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Writer's pictureDr Rose-Marie Daly

Mouth Ulcers


The mouth is one of the most sensitive areas of the body so when children get ulcers there, the pain and discomfort can be very intense. Mouth ulcers are common and can occur from infancy through to adolescence. They can form anywhere within the mouth, including on the tongue or the gums and on the inside of the lip. Ulcers can vary in size, shape. They may be single or multiple. They can be caused by viral infection, friction, be genetically inherited or can result from medical problems. Some types of ulcers are contagious and others are not. Mouth ulcers may be so painful that they make eating or even talking difficult. So what causes them, and what’s the best treatment?

Ulcers commonly occur as a result of accidentally biting the mouth, brushing the teeth too hard, or from eating something very hot. Occasionally ulcers can be an allergic reaction to certain types of food and if your child already has an ulcer, salty snacks like crisps and fizzy drinks or very spicy foods, can make them worse. Children are more likely to develop ulcers when they are tired, stressed or run down. Being low in iron or folic acid, which are found in fruit, vegetables and fish, can also make kids more susceptible to ulcers. Sometimes ulcers appear for no obvious reason at all. Ulcers usually heal within a week and often it’s just a question of waiting until they clear up of their own accord.

Mouth ulcers are often recurrent, so just because you’ve got rid of one, it doesn’t mean your child isn’t at risk from developing another. If however, a single ulcer lasts for three weeks or more, let your dentist/paediatric dentist examine your child in order to rule out any other more serious infection or condition.

A common cause of widespread mouth ulcers in toddlers occurs as a result of infection with the same virus that causes cold sores or herpes. This condition is very contagious. Children may also get mouth ulcers related to chicken-pox infection and hand foot and mouth disease. Responding to the effects of these ulcers quickly in a young child is important. The condition can be a very painful for small children resulting in an inability to eat and maintain fluid intake. Dehydration is a common complication and can sometimes require admission to hospital so the child can be put on a drip.

Getting the right guidance on how to handle the mouth ulcers is really important so that young children can continue to drink and keep a good intake of fluids. Paediatric Dentists routinely treat this type of condition. There are a range of medications and measures available that can be used to help children cope with symptoms and encourage more rapid healing. Parents should seek professional guidance promptly.

Children who are low in iron, B group vitamins and folate can often develop mouth ulcers. The reasons why children become deficient in these nutrients vary from poor diet to having an inability to absorb these nutrients from the gut. A routine dental check-up may be the first time this comes to the attention of a health professional and is yet another reason for regular visits to your dentist. Sometimes signs of coeliac disease, crohns disease and other malabsorption disorders will first present in the mouth. If a Paediatric Dentist suspects one of these conditions they may suggest running some blood tests to find out more before deciding on the most appropriate course of action.

Thankfully it is very rare but more serious medical problems can present as ulcers in the mouth. This can occur with inbuilt problems with immune cells, diabetes or as a result of certain malignancies such as leukaemia. The vast majority of mouth ulcers in children have a simple and treatable cause however, it is important that parents seek appropriate professional advice.

The term “gum boil” is often used to describe the effects of a dental abscess. Dental infections are most commonly caused by decay however they can result from traumatic injury or exposure of the nerve of the tooth from erosion and toothwear. An abscess may look like a blister or a lump in the gum above a tooth. It results from an infection in the tooth channelling out through the bone around the tooth and out onto the adjacent gum. Dental infections such as this are sometimes managed with a course of antibiotics in the short term. Antibiotics however, are never a long term solution to the problem. A dental infection can only be resolved by removing the source of the infection by either extracting the tooth or removing the infection from inside the tooth. Placing a filling or dressing in an infected tooth will not treat the infection inside.

Teenagers are more prone to bacterial infections of the gums which can cause painful gums and bad breath. Smoking and stress are important risk factors. If left untreated these types of infection can lead to permanent gum damage which cannot be repaired. It is frequently a sign that your teenaged child needs professional assistance with keeping their teeth and gums clean.

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