Multiple Oral Mucocele

The patient is a 5 year old boy diagnosed with multiple oral mucocele was referred to me by dentist. The parents did not want to opt for surgery and were seeking alternative treatment.

The parents gave consent for the dentist to discuss the case with me. The father explained that they started observing these little bumps on his mouth since a few days before. He said the child is repeatedly falling down while he is playing and he has been biting his cheek or lower lips often. He said the child had teeth marks inside his mouth and was crying with pain and the area was red and swollen. They started applying mouth gel and the boy was feeling better.

A week later the mother noticed tiny little lumps inside his mouth as he was complaining of pain.  The dentist diagnosed it as  Mucocele.  The dentist assured them that it will go away as it is just the saliva blocked inside those little cysts as a result of bites/injury or trauma to the buccal mucosa.

However after a few days his mucoceles grew big and started bothering him while eating and drinking and the dentist saw the child again and said the only option left was surgery.

The child has a habit of biting his tongue also constantly puts his fingers inside his mouth or he puts toys into mouth.

Practitioner note:

These lesions occur as the result of trauma or obstruction to the salivary gland excretory duct and spillage of mucin into the surrounding soft tissues.

Signs and symptoms:

Mucocele often show up inside the lower lips, on gums, the roof of the mouth, or under the tongue. Mucocele are movable and painless. Soft, round, dome-shaped. pearly or semi-clear surface or bluish in color. 2 to 10 millimeters in diameter.

As I observed the child, he was very hyperactive and clinging to father and demanding things, and when father said no, he was fighting with his dad and crying bitterly.

I was trying to talk to him but he refused to talk to me. He made a grumpy face and turned his face away full of tears and was not ready to cooperate with me.

His parents said he is a stubborn and pampered child. He is the only child for them and they give him everything that he demands. If he does not get what he wants he will be crying the whole day and will remain very sulky. He does not like to be reprimanded by his parents. He is not obedient. His mother said when he plays with his cousins he is very dominating, quarrelsome and annoying. He wants attention from others. At school he is shy and timid and takes time to mingle with others but he is good in studies and he loves sports and music. He likes to dance always. He is very artistic. He likes to color and draw.  He is easily distracted and feels exhausted fast.

He feels cold easily. He loves to eat sweets and chocolate. His appetite is great and he drinks water often. He likes non vegetarian food and fast foods. He perspires a lot especially while playing and on his head, palms and soles. He also complains of anal itching. Most of the time he is constipated and has difficulty in passing stool. He has tonsillitis and fever on and off.

The physical examination:

Oral cavity: Inspection: I could see multiple soft swelling lumps ranging from 1- 10 mm. some lumps are colorless and some are filled with mucus.

On palpation:  Soft and painless lumps.

All other vital parameters are normal. Lymph gland enlarged sub mental.

Totality of symptoms:

Abscesses inside the mouth, after trauma/injury/bite

Painless abscess, <eating  <drinking

He puts his fingers/objects inside his mouth

Hyperactive and irritable kid, < correction

Sulky, does not like to talk and clinging to the father

Weepy. Head strong, quarrelsome, timid. Thirsty and increased appetite constipated with anal itching, craving for sweets, chocolate, ice cream.

Reportorial Result:

The case was repertorised using Complete Dynamics. 15.2 , 2014

25 rubrics are taken under standard analysis considering all medicines and the first 5 remedies which came forward were:

1. Silicea 100/15
2. Lyco 87/14
3. Staph93/13
4. Calc 90/13

Remedy of choice:  Silica 200

After reportorial analysis I decided to prescribe Silicea 200 based on his pathology as well as considering his characteristic homeopathic symptoms as a person.

The next closest remedy was Staphysagria as it covers most of the symptoms present in this case and it is also a suitable remedy for this kind of pathology.

General management:

Avoid the habit of chewing or sucking on the lips or cheek.

Give semi solid food to avoid the bite

Maintain the oral hygiene; wash the mouth after each meal.

Advised not to bite and take care of the baby from repeated falls to avoid bite marks.

Try not to burst it open to avoid ulceration.

Don’t let him put objects inside his mouth.

Prescription:

Silcea 200 was given based on patient’s age and susceptibility, sensitivity and vitality of the patient. The first dose was one dose orally allow medicine to dissolve under the tongue. Second dose of Silicea 200 was given to the patient’s mother to be given after 1 week at bedtime. Follow-up appointment was given after 15 days.

First follow up ( sep 28^th 2014)

Patient’s mother said after a week of medication the lump inside the mouth started reducing slowly in size and also she did not see any new one’s appearing. She said his behavior changed drastically. He was quiet and calm, eating well and passing stool daily, drinking water regularly. His cold and throat pain went away after a few days. I could see Herings law of cure happening in this patient which is a good sign.

The physical examination:

Oral cavity: I could see multiple soft swelling lumps size ranging from 2- 5 mm (compared to 1^st visit the size and number is reduced to half)

On palpation:  Soft and painless lumps.

All other vital parameters are normal.

I felt I must repeat Slicea 200 once again as I there are still lumps inside his mouth. So Silicea 200 was given once a week at bed time for 15 days.

Second follow-up ( October 15^th 2014)

Patient’s mother said one by one all the lumps slowly disappeared.

The physical examination:

Oral cavity: Inspection: No lumps but small tiny marks are seen in those areas of lesions. On palpation: Nothing palpable.

All other vital parameters are normal.

Inference:

After 1 month of medication with Silicea 200 – 4 doses the lumps inside the mouth went away completely. I informed the dentist that the child is completely recovered and told him to examine for further confirmation.

End of the case

In this case the patient improved within a month of homeopathic medicine.

 Before treatment (Oral Mucocele)

During treatment

After treatment