribed. Medicines are recommended to enhance immunity (gamma globulin injections, Lysozyme, Prodigiosan, herpetic immunoglobulin, etc.); facilities general therapy– Diphenhydramine, Suprastin, Pipolfen, calcium gluconate, etc.

Local therapy for the disease consists of treating the oral cavity with agents that relieve painful sensations, preventing the spread of rashes, stimulating the processes of regeneration of damaged tissues.

To destroy viruses, various ointments are prescribed (Oxolinic, Florenal, Heliomycin, Interferon, etc.). For antiseptic treatment use solutions of furacilin, Etonium, Ethacridine, rosehip oil, Karatolin, Solcoseryl.

All dishes for feeding a child should be liquid or porridge-like (soups, broths, purees). To relieve intoxication, drinking plenty of fluids is recommended. Before eating, the oral cavity must be treated with an anesthetic (5% anesthetic emulsion), and after eating, rinse the mouth.

Aphthous stomatitis

Aphthous stomatitis can be of an allergic or infectious nature, alternating between periods of remission and exacerbation. The first symptoms of the disease are fever (+39… +40ºС), restlessness and moodiness of the child, lethargy, dry mouth.

Gradually, the oral mucosa swells, turns red, and hyperemia of the mucous tissues increases. Aphthae appear on days 3-4 in the form of round or oval erosive formations ranging in size from 1 to 5 mm with a yellow or gray coating, surrounded by a red rim. They affect the tongue, lips, cheeks, and can be single or multiple. The disease is accompanied by pain in the mouth, migraine, loss of appetite, bowel dysfunction, and swollen lymph nodes. The duration of the disease is 2-3 weeks.

Candidal stomatitis

Candidal stomatitis is an inflammation of the oral mucosa caused by Candida fungi. The disease begins with redness and swelling of the tongue, then a white cheesy coating appears on the mucous surface of the cheeks and lips. Under the plaque, ulcers and erosions form, which bleed and hurt.

The cause is a weakened immune system, and the development of the disease and the spread of fungi is provoked by the milk feeding of infants. For treatment, immunomodulatory drugs are prescribed, and the mouth is regularly treated with soda solution. A 2% solution of boric acid, which is used to treat the oral mucosa 3 times a day, is well suited for removing Candida fungi.

Gingivitis or gingivostomatitis

Gingivitis is a disease associated with inflammatory processes occurring in the gums. It is a consequence of dental damage (caries, plaque or tartar). Often, factors that provoke gingivitis can be vitamin deficiency, weakened immunity, hormonal imbalance, infections (herpes).

The disease is accompanied by pain that intensifies during eating and brushing teeth. The gums turn red, swell, become loose and bleeding. If the nature of the disease is infectious, then ulcerative or erosive formations may appear on the gums. Characteristic signs are bad breath and excessive salivary secretion. Without proper treatment, the disease can be complicated by the development of periodontitis and tooth loss.

To prevent the disease, it is necessary to carefully care for the oral cavity (teeth, gums) - regular hygiene, timely removal of tartar. For treatment, mouth irrigation with infusions is prescribed medicinal herbs– chamomile, sage, plantain. To exclude various pathologies of internal organs, you should undergo an examination by a pediatrician.

Thrush in children

Thrush is caused by the pathogenic proliferation of fungi of the genus Candida, caused by weakened immunity due to various diseases, dysbacteriosis due to prolonged use of antibiotics. The disease most often occurs in infants and children under 1 year of age. The pathology appears in the form of a white cheesy coating in the mouth and throat.

A baby can become infected with a fungus during childbirth, if the mother has vaginal candidiasis or due to poor hygiene during subsequent care, if the intestinal microflora is disrupted, which is often found in babies in the first six months of life.

Treatment of the disease consists of treating the oral cavity with a baking soda solution. If thrush is antibacterial in nature, Nystatin or Levorin is prescribed. To increase the level of immunity and normalize intestinal flora The child is prescribed a nutritious diet with a high content of vitamins (groups B, C, A, nicotinic acid).

Treatment and causes of cheilitis in children

Cheilitis is an inflammation of the lips caused by infection of a wound on the lips resulting from injury (cut, burn, mechanical damage from an impact, fall, etc.). Also, the causative agents of the pathology can be herpes viruses, erysipelas or eczema. Oral disease can also be caused by vitamin B2 deficiency.

The disease is accompanied by swelling of the lip and impaired mobility; the mucous membrane of the oral cavity becomes red and painfully sensitive. Sometimes symptoms of general intoxication appear - weakness, headaches and muscle pain.

Zaeda or angular cheilitis is a subtype of cheilitis. The causative agents of the disease are streptococci or fungi. When caught, the corners of the mouth are affected by small but painful erosions, which crack and bleed when the mouth is opened, then become covered with crusts.

