Dental Eruption Cyst
A 16-month-old boy presented to a primary care clinic for symptoms of a viral upper respiratory infection. He had been having rhinorrhea, congestion, and a productive cough for the previous 3 days. He had been noted to be drooling more than usual, but otherwise had not had vomiting, diarrhea, rash, or fever.
He had been previously healthy, and his growth was developmentally appropriate. He had been playful and had been eating and drinking normally.
On physical examination, the boy was very active and running around the room. He had noisy breathing with heavy, clear rhinorrhea and yellow crusting within the nares bilaterally. Both tympanic membranes appeared normal. He was drooling but had no difficulty swallowing. Small (< 0.5 cm) cervical lymph nodes were palpated bilaterally.
On examination of the oropharynx, the child was noted to have moderate dental hygiene, with heavy plaque buildup but no apparent caries.
A small blue to black blister was noted on the bottom gum at the position of the first molar. This blister was tense on palpation with a tongue depressor and was nontender. The surrounding gum tissue did not demonstrate erythema or swelling. The rest of the physical examination findings were within normal limits.
The boy’s mother had not noted the discoloration or swelling previously, and she reported that he had not been having any discomfort or difficulty eating solid foods. She also denied any known trauma to the boy’s mouth.
Based on the clinical findings, the boy received a diagnosis of a dental eruption cyst.
Dental eruption cysts are formed within the soft tissue overlying an erupting tooth.1,2 As the tooth develops, separation of the follicle of the tooth from the crown surrounding the tooth may occur. Within the space created by the separation, a cyst remains. The fluid in a dental eruption cyst usually is clear, and the cyst appears pale but often may contain blood from tissues that have been disrupted by the growing tooth or from trauma to the initial cyst, leading to an eruption hematoma.3
Dental eruption cysts are benign and may surround a primary or a permanent tooth.1 They most commonly occur in children between 6 and 9 year of age, when the incisors and molars are erupting.1 The cysts tend to occur singularly, although cases of bilateral or recurrent cysts have been reported. Some studies have indicated that the etiology may be caries or trauma. Some children have a predisposition to the development recurrent dental eruption cysts.3
Treatment is purely observational, since the majority of these cysts resolve spontaneously. Surgical intervention may be considered if the child presents with discomfort, infection, and bleeding, or with eruption failure.1,2
References
1. Bodner L, Goldstein J, Sarnat H. Eruption cysts: a clinical report of 24 new cases. J Clin Pediatr Dent. 2004;28(2):183-186.
2. Dhawan P, Kochhar GK, Chachra S, Advani S. Eruption cysts: a series of two cases. Dent Res J (Isfahan). 2012;9(5):647-650.
3. Aguiló L, Cibrián R, Bagán JV, Gandía JL. Eruption cysts: retrospective clinical study of 36 cases. ASDC J Dent Child. 1998;65(2):102-106.