Swelling, sores and crooked teeth can indicate a tumor in the mouth of children

In November last year, Kauã Costa da Silva, 16, returned to the dentist 15 days after pulling out a tooth to remove the stitches. From that moment on, he noticed that the spot began to swell and become painful.

Neither he nor his parents knew yet, but there began a disorder that would change his future forever. The extraction of the tooth made a desmoid tumor emerge, which, in a few months, took the entire bony part of his dental arch until it reached the base of the skull. The good news, discovered later, is that it was benign.

The case of Kauã shows the importance of taking care of the oral health of children and adolescents. Any change can be a sign of a bigger problem than just cavities. And parents need to be careful.

According to Camila de Barros Gallo, professor of the discipline of Clinical Stomatology at Fousp (School of Dentistry, University of São Paulo), usually cases of tumors in children and adolescents are benign, but even so, they need to be treated urgently.

“Malignant tumors usually happen due to the accumulation of errors, the DNA accumulates errors, and this happens in the elderly. In children it is not expected, unless it is genetic”, he says.

The teacher warns that the child’s brushing must be accompanied by an adult until at least six or seven years old, age at which he will acquire the motor capacity to do the hygiene alone. “Until this stage, the adult will notice if there are changes in the positioning of the teeth or the increase in volume in the region.”

There are three signs that parents need to be aware of in the mouths of their little ones. The first is the appearance of bumps on the face, like the one in Kauã. Then, the appearance of sores on the gums that do not heal within 15 days. And lastly, if the teeth start to crook or create spaces that didn’t exist between them before.

Head and neck surgeon Marcos Roberto Tavares, who monitored Kauã at the Hospital das Clínicas, says that the teenager also had crooked teeth, in addition to swelling, reasons to turn on the red alert and seek professional help.

As is often the case in healthcare, the delay in diagnosis ends up worsening the patient’s situation. That’s what happened to Kauã. After the tooth was extracted and the swelling increased, he went back to the dentist who, even with the X-ray in hand, said it was normal.

Only after receiving a referral did his mother, Edilaine da Silva Costa, take him to a dentist specializing in oral and maxillary surgery at Hospital do Mandaqui, in the north of the capital. From there, he was taken to Hospital Santa Marcelina, in the east, where he was diagnosed for the first time with a benign desmoid tumor.

“The hospital said that it could not perform the surgery and that the procedure would be at the Municipal Hospital of Tatuapé, specializing in surgery and oral and maxillofacial traumatology. The problem is that the operation was only scheduled for the end of this month of July”, says the mother.

With her son’s face increasingly swollen, the mother did not want to wait and took him to the Emergency Room of Hospital das Clínicas, where he began to follow up until the surgery was scheduled for June 21, a procedure that was postponed for three days. later due to lack of anesthesiologist. The hospital reported that the professional needed to be moved for an emergency operation.

Finally, Kauã was operated on by three different teams for about 16 hours. The head and neck surgery team removed the tumor from the jaw, the neurosurgery team removed the base of the skull and the plastic surgery team reconstructed the facial bones.

“Sometimes, the tumor starts in the face and goes to the brain, at the base of the skull. So, we take the tumor from the bottom up and the neurosurgeons take it from the top down. And then the plastic surgery does the reconstruction. I couldn’t have this type of surgery because I didn’t have the reconstruction, but nowadays plastic surgery does it. They take part of a bone from the leg, the fibula, and make all the curves to fit the jaw. It’s a complex surgery”, he says. the doctor Marcos Roberto Tavares.

Even without the need to undergo chemotherapy, which is only performed in malignant tumors, Kauã’s recovery must be prolonged and will require a lot of care. He left the ICU (Intensive Care Unit) on Thursday (7) and is recovering in his room. Therefore, in order not to reach this severity, the ideal is that the diagnosis is made as soon as possible.

“What scared me the most was when I discovered the tumor. I didn’t know that this could happen because of a tooth. I was very frustrated when they told me at Santa Marcelina that he had a tumor in his jaw, that he was going to lose his jaw and not I wouldn’t be able to chew if I didn’t have a way to make the prosthesis”, says Edilaine.

“As it took a long time to do the surgery, the tumor reached the base of the skull. He could lose sight and movement in his face, not just in his jaw. It scared me a lot.”

“Everything that is simple, irrelevant, will end in two weeks. If it is more complex, it is good to look for a professional, even if it is a benign tumor”, warns Professor Camila de Barros Gallo.