Antibiotics are prescribed to eliminate the infection. If an abscess forms, it must be opened and treated with an antiseptic. In case of inflammation of the labial glands, opening, drainage and cleaning of the infected areas are also indicated.

To treat a fungal infection, nystatin ointment is used, and a viral infection is treated with synthomycin emulsion or penicillin ointment. Vitamin B2 deficiency can be compensated for by consuming riboflavin. It is necessary to regularly clean the mouth, dishes and children's toys, use individual means hygiene (towel, washcloth, toothbrush, dishes).

Traumatic lesions of the oral mucosa

Traumatic stomatitis can be caused by various one-time injuries or constant mechanical irritation of the oral mucosa. In children, injuries occur due to toys, when falling or biting the tongue or cheek, due to wearing braces; In infants, gum damage may be caused by tooth growth. As a result, pustules, abscesses, ulcers or erosions form at the site of violation of the integrity of the mucous membrane. If there is no external infection in the wound, it heals quickly without side effects.

Treatment consists of eliminating the cause of the injury (the tooth fragment is removed or ground, tartar is removed, incorrect braces or dentures are corrected); wounds are treated with an antiseptic. If infection is present, anti-inflammatory drugs are additionally prescribed.

Glossitis or inflammation of the tongue

Glossitis is an inflammatory lesion of the tongue, expressed in peeling of the skin layer and the formation of a whitish thickening in the form narrow strip. The affected surfaces are in the form of rings or semi-rings of a light red hue, sometimes merging into larger spots. This condition is called “geographical” tongue due to the loss of uniformity of the surface of the organ and its resemblance to a geographical map. There are no other signs in the form of pain or discomfort, redness or swelling; in rare cases, a slight burning sensation of the tongue is felt.

The causes of the disease are unknown, treatment is not prescribed. It is recommended to rinse the mouth with soda solution or Citral.

Other types of diseases

There are many diseases of the oral cavity, the most common of which are discussed above. Also in medicine, such pathologies of the oral mucosa are described as Infectious mononucleosis and viral warts.

Infectious mononucleosis is a viral disease. It manifests itself as enlargement (to the size of a walnut) and soreness of the lymph nodes in the neck and under the jaw, the development of sore throat, stomatitis and changes in blood composition.

Infection occurs through the pharynx or nasopharynx and quickly spreads through the lymphatic system and blood. The disease is accompanied by fever, headaches, drowsiness, lethargy and fatigue, nausea and vomiting. In young children, an increase in the size of the liver and spleen may be observed. The analysis shows an increase in leukocytes, lymphocytes and monocytes, appearing in the blood and atypical mononuclear cells (15-30%).

Treatment of mononucleosis is aimed at relieving symptoms - prescribing painkillers and antipyretics, NSAIDs, vitamin and mineral complexes to boost immunity. As a local treatment for the disease, it is recommended to rinse the oronasal cavity with a solution of furatsilin. The patient is prescribed bed rest, isolation, high-calorie diet and plenty of fluids.

Viral warts in the oral cavity are neoplasms of benign etiology. There are flat and pointed ones. Most often they affect the inner corners of the mouth and the side walls of the tongue, and less often they can appear on the gums, lips or the outside of the mouth. In most cases they are concomitant wart formations on the hands or genitals.

Treatment of viral warts is carried out with Oxolinic ointment (3%), Bonafton (0.5%), Florenal (0.5%) and other antiviral ointments. Before applying the product, it is necessary to thoroughly rinse the mouth and brush the teeth.

Prevention of oral diseases

In order to avoid the development of various diseases of the oral cavity, a child should be taught from early childhood to follow the rules of care and hygiene - regularly brush his teeth, limit the consumption of sweets. Subsequently, children can be taught to use dental floss and rinse after each meal.

It is necessary to regularly, at least 2 times a year, visit the dentist with your child, treat caries in a timely manner, remove plaque and stones. Children's immunity should be strengthened by hardening, physical exercise, swimming.

The child needs to be provided with adequate nutrition, rich in various vitamins and minerals. In winter, as prescribed by the pediatrician, the baby should be given various vitamins. It is important to remember that it is always easier to prevent the development of a disease than to treat its consequences.

Diseases of the oral mucosa in children

Chronic recurrent aphthous stomatitis (CRAS)– one of the most common diseases that can be classified as infectious-allergic. HRAS is characterized by periods of remission and exacerbation and manifests itself in the form of aphthae – superficial painful defects of the mucous membrane. Aphthae have a round or oval shape, are covered with a fibrinous coating, and red hyperemic rims are visible around the afta. The appearance of aphthae is not preceded by the formation of blisters. HRAS can occur in a mild form (1-2 aphthae) and in a severe form, when recurrent deep scarring aphthae are formed, the period of epithelization of which lasts up to 2-3 weeks. At the same time, relapses of the disease are very frequent (can occur monthly).
The treatment regimen includes a diet with the exclusion of irritating foods, the prescription of immunocorrectors and immunomodulators (after consultation with an immunologist), vitamins B and C, and desensitizing therapy. The child's oral cavity is treated locally with antiseptic solutions, applications of proteolytic enzymes are used, and lubricated with oil solutions of vitamins.

