Riga Fede disease is a rare, benign ulcerative condition that primarily affects the ventral (underside) surface of infants’ tongues. It is typically caused by the presence of teeth at birth, known as natal teeth, or teeth that erupt shortly after birth, referred to as neonatal teeth.
Identifying Riga Fede Disease
Riga Fede disease is caused by repetitive trauma and friction. This irritation is most often inflicted by natal or neonatal teeth, which are usually the lower central incisors, as they rub against the delicate underside of the infant’s tongue during feeding or other oral movements. This constant mechanical irritation leads to the formation of a lesion.
The physical appearance of the ulcer is quite distinctive, often presenting as a fibrous, whitish-yellow lesion with elevated or raised borders. Infants with this condition may exhibit several behavioral symptoms due to the discomfort, including excessive crying, difficulty in latching during breastfeeding, or outright refusal to feed. Such feeding difficulties can sometimes lead to poor weight gain.
Professional Treatment Approaches
Treatment for Riga Fede disease often begins with conservative methods to alleviate irritation. One initial step involves smoothing or polishing any sharp edges of the offending teeth to reduce the abrasive contact with the tongue.
When smoothing alone is insufficient, protective measures may be employed. This can include applying a smooth composite resin material over the sharp tooth surfaces to create a barrier. Another option is the creation of a custom protective guard, sometimes called a stent, which fits over the teeth and shields the tongue from further injury.
If conservative and protective measures fail to resolve the ulcer or if the infant’s feeding is severely compromised, tooth extraction becomes a consideration. This decision is typically reserved for cases where the natal or neonatal teeth are causing significant pain, persistent feeding issues, or are deemed supernumerary (extra teeth). All treatment decisions, from polishing to extraction, are made by a qualified pediatric dentist or physician after a thorough assessment.
Home Care and Prognosis
While professional interventions address the source of irritation, home care focuses on managing feeding to ensure the infant receives adequate nutrition and hydration. Parents may need to adjust feeding positions or consider alternative feeding methods, such as using a soft nipple bottle, if direct latching is painful for the infant. Ensuring consistent hydration is also important, particularly if feeding intake is reduced due to discomfort.
The prognosis for infants with Riga Fede disease is generally excellent. Once the source of irritation is effectively managed or removed, the ulcer usually heals completely and quickly. Healing often occurs within one to two weeks, and there are typically no long-term complications associated with the condition.