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Soft tissue lesions of the oral cavity in children

Martha Ann Keels, DDS, PhD
Section Editor
Ann Griffen, DDS, MS
Deputy Editor
Mary M Torchia, MD


Soft tissue lesions of the oral cavity in children may be normal/developmental findings or indicative of gingivitis, periodontal disease, local or systemic infection, benign tumors, or life-threatening systemic conditions (table 1).

The clinical features and management of common soft tissue lesions of the oral cavity in children will be reviewed here. Congenital anomalies of the oral cavity, gingivitis, periodontal disease, and the oral manifestations of systemic conditions are discussed separately. (See "Congenital anomalies of the jaw, mouth, oral cavity, and pharynx" and "Gingivitis and periodontitis in children and adolescents" and "Periodontal disease in children: Associated systemic conditions".)


Eruption cyst or hematoma — Eruption cysts are dome-shaped soft tissue lesions associated with the eruption of primary or permanent teeth. They are caused by fluid accumulation within the follicular space of the erupting tooth. Eruption cysts are called eruption hematomas when the cyst fluid is mixed with blood (picture 1). No treatment is needed; eruption cysts resolve spontaneously as the tooth erupts through the lesion. If the tooth does not erupt within two weeks, the child should be reexamined to evaluate other causes.

Pigmentation — In dark-skinned children, pigmentation of the attached gingiva, due to melanin, is a normal finding [1].

Retrocuspid papillae — Retrocuspid papillae are small (2 to 3 mm [0.1 inches] in diameter), firm, round, pink to red, fibroepithelial papules on the gums behind the lower canines in most children (picture 2). They are often bilateral. They usually are asymptomatic and decrease in size with age. No treatment is necessary.

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Literature review current through: Dec 2017. | This topic last updated: Oct 23, 2017.
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