Acute herpetic stomatitis
Much more dangerous and, unfortunately, widespread is another form - acute herpetic stomatitis. Infection of children with the herpes simplex virus is 60% under the age of 5 years, and 90% by the age of 15 years. In addition, acute herpetic stomatitis in children with reduced immunity is very contagious. The disease spreads through airborne droplets and household contact. The older the child, the lower the likelihood of acquiring acute form herpetic stomatitis due to acquired immunity.
The disease occurs in mild, moderate and severe forms. Incubation period up to 17 days (in newborns – up to 3 days). A child with acute herpetic stomatitis may have a fever (up to 37-39o C, depending on the severity of the disease). The mucous membrane of the oral cavity is hyperemic, then single or grouped lesions appear. In more severe forms, rashes can appear both in the oral cavity and on the skin in the perioral area. The disease is accompanied by symptoms of catarrhal gingivitis (inflammation and bleeding of the gums
The most reliable method for diagnosing herpes infection is the polymerase chain reaction (PCR diagnosis) method.

Treatment of acute herpetic stomatitis.
The treatment is complex. First of all, it is necessary to provide the child with adequate nutrition, however, eliminating all traumatic factors from the food (food should not be hard, spicy, salty, hot, etc.). It is important to ensure you drink plenty of fluids. Before each feeding of the child, his mucous membrane must be anesthetized (2-5% oil solution of anesthesin or lidochlor gel). Antiviral therapy involves taking special antiviral drugs (as prescribed by a doctor. For epithelization of the affected areas, ointments based on proteolytic enzymes of animal origin, as well as oil solutions of vitamins are used. Antiviral drugs must be combined with immunomodulators (as prescribed by a doctor). When using a laser, fibrinous plaque is cleansed from the aphthae , healing processes are accelerated.
To prevent relapses, it is necessary to strengthen the child’s immunity naturally: hardening, swimming, good nutrition, etc. Thorough sanitation of the oral cavity is also important: removal of dental plaque, treatment of caries and its complications.

Pyoderma
Treatment of pyoderma in children
Pyoderma is streptostaphylococcal lesions of the oral mucosa, lips (cracks), and skin of the perioral area. Occurs in weakened children with low immunity, as well as in children who do not receive a balanced diet. Children with diabetes are extremely susceptible to pyoderma, which creates a good breeding ground for bacteria. Provoking factors are: hypothermia, overwork, overheating of the body, systemic diseases other organs.
With pyoderma, body temperature can rise to 38-39 degrees. C, lymphadenitis is observed. Blisters-pustules form on the surface of the mucous membrane, the surface around which is hyperemic, and with rashes on the skin, purulent pustules and crusts appear. If left untreated, the infection can easily spread to other parts of the body (eyes, hands, etc.).
Treatment of pyoderma is determined by the nature of the pathogen. Therefore, it is necessary to carry out bacteriological culture to determine the causative agent of infection and its sensitivity to certain antibacterial drugs, and only after that the doctor can prescribe adequate treatment. Self-medication without tests can only blur the picture without destroying the causative agent of the infection.

Catarrhal stomatitis in children
Lesions of the oral mucosa caused by taking medications. When taking many medications (antibiotics, serums, vaccines, sulfonamides, novocaine, iodine, phenol, etc.), lesions of the oral mucosa may occur, which can be combined common name"catarrhal stomatitis".
This same group of diseases of the oral mucosa in children also includes an allergic reaction to medications. The mucous membrane is hyperemic, edematous, covered with multiple blisters, after opening of which erosions may remain. The tongue and lips are also swollen. At the same time, the child may experience hives, muscle and joint pain, dyspepsia, and even anaphylactic shock.
Treatment is aimed primarily at identifying the cause of stomatitis. If taking, for example, antibiotics is necessary in the future, it must be combined with antifungal treatment and antihistamines. Rinses, painkillers, and ointments are used locally to promote healing and epithelization of the mucosa.

Diseases of traumatic origin

IN special group It is necessary to highlight diseases of the oral mucosa in children of traumatic origin. The mucous membrane, due to its physiological characteristics, has a high regenerative ability. However, if it is mechanically damaged, it can easily get into the wound. dangerous pathogens, which will lead to its inflammation. A child can get injuries to the oral mucosa when brushing teeth, eating solid food, or during dental procedures. This may be trauma from sharp broken teeth or orthodontic devices in the oral cavity. The child may bite his tongue, lips, or cheek. If you carelessly wipe the mouth of a newborn, you can cause injury, which causes so-called neonatal aphthae.
Treatment traumatic lesions treatment of the oral mucosa begins with eliminating the causes of injury. Then antiseptics that relieve inflammation and agents that promote healing (oils, solcoseryl gel, etc.) are prescribed locally.
In case of chemical damage to the child’s oral mucosa (accidental exposure of strong chemicals to the mouth), it is necessary to immediately rinse the child’s mouth with plenty of water and a neutralizing solution (for example, alkaline for an acid burn). In the future, painkillers, antidotes, and agents that stimulate epithelialization are used. The nature of diseases of the oral mucosa in children is largely determined by the age-related characteristics of the structure of the mucosa.

