Some parents consult me about something that is very frequent to them, that has happened to them and that they 'fear' it might happen to their children. The fact of going to the dentist and the doctor, as soon as they see their teeth, tells them that they have had chickenpox and that there are consequences for their enamel. It is something initially shocking, but what we are going to explain, and that is Chickenpox can affect the oral health of children.
Chickenpox is an infectious-contagious disease caused by the varicella zoster virus (WZ) or herpes virus 3 in humans.It can affect any age, but the most frequent ages in children is between 5 to 9 years, being the extreme ages (babies and adults) where the most serious cases are seen. It is also dangerous for immunosuppressed patients, who have already been affected by the varicella zoster virus, and it is not uncommon for the virus to reactivate like herpes zoster, seriously affecting these patients.
The virus can be transmitted through the respiratory tract, by the droplets of flugge (saliva) that come out when the child speaks, coughs or sneezes and, also, is transmitted by direct contact from one child to another. After infection occurs, the virus begins to replicate in regional lymph nodes for about 2 to 3 days and then a first viremia occurs for about 4 to 6 days.
Later, the virus replicates in the spleen and liver to produce the second viremia and replicate in many other organs, even reaching sensory nerves where they remain latent and if they are reactivated they will do so as Herpes zoster.
First there is a prodromal period where there may be general malaise, sore throat, fever, headache, cough for 48 to 72 hours and then the most characteristic manifestation of the disease, which is a skin rash of generalized macules, which then evolve to papules, vesicles, pustules and scabs.
At the level of the oral cavity there is also manifestation of the disease, characterized by vesicular lesions at the level of the tongue, cheeks, hard palate, gums and posterior pillars, which later break producing little or much pain.
It has also been determined that at the level of the teeth the virus produces lesions, such as hypomineralization of the incisor-molar enamel, although in reality there are few documented cases of patients with these lesions, which is why it is suggested to continue with the investigation of the possible relationship of chickenpox virus and dental lesions.
The differential diagnosis of the chickenpox virus should be done with:
- Aphthous stomatitis
- The primary infection by herpes virus.
Complications of this disease are seen more frequently in extreme ages, pregnant women, in immunosuppressed patients and in patients with previous pathologies, especially respiratory ones, since one of the complications can be pneumonia. Encephalitis, secondary infections of the lesions, Reye's syndrome and intercostal or trigeminal neuritis can also be observed.
Before concluding and giving you some recommendations, I want to tell you about my experience with this disease ... I was pregnant with my first daughter, about to start the 30th week of pregnancy and worked as a rural doctor in an outpatient clinic in the city where I live in Venezuela.
One morning on duty I was awakened to see a boy who was consulting for a very high fever and when he got to the door, I realized that what he had was chickenpox and, really, I almost didn't go near it because I had never suffered from this disease. I made the directions and went back to the room. The next day, I had a consultation and one of the patients had a shingles and I thought: 'God, what is it'. Really, I was afraid of catching it.
The following week, I started with cold symptoms, with a lot of discomfort and a headache, and suddenly, I ran my hand over my chest and felt a nugget. I was scared and said to myself: 'Carla, this is chickenpox or as we say in Venezuela, lechina'. And I really fell into depression thinking about what was coming and the danger of being able to lose my baby
It was really like three terrible weeks in bed, with a very high fever and skin lesions all over my body and on the oral mucosa, which did not allow me to even feed myself, I only tolerated liquids. I also suffered from intercostal and facial neuritis, that is, I couldn't walk or open my mouth, it really was terrible.
The first thing I did was find out how much my baby could be affected and I was somewhat calmer when I learned that chickenpox is dangerous in the first trimester of pregnancy, since the virus crosses the placental barrier and can even cause deformities and fetal death.
However when I got to delivery, my restlessness and anguish were very great and I wanted to see her quickly to verify that everything was very well and without any deformity.
Well, thank God it was. Roxanna Andrea was born healthy, but something curious, that she was born with a scab on one of her hands, which at first I thought was a nevus (mole), but after a few days, the scab fell off. In other words, the virus did pass the placental barrier, but in too little quantity, so as not to affect the health and vitality of my daughter. Today she is a beautiful and healthy 30-year-old woman, thank God and with a beautiful 7-year-old daughter who is my beloved granddaughter.
- Give the chickenpox vaccine, in a single dose, at 12 months in some countries and at 15 months of age in others.
- Do not self-medicate.
- Consult with the pediatrician, who will give adequate indications to quickly improve symptoms and avoid complications.
- Maintain bed rest and drink plenty of fluids, especially water.
- Cut the nails and keep them very clean, to avoid reinfection of the lesions by scratching, since they are very itchy lesions.
- Avoid taking them to nursery schools, colleges or any outing while the disease is present, since chickenpox is spread at any stage of the lesions (it is very virulent).
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