BEDNAR’S APHTHAE IN INFANTS IN DUHOK; A PROSPECTIVE CROSS-SECTIONAL STUDY

Authors

  • Azad A. Haleem Department of Pediatrics, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
  • Nareen A. Abdulrahman Department of Community and Family Medicine, University of Duhok, College of Medicine, Kurdistan Region, Iraq.
  • Akrem M. Atrushi Department.of Pediatrics, University of Duhok, College of Medicine, Duhok, Kurdistan, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10388

Keywords:

Bednar’s, Aphthae, Mucosal, Neonates, Lesions, Feeding

Abstract

Background 

Bednar’s aphthae are small shallow ulcers at the margin of the palate of newborns. They primarily result from the traumatic action of a bottle teat or the nipple of the mother’s breast during feeding. More recently, an immune process has been hypothesized to explain its pathogenesis.

Objectives 

To study the clinical features, the associated factors, and the time of healing of Bednar’s aphthae in Duhok. 

Patients and Methods

This study was conducted from January 1st, 2020, to February 1st, 2021. It enrolled 17 newborns and infants diagnosed with Bednar’s aphthae through clinical examination while undergoing routine health checkups. Information about sex, delivery mode, age, birth weight, gestational age, perinatal problems, feeding method, feeding habits, type of milk (formula, breast milk, or both), and using a pacifier or not were obtained from mothers through direct interviews. Through the use of a tongue depressor, the palate was visualized. In addition, parents were educated on how to posture the patient while feeding properly. Four weeks later, a follow-up visit was for the ulcers’ course follow-up.

Results

Male is the predominant gender. Vaginal delivery was the most common. All the participants were full-term with normal birth weights. The age at which diagnosis was made ranged from 14 to 60 days. Most of them were formula-fed. In 15 patients (88.23%), feeding was in a horizontal posture; 11 (64.7%%) had weak sucking, 10(58.82%) had prolonged feeding time, and 13(76.47%) used pacifiers. The location is marginal in 12 cases (70.58%). The shape was oval in 13 patients (76.47%), and the healing time ranged from 1 week to 4 weeks. The largest ulcer was 2x2 cm, and the smallest was 0.2x0.3 cm. 

Conclusion

Bednar’s aphthae are self-limiting disorders in newborns and infants. Mechanical and immunologic factors can be responsible for their pathogenesis. Health education for mothers can help the healing of the ulcers and prevent their recurrence.

References

Nam SW, Ahn SH, Shin SM, Jeong G. Clinical features of Bednar’s aphthae in infants Korean J Pediatr. 2016;59(1):30-34. DOI: https://doi.org/10.3345/kjp.2016.59.1.30

Nebgen S, Kasper HU, Schafer D, Christ H, Roth B. Bednar's aphthae in neonates: incidence and associated factors. Neonatology 2010; 98:208-11. DOI: https://doi.org/10.1159/000285523

Bessa CF, Santos PJ, Aguiar MC, do Carmo MA. Prevalence of oral mucosal alterations in children from 0 to 12 years old. J Oral Pathol Med 2004; 33:17-22. DOI: https://doi.org/10.1111/j.1600-0714.2004.00200.x

Tricarico A, Molteni G, Mattioli F, Guerra A, Mordini B, Presutti L, et al. Nipple trauma in infants? Bednar aphthae. Am J Otolaryngol 2012; 33:756-7. DOI: https://doi.org/10.1016/j.amjoto.2012.06.009

Madurapperuma SW, Jayaweera AHH, Jayasinghe RD. Spontaneously Regressing Neonatal Oral Aphthous Ulceration of the Palate", Case Reports in Pediatrics, vol. 2021, Article ID 6660302, 3 pages, 2021. https://doi.org/10.1155/2021/6660302 DOI: https://doi.org/10.1155/2021/6660302

Dilley DC, Siegel MA, Budnick S. Diagnosing and treating common oral pathologies. Pediatr Clin North Am 1991; 38:1227-64. DOI: https://doi.org/10.1016/S0031-3955(16)38196-2

Dilley DH, Blozis GG. Common oral lesions and oral manifestations of systemic illnesses and therapies. Pediatr Clin North Am 1982;29: 585-611. DOI: https://doi.org/10.1016/S0031-3955(16)34182-7

Eversole LR. Clinical outline of oral pathology: diagnosis and treatment. 3rd ed. London: Lea & Febiger, 1992.

Pedra C, Moraes Terra C, Ejzenberg B, Baldacci E, Okay J: Oral palatine ulcers of a traumatic nature in infants: Bednar’s aphthae. Int J Pediatr Otorhinolaryngol 1996; 35:39– 49. DOI: https://doi.org/10.1016/0165-5876(95)01282-6

Martinez Sánchez L, Diaz Gonzáles E, Garcia Tornel Florensa S, Gaspá Marti J: Uso del chupete: beneficios y riesgos. An Esp Pediatr 2000; 53:580–585. DOI: https://doi.org/10.1016/S1695-4033(00)77502-3

Yilmaz AE, Gorpelioglu C, Sarifakioglu E, Dogan DG, Bilici M, Celik N. Prevalence of oral mucosal lesions from birth to two years. Nigerian Journal of Clinical Practice. 2011: 14(3); 349-53. DOI: https://doi.org/10.4103/1119-3077.86782

Majorana A, Bardellini E, Flocchini P, Amadori F, Conti G, Campus G. Oral mucosal lesions in children from 0 to 12 years old: ten years experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: e13-18. DOI: https://doi.org/10.1016/j.tripleo.2010.02.025

Rivera C, Jones-Herrera C, Vargas P, Venegas B, Droguett D. Oral diseases: a 14-year experience of a Chilean institution with a systematic review from eight countries. Med Oral Patol Oral Cir Bucal. 2017 May 1;22 (3): e297- 306. DOI: https://doi.org/10.1101/134056

Yanez M, Escobar E, Oviedo C, Stillfried A, Pennacchioti G. Prevalence of oral mucosal lesions in children. Int. J. Odontostomat. 2016;10(3):463-468. DOI: https://doi.org/10.4067/S0718-381X2016000300013

Rivera C. Essentials of recurrent aphthous stomatitis (Review). Biomedical Reports. 2019;(11): 47-50. DOI: https://doi.org/10.3892/br.2019.1221

Yao, H., Song, Q., Zhang, Q. Prevalence of oral mucosal lesions in children in Xiangyun of Yunnan, China: a cross-sectional study. Ital J Pediatr 2022;48: 15. https://doi.org/10.1186/s13052-022-01209-6 DOI: https://doi.org/10.1186/s13052-022-01209-6

Published

2022-12-21

How to Cite

1.
Haleem A, Abdulrahman N, Atrushi A. BEDNAR’S APHTHAE IN INFANTS IN DUHOK; A PROSPECTIVE CROSS-SECTIONAL STUDY. JSMC [Internet]. 2022 Dec. 21 [cited 2024 Jun. 19];12(4):433-7. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10388

Similar Articles

1-10 of 30

You may also start an advanced similarity search for this article.