Thrush (acute candidiasis)
In infancy, the epithelium of the oral mucosa is very thin, so a fungal infection, when salivary immunity decreases, very easily attaches to the surface of the mucosa. Symptoms of thrush
At the first stage of the disease, red spots appear. They can be found on the tongue, mucous membrane of the cheeks, lips and gums. After a few days, white cheesy rashes appear in place of the red areas. They look like the remains of cottage cheese or kefir in a child's mouth.
The white plaque is difficult to separate, and the wounds that are opened begin to bleed and bacteria from the oral cavity enter them, which can lead to various complications. Thrush in the mouth is painful. Because of this, children refuse to eat, cannot swallow saliva, and become restless. If you discover a manifestation of the disease, you should consult a doctor and only then begin treatment for oral thrush in children.
In severe cases of the disease, the temperature rises, the baby becomes lethargic, and symptoms of intestinal diseases appear.
Treatment depends on the extent of the disease. It is necessary to treat the baby's cavity regularly. Even if there are visible improvements, it is necessary to continue treatment according to the doctor's prescription. Since this is a fungal disease, it can appear again and again. Treatment of thrush in children continues until the infection disappears completely, as evidenced by repeated laboratory tests.
If thrush is found in the mother, then the child will definitely have it too.

Prevention of thrush
Follow the rules of hygiene for children: bathe your baby regularly, boil pacifiers, bottles, toys. Strengthen your child's immunity with walks in the fresh air, vitamins from fresh vegetables and fruits, therapeutic massage and, of course, love your baby, give him enough time and attention, and then he will grow up healthy.

The tooth consists mainly of hard tissues (dentin, enamel, cement) and is located in the alveoli of the jaws. Dental development begins in the embryonic period and ends at 18-20 years of age. The formation and formation of baby teeth in humans begins at the 6-8th week of embryonic life.

Teething

A CT is physiological and cannot cause any diseases. Signs of correct eruption are the paired eruption of symmetrical teeth in a certain sequence - first on the lower jaw, then on the upper jaw. Teething is an indicator of the child’s proper development.

In the second half of the 1st year of life, the child’s teeth erupt and he gradually learns to chew.

A child is born, as a rule, without teeth; cases of intrauterine eruption are rare. Teething begins with the formation of dense protrusions on the gum of the lower jaw, the so-called mounds, corresponding in size and shape to the future crowns of baby teeth. At 6-8 months of a child’s life, the cutting edges of two central incisors appear on the surface of the gums: first the lower incisor, then the upper. Next, the lateral incisors of the lower jaw erupt, followed by the lateral incisors of the upper jaw. Thus, by the beginning of the 2nd year of life, the child should have 8 teeth. After a short break of 2-3 months, the first primary molars erupt, followed by the canines and lastly the second primary molars. By the age of 2-3 years, the eruption of all 20 baby teeth ends, which are indicated by a formula using Roman numerals:

V IV III II I I II III IV V
V IV III II I I II III IV V

Timing of baby teeth eruption

I incisor - 6-8th month

II incisor - 8-12th month

III incisor - 16-20th month

IV first molar - 12-16th month

V second molar - 20-30th month.

Frequently ill children may experience so-called difficult teething, accompanied by general malaise, anxiety, insomnia, a short-term increase in body temperature, the appearance of mild dyspeptic symptoms, delayed weight gain, and increased or onset of skin rashes.

The teeth are arranged so that their crowns form an arch, or row, on the upper and lower jaws. The relationship between the dentition of the upper and lower jaws with the most complete closure of the antagonist teeth is called “bite”. There are primary (temporary), removable and permanent bites. After 6 years of age, the change from primary to permanent bite begins. This is preceded by the growth of the rudiments of permanent teeth and the physiological absorption (resorption) of the roots of baby teeth, which look shortened and eaten away.

Period of resorption of the roots of baby teeth

Following the loss of a milk tooth, the eruption of a permanent tooth begins, part of the cutting edge or cusps of the crown of which are visible after the loss of a milk tooth (Table 28).

Table 28. Timing of eruption of permanent teeth

Anomalies of the dental system manifest themselves in the form of disturbances in the development of teeth, dentition or jaws.

