either supernumerary or true deciduous teeth and are usually found in the lower incisor region Natal teeth may lead to ulcerations of the underside of the tongue, called Riga–Fede disease Patients with ankyloglossia may be referred to as “tongue tied” because of congenital shortening of the lingual frenum, limiting their ability to fully extend the tongue Surgical correction is considered when speech or feeding is affected Epulis is a congenital, fibrous, sarcomatous tumor that arises from the periosteum of the mandible or maxilla The mass is firm and pedunculated and may regress spontaneously Excision is required if it interferes with feeding or breathing, or for cosmetic reasons Lymphatic malformations (LMs), also called lymphangioma or macrocystic LM (formerly cystic hygroma), are benign congenital tumors of lymphatic vessels that can appear on the tongue, lips, or buccal mucosa at birth or in early infancy They generally grow with the child, and can expand rapidly with intralesional hemorrhage or infection Hemangiomas are benign vascular tumors that become more apparent as the patient grows Oral hemangiomas may be accompanied by additional internal or external vascular lesions They generally involute spontaneously, but if bothersome they may be treated medically, often with propranolol, or surgically In contrast, vascular malformations are congenital structural anomalies of blood vessels which neither proliferate nor involute They appear as compressible blue or purple mucosal lesions, and may expand with infection, injury, crying, or dependent position They not respond to propranolol, requiring instead embolization, sclerotherapy, or surgical excision Dermoid or epidermoid cysts can be found on the floor of the mouth, soft palate, or uvula, sometimes leading to submental swelling They may contain hair follicles, sebaceous glands, or sweat glands Symptoms are minimal, and treatment is surgical removal Foregut duplication cysts may be present in the floor of the mouth, containing ectopic or abnormally migrated stomach or duodenal tissue, requiring surgical removal White sponge nevus is an autosomal-dominant condition presenting with white, raised, folded-appearing lesions, often on buccal mucosa It may be mistaken for candidiasis Infectious Oral Lesions Infectious oral lesions are most often viral in origin but may also be caused by bacterial or fungal infections (see Chapter 94 Infectious Disease Emergencies ) Candidiasis, or thrush, is common in neonates and infants Caused by Candida albicans , it presents as white plaque on the buccal mucosa, gingivae, and palate that cannot be removed with gentle scraping Thrush outside of infancy should