Riga–Fede disease (RFD) is a rare and benign mucosal condition, characterized by a tongue ulcer that is frequently brought on by traumatizing injuries sustained from repeatedly moving the

tongue The tongue is a muscular organ (anatomy), organ in the mouth of a typical tetrapod. It manipulates food for mastication and swallowing as part of the digestive system, digestive process, and is the primary organ of taste. The tongue's upper surfa ...

back and forth over the

mandibular In anatomy, the mandible, lower jaw or jawbone is the largest, strongest and lowest bone in the human facial skeleton. It forms the lower jaw and holds the lower teeth in place. The mandible sits beneath the maxilla. It is the only movable bone ...

anterior incisors.

Signs and symptoms

Clinically, it typically manifests as a tongue-localized ulcer (60 percent of lesions), though it can also affect the lip, palate,

gingiva The gums or gingiva (plural: ''gingivae'') consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health. Structure The gums are part of the soft tissue lini ...

, vestibular mucosa, and floor of the mouth. RFD may not cause any symptoms or may occasionally be accompanied by pain.

Causes

RFD is most frequently linked to the emergence of the natal-

neonatal teeth Natal teeth are teeth that are present above the gumline (have already erupted) at birth, and neonatal teeth are teeth that emerge through the gingiva during the first month of life (the neonatal period). The incidence of neonatal teeth varies c ...

in newborns or the primary lower incisor in older infants.

Diagnosis

Histopathologically speaking, RFD is characterized by mucosal areas that are ulcerated, granulation tissue present, and a mixed inflammatory infiltrate that is abundant in mast cells,

macrophages Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer ce ...

lymphocytes A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic adap ...

, and

eosinophils Eosinophils, sometimes called eosinophiles or, less commonly, acidophils, are a variety of white blood cells (WBCs) and one of the immune system components responsible for combating multicellular parasites and certain infections in vertebrates. A ...

Treatment

The lesion can be removed, the sharp incisal edges can be smoothed, or the tooth's sharp edges can be rounded with composite increments. The latter is where mild to moderate ulceration can occur. Teeth extraction may be helpful if the ulceration is large and preventing the patient from eating.

References

External links