Anomalies in the number of teeth: primary adentia - absence of teeth, can be complete or partial; observed in both primary and permanent dentition. Secondary adentia occurs after tooth extraction.

Tooth retention- delayed eruption of a fully formed tooth, the position in the jaw is revealed by x-ray.

Supernumerary teeth- teeth located outside the dentition, and sometimes in the dentition, without disturbing its shape.

Anomalies in the shape and size of tooth crowns- increase in the size of all teeth in the arch (“gigantism”). The presence of small crowns of teeth leads to large gaps between teeth. The gap between the central incisors is called diastema.

Anomalies in the position of individual teeth: distinguish between palatal, lingual, vestibular, distal position, rotation of teeth, etc.

Anomalies in the development of hard dental tissues manifest as hypoplasia.

Enamel hypoplasia- a malformation of enamel, manifested in the form of chalky spots, pits, grooves without compromising the integrity of the enamel.

The presence of enamel hypoplasia indicates that during the period of tooth formation, the metabolism in the growing body was sharply disrupted.

The development of hypoplasia of milk teeth refers to the uterine and neonatal periods, and of permanent teeth - to early childhood. Hypoplasia occurs after rickets, severe infectious diseases, dyspepsia, and insufficiency of the endocrine glands in childhood. The severity of hypoplasia depends on the severity of the disease suffered by the child. With weakly expressed substance disorders, only chalky spots can form on the entire shiny surface of the enamel.

Enamel hypoplasia is divided into systemic(symmetrically located white spots on the teeth of the same name) and local(changes in the enamel of 1-2 permanent teeth). One type of systemic hypoplasia is “tetracycline” teeth. These are teeth that have a changed color as a result of taking tetracycline during the formation and mineralization of dental tissues. Taking tetracycline by a pregnant woman leads to staining of the incisors of a child's baby teeth, and administration of tetracycline drugs to children aged 6 months to 12 years leads to staining of permanent teeth. With age, the color changes, but does not disappear completely.

Fluorosis- disease associated with fluoride intoxication; occurs as a result of increased fluoride content in drinking water. This disease is endemic. The permanent teeth of children living in areas of endemic fluorosis or who settled there at the age of 3-4 years are more often affected. The maximum permissible concentration of fluorine in drinking water is 1 mg/l. Treatment and prevention of fluorosis are carried out by a dentist.

Malocclusions- violation of the relationship of the jaws in the sagittal, vertical or transversal direction. Anomalies are reflected in the appearance of the child and are accompanied by dysfunction of chewing, swallowing, speech, and breathing. Anomalies can be congenital or acquired. Progenic bite - The teeth of the lower jaw are located in front of the corresponding teeth of the upper jaw due to the displacement of the lower jaw or its larger size compared to the upper jaw. Open bite - when closing teeth between separate groups There is no contact between the teeth of the upper and lower jaws. Prognathic bite - The incisors and canines of the upper jaw are located in front of the corresponding teeth of the lower jaw.

Causes of malocclusion: hereditary predisposition, endocrine disorders, impaired intrauterine development of the jaw, improper artificial feeding, bad habits (finger sucking, lower lip), etc.

Treatment. The treatment is carried out by an orthodontist.

Prophylactic A. When artificial feeding, it is necessary to provide conditions for active sucking (use of an elastic nipple, shaped like a breast nipple, with a small hole). A pacifier is given to the child after feeding, if satiety with food has occurred and the sucking reflex has not subsided.

At 4-8 months, it is necessary to organize proper complementary feeding, eliminating the formation of bad habits.

At 7-8 months, the consistency of food consumed is changed; It is necessary to include pureed and porridge-like foods in the diet thick consistency; teach eating with a spoon, at night you can feed through a pacifier.

By the end of the first year, you need to teach your child to chew food correctly with his mouth closed. After one year, the child should be fed only with a spoon and watered from a cup; completely eliminate pacifiers and pacifiers.

If, when the jaws are closed, the teeth of the lower row are located behind the teeth of the upper jaw, the baby’s head should be placed on a higher pillow while sleeping. If the lower jaw protrudes above the upper jaw, then during sleep the child’s head should be placed on a flatter pillow. Eliminate the habit of sleeping with your head on the handle.

Viral diseases of the oral mucosa

Viral diseases today- the most common human diseases. They can occur acutely, chronically and latently. Many viral infections manifest clinically in the oral cavity. Most common viral disease- ordinary herpes. Diseases of the oral mucosa caused by various viruses (common herpes viruses, chickenpox, herpes zoster, Coxsackie A, foot and mouth disease), have similar clinical manifestations. The main morphological element of damage to the oral mucosa is a vesicle, which turns into erosion - aphtha.

