Differential diagnosis of oral enlargements in children

The purpose of this article is to review soft tissue and bony enlargements that typically occur in the oral and perioral region of children. In order to organize these lesions into a thorough but comprehensible format, the principles of differential diagnosis must be used. All oral enlargements are broadly classified as soft tissue or bony abnormalities. Determination of the specific lesion category is based primarily on a prominent feature that demonstrates the nature of the lesion, followed by the secondary clinical features and any contributory patient information. Classification of exophytic soft tissue entities includes: papillary surface enlargements, acute inflammatory enlargements, reactive hyperplasias, benign submucosal cysts and neoplasms, and aggressive and malignant neoplasms. Bony enlargements of the maxilla and mandible are divided into three categories: inflammatory lesions, benign cystic and neoplastic lesions, and aggressive and malignant lesions. This extensive topic is summarized on flow charts for easy reference with emphasis on grouping together lesions with common characteristics.