Periostitis in children

Periostitis is also widely known by its other common name – gumboil. The word fluss comes to us from the German language, where it is used to denote a flow or stream. It very accurately and precisely reflects the very essence of this disease. Periostitis in children is characterized by a very rapid and wide spread of purulent masses in the tissues due to acute or chronic inflammatory processes in the periosteum of the jaws, in which a subperiosteal abscess is formed.

In its etiology, periostitis may be associated with dental diseases, in particular, it may arise as a consequence of inflammation of the tissues surrounding the tooth or the active stage of chronic dental infections. In this case, periostitis is a disease of odontogenic nature. Clinical manifestations of periostitis are expressed in serous, acute, purulent and chronic forms. In addition, it can be caused by non-odontogenic, traumatic factors. Based on this, it is very important to promptly determine the symptoms that characterize periostitis in children and immediately consult a doctor to localize the disease and prevent possible complications.

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Causes of periostitis in children

The causes of periostitis in children can be named as follows. One of the most common factors causing infection of the jaws are teeth affected by any, especially chronic inflammatory diseases. A neglected condition and untimely treatment of diseased teeth can cause the infection to eventually spread to the jaws and other parts of the face. Therefore, regular preventive examinations of children's teeth by a dentist and, if necessary, treatment are so important, despite the fact that the teeth are baby teeth and will eventually fall out on their own. In some cases, periostitis can be provoked as a result of traumatic impact or extensive wounds of the soft tissues of the face, when pathogens spread to healthy areas from damaged areas.

The causes of periostitis in children include such a specific factor as the spread of infection from the inflammation foci in the body through the blood and lymphatic vessels. This cause of periostitis mainly occurs in cases of tonsillitis and all sorts of childhood infectious diseases. The activation and development of the inflammatory process is also caused by a decrease in immunity, recent colds - tonsillitis, flu, etc., hypothermia, fatigue, stress.

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Symptoms of periostitis in children

To determine the symptoms of periostitis in children, it is necessary first of all to pay attention to the fact that the onset of this disease is indicated by the occurrence of edema in the inflammation center. The gum around the affected tooth significantly increases its volume in a short time, which is accompanied by severe persistent pain. After several days, an abscess appears under the periosteum, which in turn provokes swelling of the cheek on the side where the inflammation began. The inflammation zone may include the lips, areas under the jaw and under the eye socket, localization is determined by the location of the affected tooth. Painful sensations also occur in the temples, eyes and ears.

Symptoms of periostitis in children are characterized by an increase in temperature to 38 ^o C, swelling, and general malaise. In some cases, spontaneous opening of the abscess occurs, which is accompanied by the release of a large amount of purulent exudate. In this case, the intensity of inflammation decreases for some time, but soon the inflammatory processes are activated again. The most common complication is the involvement of soft facial tissues or bones in the number of infected areas, which can cause the development of osteomyelitis.

Odontogenic periostitis in children

Odontogenic periostitis in children is a consequence of inflammatory processes in the gum of the affected tooth, which have a chronic stomatogenic infection as a prerequisite. Odontogenicity in this case indicates the source and cause of the infection in the periosteum. This disease mainly occurs in the spring and autumn season in children aged 4-5 years. Odontogenic periostitis can develop as a complication against the background of chronic acute and exacerbated periodontitis and be provoked by microflora, which is mainly located in the periodontium, penetrating there through the dental canal. In addition, there is a possibility of its manifestation due to osteomyelitis, difficult teething and periodontal diseases. Odontogenic periostitis in children is distinguished as an independent nosological form of periostitis and can sometimes act as an accompanying aspect of some forms of inflammation in the dental pulp. Acute periodontitis in all forms also occurs in its accompaniment, in addition, its causes include suppuration in the tooth root cyst. Based on where it is localized, whether in the alveolar processes or tubercles of the upper jaw, or in the lower jaw (alveolar process, branch, edge), it has certain specific features of the course of the disease.

Acute purulent periostitis in children

Acute purulent periostitis in children may occur as a complication of acute serous periostitis, which in turn occurs against the background of chronic acute or exacerbated periodontitis. The period in a child's life when this disease mainly occurs is determined by the age of 6-8 years. Its peculiarity is the accumulation of purulent masses in the form of abscesses in the subperiosteal region. There is swelling of the soft tissues of the face, in areas associated with foci of pus accumulation, their compaction and infiltration are observed. It is accompanied by an increase in body temperature to 38-38.5 C and phenomena of neutrophilic leukocytosis. The tooth affected by the infection becomes mobile, lymphadenitis may develop, changes in the blood composition occur, in particular, the level of leukocytes and ESR increase. In many cases, there are signs of severe intoxication. The general condition of young children can vary in severity from moderate to severe. If you do not contact a specialist in a timely manner to prescribe adequate treatment, there is a risk that acute purulent periostitis in children will progress to the stage of acute odontogenic osteomyelitis, which will become a prerequisite for the development of phlegmon and abscess.