Clinical picture. Viral hemorrhagic fevers manifest themselves in the oral cavity in the form of a “flaming” pharynx, catarrhal gingivitis, enanthema on the soft palate, hyperemia of the lips, seizures, and hemorrhagic rashes. Changes in the pharynx and soft palate are also observed with many other viral infections: influenza, parainfluenza, rhinovirus and adenoviral diseases, rubella. Specific changes occur in the oral mucosa during measles and scarlet fever. Clinically, herpetic infection in the oral cavity manifests itself in two forms: primary herpetic infection - acute herpetic stomatitis (primary herpes) and chronic recurrent herpes (recurrent herpetic stomatitis).

Gingivitis

Inflammation of the gums caused by the adverse effects of local and common factors and occurring without violating the integrity of the dentogingival junction. Gingivitis can appear as an independent disease or be a symptom of other diseases. According to clinical manifestation, gingivitis is divided into acute and chronic.

Clinical picture. Acute gingivitis is characterized by swelling, hyperemia of the gums, bleeding, and sometimes ulceration. In chronic gingivitis, inflammation of a productive nature predominates, when the gum becomes hyperplastic and partially or completely covers the tooth crown. Gingivitis is very common among schoolchildren as a result of unhygienic maintenance of the oral cavity and many untreated carious teeth. Gingivitis is common in children suffering from general diseases: rheumatism, tuberculosis, diabetes mellitus, hepatocholecystitis, nephropathies, etc.

Treatment. The basis of treatment is to eliminate the causes that provoked the development of gingivitis. For blood diseases and diseases of the gastrointestinal tract, treatment of gingivitis comes down to sanitation of the oral cavity. You should protect your gums from injury. The teeth are treated conservatively: wipe with swabs soaked in hydrogen peroxide, rinse the mouth with solutions of furatsilin and lysozyme. In case of increased bleeding, the gums are treated with a 5% solution of potassium permanganate. In case of diabetes, curettage of periodontal pockets is carried out only under anesthesia in combination with novocaine blockade. Add 1 ml of 5% vitamin B1 solution to the novocaine solution. The course of treatment consists of 20 blockades. Chronic gingivitis, in addition to traditional sanitation, they are treated by injecting a 40% glucose solution into the apex of the papilla - 0.1-0.2 ml 3 to 8 times into each papilla with a break of 1-2 days. Corticosteroids are used in the form of ointments or injections into the papillae - 0.1-0.2 ml of hydrocortisone.

Fungal diseases of the oral mucosa

Etiology. The disease is caused by yeast-like candida fungi, which are normally saprophytes of the oral cavity and are found in 40% of cases. healthy people. When the reactivity of the child’s body decreases, especially in early age, these fungi acquire pathogenic properties.

Clinical picture. Candidiasis develops - thrush. It occurs in mild, moderate and severe forms. The disease begins asymptomatically. Later, children become restless, sleep poorly, and suck the breast sluggishly. Older children complain of an unpleasant taste in the mouth, a burning sensation, and then pain appears when eating, especially spicy and hot food. Regional submandibular and mental lymph nodes may be slightly enlarged and painful. Body temperature is within normal limits or low-grade. Upon examination, on the unchanged or hyperemic mucous membrane of the tongue, lips, cheeks, and palate, groups of pearly-white spots ranging in size from fractions of a millimeter to 1-1.5 mm, round in shape, looking like semolina, are found. As the fungus multiplies, the affected areas slowly increase in size; merging with each other, they form a white film that rises above the level of the mucous membrane and resembles curdled milk. Sometimes the plaque is coarser, curdled, crumbly or foamy, and cracks (jams) form in the corner of the mouth.

Treatment. It is important to create an alkaline reaction in the oral fluid, which prevents the growth of the fungus. After each feeding of the child, the oral cavity should be washed with a 1-2% solution of baking soda or boric acid. A suspension of nystatin (1 tablet - 500,000 units) in 5 ml of breast milk is also successfully used. Older children, in addition, are prescribed rinsing with iodine water 5-6 times a day (5-10 drops of iodine tincture in half a glass of water) and lubricate the affected areas with a 0.5-1% alcohol solution of aniline dyes, and also use antifungal antibiotics.

Dental caries

A pathological process that occurs after teething, during which demineralization and softening of the hard tissues of the tooth occur, followed by the formation of a defect in the form of a cavity. The first signs of damage may appear during the eruption of primary and permanent teeth. With age, dental caries increases. Caries of primary teeth is found in children aged 2-3 years, the greatest damage is observed at 6 years, permanent teeth - during puberty.

The number of carious teeth in one child, as well as the number of carious cavities in one tooth, varies and determines the degree of caries activity. With a compensated course of caries, a 10-12 year old child in the oral cavity has no more than 4 teeth affected by caries, with subcompensated - up to 8-9 teeth. The decompensated form of caries is characterized not only by a large number of affected teeth (more than half of the teeth), but also by a large number of carious cavities. Children have many decayed teeth, devoid of pulp. When treating such teeth, it is difficult to achieve good fixation of fillings; the teeth do not maintain optimal physical activity, quickly collapse (crumple).

