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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 10  |  Issue : 3  |  Page : 80-81

Epidemiology, Etiopathogenesis, Treatment and Prognosis of Oral Thermal Burns from Food and Drinks


1 Department of Systems Medicine, University of Rome “Tor Vergata”, Italy
2 Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy; School of Applied Medical-Surgical Sciences, University of Rome “Tor Vergata”, Italy
3 Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Italy
4 Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome,; School of Applied Medical-Surgical Sciences, University of Rome “Tor Vergata”, Rome, Italy

Date of Web Publication28-Nov-2019

Correspondence Address:
Rocco Franco
DDS Phd Student
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/denthyp.denthyp_56_19

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How to cite this article:
Bollero P, Franco R, Gianfreda F, Gualtieri P, Miranda M, Barlattani A. Epidemiology, Etiopathogenesis, Treatment and Prognosis of Oral Thermal Burns from Food and Drinks. Dent Hypotheses 2019;10:80-1

How to cite this URL:
Bollero P, Franco R, Gianfreda F, Gualtieri P, Miranda M, Barlattani A. Epidemiology, Etiopathogenesis, Treatment and Prognosis of Oral Thermal Burns from Food and Drinks. Dent Hypotheses [serial online] 2019 [cited 2019 Dec 11];10:80-1. Available from: http://www.dentalhypotheses.com/text.asp?2019/10/3/80/271956




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Dear editor,

It sometimes happens to voraciously bite a particularly good food without considering that it is boiling. Just as it sometimes happens to ingest very fragrant tea, forgetting that the liquid is incandescent. At first, immediately after the burn, only pain is felt. After a few seconds, flittena can form which can also break, detaching the affected epithelial tissue and creating even nefarious pictures.

The spectrum of this kind of injury includes scald burns of the trachea, palate, oropharynx and oesophagus due to aspiration and ingestion of foods that have been overheated.

The consumption of food heated in a microwave oven, however, can result in a more significant thermal injury. This is due to the ability of microwaves to produce a differential heat in the food, whereby the exterior may feel cool but

the interior may have a high temperature. In more complex cases, an airway management may be necessary and in the literature cases of death have also been reported.

This phenomenon can in fact have a wide variety of clinical manifestations ranging from simple erythema on the palate that does not require specific interventions to the complex picture with risk of death. However, the most involved subjects, as regards this phenomenon, seem to be pre-school children with risk factors like preschool age, youth and educational status of parents, socioeconomic level and malnutrition. [1] According to the research of Cowan et al. [2], the most involved sites in children’s oral burnes are the lips (56%) and tongue (48%).

Milk seems to be a very dangerous agent because of its fat whose effects on the skin could be similar to oil. [3]

Subjects at risk of burns may be users of microwave ovens because the use of them causes a rapid dielectric heating of the water inside the food and produce high steam and pressure gradients causing explosive decompression. Those who cook according to this method have a high chance of failing to recognize the real temperature of their meals because fats and sugars are less polar than water and have a higher vaporization temperature than water, allowing them to reach temperatures well above the boiling point.

Due to the movements responsible for swallowing, one of the areas most exposed to thermal burns from food is the hard palate. In the literature, a case of a 27-year-old patient with perforation in the palatal submucosal fissure consequent to an excessively heated food was reported.

Thermal burns of the oral cavity or laryngopharynx are common in patients with mental illness, alcohol-dependent patients or patients with diabetic neuropathies.

Instead, the use of total dentures is a likely risk factor because the resinous palate of the prosthesis completely covers the hard palate preventing the perception of heat.

In the most serious cases, the upper airway burn following the ingestion of a bolus of hot food is similar to that of secondary burns to inhalation wounds.

The lesions of oral mucosa that generally manifest clinically are areas of erythema, erosion or ulceration with or without superficial necrosis. Mild burns from hot foods are relatively common and often inconspicuous usually resolving quickly without treatment.

The use of Low-Level Laser Therapy appears to be useful in healing the chronic mucosa burns wounds.

In the most serious cases involving children, the literature reports that the average length of hospitalization was three days.

Of those admitted, in the most serious cases systemic steroids and antibiotics were administered, of which clindamycin was the most used. A total of 8% received systemic steroids and 30% received antibiotic coverage. The most common systemic antibiotic used was clindamycin (63%). Additional skin burns were treated with topical antibiotics and sylvadene ointment.

In one case, the perforation in the cleft palate due to burning of hot food developed a hole in its velum. The treatment consisted in the removal of the necrotic tissue and the closure of the defect with the V-Y push-back method.

However, when injuries are severe and also involve laryngopharynx, there is a risk of emergency of the respiratory tract and esophagus stenosis.[3]

Upper airway edema due to injury can cause wounds that occur quickly and many develop complete airway obstruction. Intubation should not be delayed in case of breathing difficulties, it is present or anticipated in a burn victim ([Table 1]). Another negative consequence of thermal burns is definitely dysphagia.
Table 1 Treatment plan for different kind of lesions

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However, further research will be needed to improve the prognosis with a treatment plan that is simple, easy and repeatable to avoid the manifestation of dysphagia in the worst cases. [4],[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Yontar Y, Esmaoglu A, Coruh A. Retrospective analysis of burn injuries caused by hot milk in 159 pediatric patients: 14 years of experience in a burn unit, Ulus Travma Acil Cerrahi Derg 2014;20:281-5.  Back to cited text no. 1
    
2.
Cowan D, Ho B, Sykes KJ, Wei JL. Pediatric oral burns: A ten-year review of patient characteristics, etiologies and treatment outcomes. International Journal of Pediatric Otorhinolaryngology 2013;77:1325-8.  Back to cited text no. 2
    
3.
Cekin N, Akçan R, Arslan MM, Hilal A, Eren A. An unusual cause of death at preschool age: Scalding by hot milk. Am J Forensic Med Pathol 2010;31:69-71.  Back to cited text no. 3
    
4.
Chaplin M. “Water and Microwaves, ” Water Structure and Science. London South Bank University, 2012. http://www.lsbu.ac.uk/water/microwave.html.  Back to cited text no. 4
    
5.
Rumbach AF, Ward EC, Cornwell PL, Bassett LV, Muller MJ. Clinical progression and outcome of dysphagia following thermal burn injury: a prospective cohort study. J Burn Care Res. 2012;33:336-46.  Back to cited text no. 5
    



 
 
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