Cysts in child's mouth

[crapatthis1]

Hi guys

Just have some reassurance from anyone that's had their child had anything similar.

DD (13) had a standard check up today at the dentist, all fine with her teeth, good brushing.
However they spotted some swelling in her cheek (no one had noticed it) but upon an X-ray they discovered that she had a large cyst growing and also a smaller one on the other side. They said that there was possibly one growing in her sinuses too. The large one had completely eroded the bone under one of her back teeth and just one football to the head etc and could fracture her jaw! The swelling wasn't noticeable on the outside and DD had no pain and full sensation, dentist said it was just unlucky, last seen in May no issues.

DD will now be urgently referred to hospital by the dentist to get them removed. Can't do sports until then.

I'm so worried and upset. My poor DD. The dentist said she'd never seen it before which is always worrying to hear. I forgot to ask if it was cancerous and I'm imaging all sorts now.

Has anyone's child had this or similar and been okay?

Just giving you a bump, sorry no advice. That sounds worrying, presumably the dentist would have told you to go straight to the GP or A&E if it was anything sinister.

Thank you, I'm hoping so. So many things I wished I'd asked but I think was in shock. They just said she would need to go for surgery and to not do PE in case of breaking her jaw. They've put through an urgent referral.

Bump!

Crikey I didn't want to read and run either. Wishing your daughter all the best but no advice sorry.

Thank you :)

DD has something rather similar but the small bone lessions in her jaw were found to be part of polyostotic fibrous dysplasia. She has had work on her jaw and legs becuas eof it.

Good call on the dentist making an urgent referral as any large bone legion be if PFD or a cyst will weaken the bone. Its a lot less painful to have surgery as an urgent planned than as an emergency due to a fracture over a weak section of bone. Best thing to do is write down any questions you want to ask and take them with you to remind you what you wanted to ask.

The bit about PE is a genuine and serious risk till the hospital have chance to assess and work out how weak the jaw may be. DD had to stop all high impact sports in case she breaks across one of her weak points.

DD is fine. She does have bone pain from the larger lessions. She has had surgery to repair breaks and internal fixtures to hold weak bones together. She has regular check ups done under oncology- you MIGHT be refered there not becuase they think its cancer but because ortho-oncologists have the surgical skill to manage bone lessions regardless of cause.

For bone surgery- if thats the route recommended encourage yourDD to accept all the pain meds on offer for major bone work for the first 12- 24 hours. My DD swears that of you hit the initial post-op pain back hard you can then titrate the pain meds down as you regain movement and work with phsyio's and SALTs. Talk to the surgeons about post-op pain management if she is very unlucky and needs more than a day case care. If they are talking day case the initial pain med in recovery should see her through with milder oral meds like paracetomol to take at home.

Hope all goes well

Thank you so much, that's really detailed and helpful information. The dentist just said that she'd need to have surgery in hospital and after can only eat soup in a straw for a few days! That's literally all I know and I was only once I got home I kicked myself for not asking more. I was just shocked, was meant to be a normal check up, DD had no symptoms , no pain so it's all a bit overwhelming.

You have done the right thing by keeping your DD's routine dental check up. They exist to spot any developing problems as this one did. Some kids are simply prone to developing cysts. If your DD is one of them the dentist will keep a closer eye on her. My DD has 3 monthly dental check ups as the FD lessions are in her jaw under her teeth and have prevented some of her adult teeth from forming and prevent her teeth from being well rooted. You can ask the hospital if there is anything that might reduce this happening for your DD in the future.

Soup is okay for a couple of days but it gets boring fast if that all you have. Just make sure whatever you use has no bits and is of a smooth consistancy. Very cold and very hot is not usually recommended post oral surgery. Check with the surgeons/nurses what they recommend post op as what your DD needs done will effect what post-op care they recommend. Do follow the post op care as its designed to help the inside of the mouth to heal.

These are my DD's go to's when she has had to play with maxofacial surgeons. Sharing so you can have some ideas of what MIGHT be possible depending on your daughters post op care.

Please note that my DD is allowed the sugar and higher fat as she always looses weight when she has work done for the FD lessions in her face. To puree I use the liquidser on my mixer. I warn you now, after the first 24 hours you are likely to have a bored with bland pureed foods teen on your hands so try and be creative and ask your DD if she can suggest tastes she like and if she could help you to make them. My DD would not eat anything I would not try after some of the dietery supplements the hospital dietician tried to sneak her.

