2 month baby having ulceration of tongue

 # Mother presents with a 2 month old baby having ulceration of tongue in relation to erupted tooth in mandibular incisor region. Treatment: 

A. Extraction

B. Prescribe local anesthetic gel

C. Radiograph to confirm presence of deciduous tooth followed by rounding of incisal edges

D. Counsel mother and recall

The correct answer is C. Radiograph to confirm presence of deciduous tooth followed by rounding of incisal edges

This case likely involves Riga-Fede disease, a traumatic ulceration of the tongue caused by the sharp incisal edges of a natal or neonatal tooth (typically a mandibular primary central incisor) in an infant. At 2 months old, tooth eruption is premature, so confirming it's a deciduous tooth via radiograph is essential to rule out anomalies like supernumerary teeth. The primary treatment is conservative: smoothing or rounding the incisal edges to eliminate the trauma source, allowing the ulcer to heal spontaneously (often within 1-4 weeks). Extraction (option A) is reserved for highly mobile teeth or severe feeding interference, not routine here. Local anesthetic gel (option B) offers only temporary symptom relief without addressing the cause. Counseling and recall (option D) suit asymptomatic cases but not active ulceration. Follow-up is recommended post-treatment to monitor healing and eruption.