My son seems to be allergic to the mouthpiece he uses in football practice. He has broken out in horrific sores on the sides of his mouth and has all bubbles and sores in his mouth and on his tongue. The pediatrician advised a combination of Benadryl and Maalox applied to the sores inside and out, and said to apply Neosporin to the exterior sores at night. Is this also called "trench mouth" or "Kawasaki disease" and can something else be recommended? My poor son is in such agony.

Pat

DON'T LET HIM PUT THAT MOUTHPIECE BACK INTO HIS MOUTH! From your description, this is neither trench mouth nor Kawasaki disease. The most likely explanation for your son's problem is latex allergy. Latex allergy is a hypersensitivity to latex, or "natural rubber," a material that is harvested from rubber plants. Many products contain latex: disposable gloves, balloons, tennis shoes, condoms, baby pacifiers and so forth. The most common mechanism for the development of latex allergy is repeated exposure to the latex product. Trauma seems to facilitate development of latex allergy; thus, if your son's mouthpiece "digs" into his oral mucosa (mucous membrane) on a regular basis, he may have had ample chance to develop this hypersensitivity.
The symptoms of latex allergy range from minor annoyance (hay fever-like symptoms such as nasal congestion and "sniffles") to life-threatening (anaphylactic shock). Anaphylactic shock, or anaphylaxis, is a severe reaction that may include some or all of the following symptoms: a drastic drop in blood pressure, rapid heart rate, swelling of the airway (which may be severe enough to cause suffocation), tightening of the airways in the lungs (which can cause wheezing and a dangerous drop in blood oxygen content) and hives.

Your son's reaction sounds severe, although not life-threatening. Nevertheless, he is at risk for developing a more severe reaction in the future. Latex is everywhere, so it is extremely important that he learn for certain whether he has a latex allergy.

Next stop: Take him to an allergist. Latex allergy can be confirmed with a simple skin test ("scratch test"). Since the test itself may cause an anaphylactic reaction, it should be administered only by an allergist or immunologist who is trained to respond appropriately. Alternatively, there is a blood test that may indicate hypersensitivity to latex.

If he does have a latex allergy, then the only treatment is avoidance. (Some patients with latex allergy must also avoid certain fruits, such as bananas and avocados, since these foods contain proteins similar to latex.) He will need to obtain a "Medic Alert" bracelet warning emergency personnel and healthcare workers that he is allergic to latex. (That's because most medical gloves contain latex, and latex is present in MANY other medical products, including IV tubing, catheters, airway tubes and so forth.) Considering the severity of his reaction, it may even be wise for him to carry an "emergency kit" in case he begins developing symptoms of anaphylaxis. This is the same sort of kit carried by people who are allergic to bee stings. His allergist will be able to decide if this is necessary and, if so, will instruct him in its appropriate use.