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ABSTRACT:
Traumatic ulceration that occurs on the ventral surface of the tongue in neonates and infants has been described as the Riga-fede disease. Most commonly associated with natal or neonatal teeth but can also occur due to primary lower incisors. Failure to diagnose at an early stage can affect the overall health of the infant. Conservative treatment approach is always recommended followed by surgical excision of the lesion in case the earlier did not yield positive results. Here we present a case of riga-fede disease in an 8 month old infant due to trauma from deciduous lower incisors.
Key words: Riga-fede disease, tongue deformity.
Received: 02/05/2020 Modified: 10/06/2020 Accepted: 15/06/2020
INTRODUCTION
Traumatic ulceration occurring on the ventral surface of the tongue due to repetitive protrusive and retrusive movements over the lower incisors in neonates is termed as riga-fede disease. It is an uncommon benign mucosal disorder caused by natal or neonatal teeth, sometimes may be due to primary incisors.1 This condition in infants has been given various other names like traumatic lingual ulceration, eosinophilic granuloma and traumatic eosinophilic ulceration of the tongue and oral mucosa, sublingual fibrogranuloma, sublingual growth in infants, traumatic atrophic glossitis.2
This disease was first identified, by an Italian physician, Antonio Riga in 1881 and was described by Fede in 1890 who performed the histological studies of the lesion thus being called Riga-Fede disease. The expression traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) was coined by Elzay in 1983, referring to a chronic but self-limiting reactive ulcer of the oral mucosa.2
Initially the lesion begins with ulceration on the ventral surface of the tongue, but with repeated trauma may lead to the formation of an enlarged fibrous mass resembling an ulcerative granuloma. Pain caused due to ulceration can lead to feeding difficulties in infants affecting nutrient intake leading to dehydration with other medical sequelae.3
Treatment focuses on eliminating or reducing the factors causing trauma. Treatment depends on the tooths mobility and the risk of aspiration or swallowing; whether it is supernumerary or regular primary teeth; whether it is causing interference in...