Pathogenesis. Factors contributing to the development of caries in younger age, are disturbances in the structure of dental tissues that arose during embryogenesis, in the antenatal period, under the influence of extragenital diseases of the mother.

Dental caries- this is a long-term chronic process, which is the focus and source of infection and allergization of the child’s body, since with food the child constantly swallows a large number of microorganisms and decomposition products of tooth tissue and food that lingers in the carious cavity. In addition, these same microorganisms, their toxins and waste products are absorbed into the blood through the mucous membrane of the mouth and at the points of contact between the tooth and the jaw. Such constant infection of the body and its sensitization contribute to the development of chronic tonsillitis, rheumatism, kidney diseases, joints, gastrointestinal tract and impaired vision.

Prevention. Caries prevention should begin in the prenatal period and continue throughout life. A pregnant woman's diet should include a wide range of proteins (primarily of plant origin), carbohydrates, and fats (milk, cheese, butter). The most valuable nutrition for a newborn is breast milk, since it contains the optimal set of necessary nutrients. During lactation, nursing mothers have a need for mineral salts, microelements, and vitamins. This need can be met by eating cottage cheese, cheese, milk (at least 500 g per day), eggs (1-2 pcs.), vegetables ( fresh cucumbers, carrots, radishes, etc. in an amount of at least 800 g per day). It is advisable to include fruits, berries, fresh herbs (sorrel, lettuce, etc.) in the diet of nursing mothers. It is better to eat bread made from wholemeal flour. Fluid intake should be limited to 2 liters per day.

The daily diet of a child aged 1-3 years should include milk (at least 700 g), cottage cheese (35-40 g), vegetables (at least 150 g, in addition to potatoes), and fruits (at least 100 g). The amount of sugar should not exceed 60 g, and sweets - no more than 100 g per day. Sometimes, even if all these conditions are met, children with multiple caries teeth. In these cases, it is necessary to identify the presence of factors contributing to its development: previous infectious and other serious diseases, impaired metabolism or impaired absorption and assimilation of certain nutrients, which is often observed in disorders of the gastrointestinal tract. In each individual case, appropriate measures should be taken aimed at treating existing diseases, rationalizing nutrition, additionally introducing calcium and phosphorus into the body in the form of calcium gluconate, calcium glycerophosphate with fish oil, vitamins BI, D, E, if they enter the body in insufficient quantities. Additional administration of vitamin BI reduces the incidence of dental caries. Vitamin BI is prescribed 2 times a day in doses containing as many milligrams per dose as the child is old, but not more than 10 mg per dose.

Limiting carbohydrates in the diet of both infants and older children and replacing sugar with non-cariogenic products (sorbitol, xylitol) in infant formula and confectionery - promising directions in the prevention of caries in children of preschool and school age. The most common method of preventing dental caries at present is artificial fluoridation of drinking water (up to a concentration of 1 mg/l), which reduces the incidence of caries by 30-50%. IN preschool institutions and schools practice rinsing the mouth with a sodium fluoride solution, as well as ingesting fluoride tablets and a fluoride solution with vitamins (vitaftor) as prescribed by the dentist. Fluorine-containing varnishes and gels are also used to coat tooth enamel. Fluoride-containing toothpastes “Ftorodent”, “Cheburashka”, “Signal”, “Lockout”, etc. have proven themselves well.

Treatment. Performed by a dentist. In organized groups of children, oral sanitation is carried out for children with a compensated form of caries once a year, with a subcompensated form - twice a year, and with a decompensated form - three times a year.

Periodontal disease

Periodontium refers to the complex of tissues surrounding the tooth and closely related to each other genetically, morphologically, and functionally. This morphofunctional complex includes the gums, alveolar bone tissue, periodontium and tooth tissue.

Periodontal disease- inflammation of periodontal tissues, characterized by progressive destruction of the periodontium and bone of the alveolar processes of the jaws. Periodontal disease is a dystrophic lesion of the periodontium. Inflammatory diseases periodontal disease occurs in children over 10 years of age and does not exceed 20 % from all inflammatory diseases.

Allergic stomatitis

Multiform exudative erythema. This is a recurrent disease that occurs with damage to the mucous membrane of the mouth and skin.

Etiology and pathogenesis. The etiology is unclear. Various intoxications play an important role in the pathogenesis, as well as the action of a number of unfavorable factors: biological, physical, chemical, which are allergens for the body.