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Periostitis of the jaw in children

Periostitis of the jaw in children most often occurs as a result of caries, accompanied by all sorts of complications, or dental pulpitis - inflammation of the bundle of vessels and nerves that feed the tooth. Periostitis of the jaw can also occur due to damage to the jaw (fractures) or soft tissues in the oral cavity. In children, the infection that causes the development of this disease occurs by transporting the infection through the lymphatic or circulatory system. The risk factor in this case is the presence of infectious diseases, tonsillitis, sore throat, etc. One of the very first symptoms by which one can determine periostitis of the jaw in children is the increasing swelling of the soft tissues surrounding the diseased tooth, accompanied by pain. If treatment is not started within a short time, the inflammation spreads to the periosteum, under which a collection of pus begins to form. Depending on the location of the affected tooth, the swelling can be localized on the neck, in the eye or lip area. At the same time, the intensity of pain constantly increases. The pain may decrease if the abscess spontaneously opens through the mucous membrane in the oral cavity. However, this does not stop the progression of the disease.

Diagnosis of periostitis in children

Diagnosis of periostitis in children is a task that requires a high level of competence from a specialist and assumes great responsibility. The difficulties in diagnosis are that periostitis, by a number of signs, is very similar to acute odontogenic osteomyelitis. The degree of similarity is such that in some cases, for the most accurate confirmation of the diagnosis, it is necessary to perform an incisional biopsy - taking a fragment of living tissue from the affected area for subsequent examination under a microscope. In addition to this method, diagnosis of periostitis in children comes down to the analysis of the following factors. The presence of a carious tooth that caused the spread of infection is determined; swollen or protruding transitional fold; the mucous membrane in the area of 1-2 adjacent teeth is hyperemic or edematous; the pathological focus is localized only on one side of the maxillary alveolar process (usually at the vestibule of the oral cavity); detection of a fluctuating symptom, which indicates destruction of the periosteal part and that pus is spreading under the mucous membrane. Rarely, acute periostitis causes the development of an inflammatory infiltrate in the facial soft tissues. The infiltrate tends to persist even after several days have passed since the diseased tooth was removed, which can be misleading in diagnosis.

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Treatment of periostitis in children

Treatment of periostitis in children requires immediate referral to a specialist. As a result of self-treatment, the pain may go away and relief may come for some time. However, this does not mean that the problem is completely solved and the disease has finally retreated. In fact, the longer the inaction, the more intense it becomes, losing some visible manifestations and moving into a latent phase, which is an even greater danger. To achieve maximum effectiveness and to avoid complications and relapses in the future, treatment should be carried out according to the recommendations of a pediatric dentist.

Treatment in most cases comes down to the fact that the tooth causing the infection is removed or endodontic treatment is applied to it, which is carried out in order to prevent infection of the periosteum in the future. A competent doctor, having at his disposal a large set of tools and a wide range of medications, will prescribe the drug that will help get rid of the pain symptoms with the least harm to the child's health. As a result of using arsenic, the pain in the destroyed nerve will go away and it can be removed without hindrance. At the next stage, the treatment of periostitis in children consists of prescribing antibacterial therapy, the intensity of which is selected based on the severity of the disease. Traditionally, it is advisable to use antibiotics, physiotherapy procedures, iontophoresis, ultrasound therapy and laser therapy. A diet with abundant drinking is also prescribed, excluding hard and tough food, salty and spicy dishes.

Prevention of periostitis in children

Prevention of periostitis in children is currently a very pressing issue. After all, the lower age threshold for dental diseases is becoming smaller and smaller, and children face many dental problems almost from the moment the first tooth erupts. In addition, compared to adults, children are much more sensitive to pain and it is much more difficult for them to endure negative sensations. Since the treatment of periostitis requires a comprehensive approach and is associated with significant expenditure of time, effort and parental nerves. Not to mention the financial side of the problem. Therefore, it certainly makes sense to make an effort to take a number of preventive measures, because it is easier to prevent periostitis than to treat it.

Thus, prevention of periostitis in children consists of a combination of the factors listed below. One of the very first and most important aspects of a child's dental health is a balanced diet of a woman preparing to become a mother. This contributes to the correct formation of the teeth of the future child. Furthermore, one should not forget that dental health significantly affects the overall positive condition of the child's body and the well-being of the baby. The correct diet of the child is also important. He should also be taught dental and oral hygiene from an early age, and regularly taken to a pediatric dentist for preventive examinations.

Prognosis of periostitis in children

The prognosis for periostitis in children, if diagnosed early and treated immediately, is generally favorable. It is very important to establish an accurate diagnosis, determine the stage and severity of the disease, and prescribe appropriate treatment. Based on this, a treatment method is selected - conservative or surgical. The first involves the use of non-steroidal anti-inflammatory drugs, which help reduce the degree of inflammation and bring it closer to the recovery stage. A positive result of surgical intervention is that the installed drainage ensures free outflow of purulent masses from the affected area. If periostitis is caused by inflammatory processes in the diseased tooth, it is removed.

A favorable prognosis for periostitis in children is determined by a combination of a correct diagnosis and appropriate treatment. Self-treatment may result in some relief, and swelling may subside as a result of an abscess that has opened. However, one should not, based only on these facts, immediately interrupt treatment, because the disease may become chronic and cause all sorts of complications.