Sunday, September 6, 2009

My youngest patient ever.

At just under 1 month old this baby was by far the youngest patient I had ever seen.  Although the American Academy of Pediatric Dentistry recommends that the first dental exam be either when the first primary tooth erupts or by one year of age, even in the United States I rarely saw children under the age of 4.  I'll be honest I can treat fractures, infections, root canals, but this baby really intimidates me!    
From the expression on the babies face you can tell he was not happy but not because he was in pain thankfully.  He was not happy to have me prying around inside his mouth!   You can see in the above picture (if you look closely) bilateral solitary white lesions attached to the gingiva on his lower ridge.  Mom said he was breast feeding normally and growing as expected. 

The diagnosis made was gingival cyst of the newborn or Bohn's nodules.  These cysts are a result of degeneration of the epithelial rests of the dental lamina.   

The cyst is lined by odontogenic epithelium which is covered by a thick layer of keratin. Keratin gives the cyst its yellow color. Generally they rupture on their own with in the first two months of birth.  

I have seen him since the picture was taken and they had not burst as of yet. I'll continue to follow him week to week. 

1 comment:

Anonymous said...

Great pictures and a heart warming story. Can this affect his ability to nurse and consequently to grow or is all OK? Do you ever pop them or do they do so on their own? Mom