Soft Tissue Pathology

Epstein Pearls

Epstein pearls are small white lesions that form along the midpalatine raphe. They are thought to be remnants of epithelial tissue that were trapped along the raphe as the fetus grew. No treatment is necessary as the lesions spontaneously shed within weeks of birth.

Image: Epstein Pearls

Bohn’s Nodules

Bohn nodules are formed along the buccal and lingual aspects of the dental ridge and on the palate away from the raphe. The nodules are considered remnants of mucous gland tissue. No treatment is necessary as the nodules spontaneously disappear within weeks of birth.

Image: Bohn’s Nodules

Dental Lamina Cysts

Dental lamina cysts are found on the maxillary and mandibular dental ridges. It is thought the cysts originate from remnants of the dental lamina. No treatment is necessary as the cysts disappear within weeks of birth.

Image: Dental Lamina Cysts

Riga-Fede Aphthae/Granuloma

Riga-Fede aphthae are granulomatous ulcerations that appear on the tip and inferior surface of the tongue. They are due to chronic trauma to the tongue from the primary incisors during sucking or involuntary movement of the jaw. Treatment consists of reducing the sharpness of the teeth by placing a protective composite shield over the incisors or extraction of the teeth.

Image: Riga-Fede Aphthae/Granuloma

Eruption Cysts

Eruption cysts are associated with erupting deciduous or permanent teeth. The lesions present as soft well demarcated swellings overlying the crown of the erupting teeth. Variations in color may exist depending on the amount of blood contained within the cyst. Treatment for the cysts is often not necessary because they rupture as the teeth erupt. However it is suggested that the clinician inform the parent of the possibility of the appearance of blood on the pillow following sleep.

Image: Eruption Cysts
Image: Eruption Cysts - close-up

Geographic Tongue

Geographic tongue is a harmless common disorder of the tongue characterized by atrophy or temporary loss of filiform papillae. The lesions are usually multiple and asymptomatic, although burning can occur. The lesions can last for two weeks, disappear and reappear in another area. No treatment is indicated.

Image: Geographic Tongue

Postoperative Soft Tissue Injury

Accidental biting or chewing of the lip, tongue or cheek is a problem seen in very young pediatric patients and mentally or physically disabled patients. Soft tissue anesthesia lasts longer than pulpal anesthesia and may be present for up 4 hours after local anesthesia administration. The most common area of trauma is the lower lip and to a lesser extent the tongue, followed by the upper lip. The management of soft tissue trauma involves reassuring the patient and parent that it’s normal if the tissue turns white, allowing up to a week for the injury to heal, and lubricating the area with petroleum jelly or antibiotic ointment to prevent drying, cracking and pain.

Image: Postoperative Soft Tissue Injury