lymphadenopathy, and facial cellulitis Penicillin or clindamycin is considered first-line therapy; definitive therapy requires drainage of the abscess Pericoronitis is the local infection of the gingiva surrounding an erupting tooth, sometimes associated with lymphadenopathy and facial swelling Although antibiotic therapy may be required, good oral hygiene is essential Acute necrotizing ulcerative gingivitis (ANUG), also called trench mouth or Vincent angina, is a spirochetal infection of the gingiva found in adolescents, causing tender, bleeding gums and fetid breath Gums are hyperemic and appear “punched out” due to tissue loss between the teeth Treatment includes oral hygiene, hydrogen peroxide mouth rinses, oral antibiotics, and sometimes debridement of necrotic tissue Noma, or cancrum oris, is a potentially fatal, gangrenous anaerobic infection of the oral cavity that may spread rapidly outward to involve large areas of the face It typically begins as an oral mucosal ulcer or as ANUG, particularly after a bout of measles or other illness in malnourished or immunocompromised patients It is being recognized increasingly in HIV-infected or malnourished children in subSaharan Africa The oral lesions of congenital syphilis may not be seen until several months of age Erythematous papules can be seen in the mouth and other mucocutaneous sites Hutchinson teeth , peg-shaped upper central incisors, present later in life The secondary stage of acquired syphilis is characterized by patches of ulcers or raised lesions in the mouth along with generalized rash, fever, malaise, and adenopathy Patients receiving long-term antibiotic therapy may develop elongation of filiform papillae of the dorsum of the tongue and a “hairy” appearance from fungal overgrowth called hairy tongue Hairy leukoplakia of the lateral aspects of the tongue is found in HIV-infected patients with intraepithelial proliferation of Epstein–Barr virus infection Tumorous Oral Lesions The vast majority of tumorous oral lesions in children are self-limited and benign Eruption cysts, which may contain blood, may appear on the alveolar ridge with eruption of teeth; they resolve spontaneously In addition, there are a number of types of odontogenic cysts that can arise from tissues involved in tooth development Oral papillomas are finger-like extensions from the epithelium of the oral mucosa, commonly caused by human papillomavirus They are typically benign, although a small percentage may become malignant Treatment is generally surgery or laser ablation