Clear fluids post op: DD is allowed to use a premium sugar based fruit cordial. The sugar content helps her with energy until she is able to manage purees. Pre if LA or post op if GA your DD MIGHT be offered a sugary shot drink for a similar reason. It can really help if the Drs think its needed.

I take Baby fruit and veg smooth purees in to hospital if DD is in for more than a day. The baby small smooth puree packs for 6 month olds are fine- at this stage my DD can usually only manage 2-3 teaspoons at any time.

At home.
Cream of chicken soup [make sure its smooth- look out for chicken lumps]
Pureed broccalli and stilton soup. You can melt extra stilton into the soup to make a more filling/calory dense soup.
Pureed lentil soup.
Any soup your DD fancies that CAN be easily pureed to a smooth puree and still look and taste okay. Look for ones with a source of protein in i.e carrot with added beans, veg with lentils. TBH beans and pulses puree better than meat
Home made banana with vanilla clotted cream or just use blue top milk shakes.
Premium custard [the kind in the supermarket that is made with cream and eggs]

When she is able to manage some consistancy:
Jelly - no fruit bits though.
The top section of a premium plain new york cheescake.
Plain yogurt with seived fruit puree [removes any seeds and all but the softest lumps]
Mashed potato moving on to adding melted cheese or blitzed baked beans.
As her mouth heals you can gradually move on to very slow cooked cassorles that are soft enough to fall apart.

Hopefully your DD will only have small incisions that heal cleanly and quickly

Thank you , great tips.

She's worrying about the food so I'll definitely use your suggestions. She's also worrying about being put to sleep but Ive reassured her it'll be fine. I just don't understand how we didn't notice or she didn't have symptoms that she had a huge cyst that has eroded some of her bone. She doesn't look swollen at all from the outside, full sensation on her face and in no pain at all!

I admit I was aghast when I saw the full mouth and face x-rays of my DD. Mine you I did not know about the massive FD lessions in her legs and put the on off pain she sometimes mentioned down to growing pains and her largest FD lession in her femur is 15cm in length and its very wide hence the metal work. It only twinges when its snowing or heavy rain. It is not always possible to have an inkling of what is going on under the skin until someone spots it usually with an eray, cat scan or MRI. It is even harder if your child has not noticed significant pain or developed sign-posting systems that all is not well. The only external clue to possible PFD on my DD are tiny cafe au lait spots on her worst affected leg and under her jaw.

Being under a GA will make it easier for your DD. My DD did not opt for LA nerve blocks for some 'lighter' maxofacial work till she was 16. She does have a very high pain threshold though but even she opts for a GA if it will involve surgical scraping a bone clean and then reconstructive packing and internal fixtures. Some things are best done under GA. She MIGHT be worrying that she will still feel or be awake when they do the surgery if this is first GA. Teens like to share some ghastly horror stories with each other about surgery at school.

Encourge your DD to chat with both the surgeons and anesthetist about her concerns and questions. When you are a young teen feeling like you have some say and that you are being listened too and answered can help you feel you have some control. Some hospitals can provide photos of pre and post-op so its a bit more familar esp if you cannot go down with your child till they are under and wake up due to covid rules.

If she knows what her pain relief options are it will help her manage any post op pain. Be honest it will probably hurt some and be uncomfy but it should not be raw agony. Knowing if your going to wake up with internal or external dressings can help with the disorentation that can happen as the GA wears off. Mine is always convinced she is swimming under water with shimmering fish as she comes out of a longer GA and needs to take her scuba mask off- so expect a bt of strangeness as she re-surfaces and the GA drugs wear off. Keep telling her she has been brave and had the op and is in recovery, if she has any surgical dressings in place that need to be left alone and where she will be when she is fully awake. The hospital will make sure that she is safe to go home and is not in huge amounts of pain before letting her go.

Paracetomol helps post op BUT make sure you have either the 6+ syrup or age suitable totally soluable tablets. They will be easier for your DD to swallow. My DD recommends the 6+syrup as it does not taste quite as foul as the soluable tablets.
If any anti-biotics are needed ask for the soluable/syrup version for the same reason.

Hope all goes well for your DD.