Clinical picture. The disease often begins acutely, with a rise in body temperature to 38 C, and is accompanied by severe intoxication. Manifests itself in various ways morphological elements: erythematous spots, papules, blisters, etc. In children, not only the oral mucosa can be affected. Patients feel severe pain and burning of the mucous membrane of the lips, cheeks, and tongue, which interfere with food intake and make speech difficult. When examined on the reddened and swollen mucous membrane of the lips, cheeks, transitional fold of the tongue, and sublingual area in the initial stage of the disease, you can see single or grouped papules, vesicles and blisters of different sizes. The blisters quickly burst, and the mucous membrane eroded in this area is covered with a thin fibrinous film of whitish-yellow color, which is usually located in the plane of the surrounding mucous membrane. The lips are often affected, especially the lower lip. Injury to blisters on the red border of the lips leads to the formation of massive dark brown crusts. With secondary infection, ulceration of eroded areas is possible. Skin rashes are localized on the back of the hands, forearms, legs, face and have the appearance of bluish-red spots with round outlines. In the center of the spot there is an infiltrate, which turns into a vesicle. Blisters may immediately appear on the skin, surrounded by a bright red or bluish-red rim. The disease lasts 2-4 weeks and is very difficult for children to tolerate.

Treatment. Locally apply mouth rinse with antiseptic solutions (lysozyme, methenamine with novocaine, oil-based fortified mixtures). Canker sores are extinguished with 1% solutions of aniline dyes or powdered with a mixture of antibiotics and vitamin BI. For the purpose of desensitization, calcium supplements, diphenhydramine, pipolfen, and large doses of multivitamins are prescribed. At in serious condition For children, these drugs are administered parenterally.

Herpetic stomatitis (aphthous stomatitis)

Etiology. An acute infectious disease caused by the herpes simplex virus in children aged 6 months to 3 years.

Clinical picture. The disease occurs in mild, moderate and severe forms. The incubation period lasts on average 4 days. The disease begins acutely, as a rule, with an increase in body temperature to 37-41 ° C and general malaise. After 1-2 days, pain occurs in the oral cavity, aggravated by eating and talking. The mucous membrane of the mouth is hyperemic, swollen, then small vesicles appear on it, individually or in groups. They quickly turn into erosion - aphtha. Afta is an erosion of a round, oval or slit-like shape with smooth edges, a smooth bottom, covered with a grayish-white coating. Erosion can turn into superficial ulcers, and when a secondary infection is added, into deeper necrotic ulcers. Aphthae are localized mainly on the palate, tongue, cheeks, lips, and transitional folds.

Characteristic is diffuse damage to the gums - acute catarrhal gingivitis, more pronounced on the palate. Necrotic areas of the gums are yellowish-white in color and are not removed during treatment. The process involves only a narrow border along the edge of the gum, which is covered with purulent plaque. The gum contours are preserved. Gingivitis in acute herpetic lesions lasts for some time after the disappearance of general phenomena and epithelization of the aphthae. The tongue is usually heavily coated. Salivation reflexively increases.

Regional lymphadenitis precedes the appearance of afts, accompanies the disease and persists for another 5-10 days after epithelization of the afts. The red border of the lips and surrounding areas of the skin are often affected; the skin of the hands may be involved in the process. Other mucous membranes also change, primarily the gastrointestinal tract.

The disease has a favorable prognosis, clinical recovery occurs in 1-3 weeks, aphthae heal without scars, and the gum edges retain their shape.

Complication of pyococcal infection leads to impetiginization of the red border of the lips and surrounding areas of the skin, which in children is macerated due to increased salivation. The addition of fusospirillosis leads to the development of necrotizing ulcerative stomatitis.

Treatment. General treatment: the antiviral drug bonafton is prescribed 0.1 g 3-5 times a day in cycles of 5 days with breaks of 1-2 days. For the purpose of detoxification, hyposensitization and increasing the body's defenses, sodium nucleinate and antihistamines (diphenhydramine, suprastin, diazolin, etc.) are used in medium therapeutic doses, calcium gluconate 0.5-1 g 3 times a day, vitamins, especially C and P. In severe cases of the disease, if it is complicated by fusospirillosis, metronidazole or broad-spectrum antibiotics are prescribed orally (children should not be given tetracycline antibiotics). Cardiovascular drugs are prescribed according to indications. Mandatory diet: crushed high-calorie fortified foods, drink plenty of fluids.

Local treatment: in the first days of the rash, antiviral drugs are prescribed - interferon in the form of a solution or ointment (interferon 1 ampoule, anhydrous lanolin 5 g, peach oil 1 g, anesthesin 0.5 g), 0.5 % bonaftone, 1-2% florenal or 2% tebrofen ointment. These drugs are applied to the entire mucous membrane after pre-treatment with proteolytic enzymes, a 0.2% solution of deoxyribonuclease, characterized by an antiviral and cleansing effect from necrotic tissue, as well as antiseptics or herbal decoctions (chamomile, sage, tea).

Prevention. Avoiding contact of a sick child with healthy ones. In children's groups, children are examined daily to identify the initial signs of the disease (lymphadenitis, catarrhal gingivitis). For children who have been in contact, the mucous membranes of the mouth and nose are lubricated with antiviral agents for 6-10 days.