Mouth ulcers in children can be very painful, especially when they eat, drink or brush their teeth. These ulcers can appear inside the mouth, on the tongue or on the gums. There are treatments that can soothe the pain while you wait for them to heal. Most mouth ulcers clear up by themselves within a couple of weeks. The tendency to develop mouth ulcers can run in families.
These ulcers can be very painful, especially when your child eats salty or spicy foods. Sometimes, your child might even refuse food until the ulcers begin to heal.
Recurrent mouth ulcers
Most patients only have mouth ulcers occasionally. However, some patients find they keep coming back. These are called recurrent apthous ulcers (RAD). Recurrent mouth ulcers are often different from those that cause single ulcers.
Recurrent ulcers can be more difficult to diagnose, treat and prevent.
and Trauma, like from a hard tooth brush, sharp tooth, habitual cheek biting, are a common cause of recurrent mouth ulcers. Here the ulcers tend to keep coming back in the same area.
and Recurrent Aphthous Disease (RAD) is a common cause of recurrent mouth ulcers in children and adults. They are also called canker sores and although sometimes thought to be caused by food allergies, stress, vitamin deficiencies and local trauma, no specific trigger is found in most people.
and Herpes Virus (Cold sore virus): Although most people with recurrent herpes infections (herpes simplex labialis) get the ulcers on the outside of their lips (cold sores or fever blisters), some get them inside too.
and Recurrent mouth ulcers can also accompany many systemic disorders, such as:
- Inflammatory bowel disease
- Cyclic neutropenia – recurrent, cyclical episodes of mouth ulcers, fever and neutropenia (low white blood counts)
- Gluten-sensitive enteropathy
- Periodic fever syndrome in which children get episodes of fever, aphthous stomatitis, pharyngitis, and cervical adenitis every 2-8 weeks.
- Vitamin deficiencies, including iron deficiency anemia, and folate, zinc, or vitamin B12 deficiency
- Behcets syndrome, with aphthous stomatitis, recurrent genital ulcers, and eye lesions.
- Candida Albican (Oral Thrush)
Treatment of Mouth Ulcers
In most cases, symptomatic treatments are the main option.
Other symptomatic treatments include:
Mouthwashes and Gel
Antimicrobial mouthwash helps to kill bacteria, viruses or fungi that may cause a mouth infection if you’re unable to brush your teeth properly.
Chlorhexidine gluconate is the most commonly prescribed mouthwash. You normally have to use it twice a day.
After using chorhexidine gluconate, you may notice that your teeth are covered in a brown stain. This staining is not permanent, and your teeth should return to their normal color once you finish the treatment.
The best way to prevent staining is to brush your teeth before using chorhexidine gluconate mouthwash. However, after brushing your teeth make sure that you thoroughly rinse your mouth out with water before using the mouthwash.
Chorhexidine gluconate mouthwash should not be used to treat infants under two years old.
Anti inflammatory Oral Paste
Medications to coat the ulcers can also be helpful, such as Lexanox and TESS oral pastes are effective.
Lexanox ® is an anti-inflammatory paste that can be applied to ulcers 2-4 times a day to make them less painful and help them heal faster.
Corticosteroids
A corticosteroid is a type of medicine that reduces inflammation. Steroids are also sometimes used to treat oral ulcers. Mouth ulcer medications contain a low dose of corticosteroid to make the ulcer less painful. It’s best to start using corticosteroid medication as soon as a mouth ulcer develops.
Hydrocortisone is the most commonly prescribed corticosteroid. It comes as a lozenge, which slowly dissolves in your mouth. You usually have to take a lozenge four times a day. Hydrocortisone can be used as gargle
Painkillers
This might include acetaminophen or ibuprofen containing pain medications.
Benzydamine, which can either, be taken as a mouthwash or a spray. The mouthwash form of benzydamine may sting when you first use it, but this should lessen as you continue to use it. You may also find that your mouth feels numb when you first use the mouthwash. This is normal and the feeling will soon return to your mouth.
Chemical or Laser Cautery of the Mouth Ulcers
Very effective treatment giving instant relief.
(Please watch the video clip)
Self-help tips
If you have a mild mouth ulcer, there are some steps you can take yourself to help your ulcer to heal more quickly:
and Use a soft toothbrush when brushing your teeth.
and Avoid eating hard foods, such as toast, and stick to soft foods that are easier to chew.
and Avoid eating foods that have triggered an ulcer in the past.
and If the ulcer has a specific cause, such as a sharp tooth cutting the inside the cheek, it will usually heal naturally once the cause has been treated. If you suspect that a sharp tooth has caused an ulcer, visit your dentist so that they can repair it.