Mouth ulcers are irregular spots or sores occurring in the mouth. These are common in children. In this article, we look at the causes of mouth ulcers in children and ways to prevent it.
Mouth ulcers are small round or circular sores appearing on the inner lining of the oral mucosa. They are usually whitish, yellowish, greyish or reddish in color. Mouth ulcers can also occur on the surface of the gums or on the tongue. Mouth ulcers in children are often painful and cause discomfort while eating especially spicy or salty food.
Children often refuse to eat due to the discomfort caused by mouth ulcers.
The ulcers are often few millimeters in size, but in some cases, they can extend up to several centimeters. They look like a shallow crater over the mucosa with or without raised borders. As the nerves are very superficial in the oral mucosa, any break in it caused by ulcers may expose the nerves causing extreme pain. This makes it difficult for the child to tolerate food, drinks, and oral care.
What Causes Mouth Ulcers in Children?
The causes of mouth ulcers in children are many and most of them have derived their names based on the cause. The commonest causes of mouth ulcers in children are aphthous ulcers, infections, and trauma.1
Some common types of mouth ulcers in children and their causes are discussed below:
This is the most common type of mouth ulcers in children. These are characterized by small and painful ulcers that appear yellow or grey with a red border. These ulcers can appear alone or in clusters. These are often recurrent, i.e. appear in multiple episodes. These ulcers are rarely seen over the gums or hard palate.
The most possible causes of aphthous ulcers are listed below:
- Immune response causing damage to the mucosal membrane
- Minor injury or trauma such as toothbrush trauma, biting of the tongue or cheeks, etc.
- Nutritional deficiencies such a folic acid and vitamin B12
- Excessive stress
This is the main cause of mouth ulcers in children, especially those that appear as isolated ulcers, after the age of 5 years. Children usually get 1 canker sore at a time, but some times they can get 2 or 3 at once. They appear as an ulcer with a white center and red border around them. Their size is usually less than 6 mm. The possible causes of canker sores include:
- Minor trauma or injury
- Food allergies or other irritants
- Vitamin deficiency (often noted in picky eaters)
- Genetic inheritance
- Other unknown causes
This is a viral infection and a common cause of multiple mouth ulcers in children. These ulcers are mainly noted on the tongue and buccal mucosa (sides of the mouth). In addition to the ulcers in the mouth, there may be small and deep blisters over the palms and soles. This disease occurs due to infection caused by a virus known as the Coxsackie virus. This condition occurs between the ages of 1 to 5 years.
Herpes Simplex Virus or Cold Sore Virus:
This too is a viral infection causing mouth ulcers in children but is quite often serious. The ulcers appear as 10 or more lesions on the gums, the tongue or lips. Mouth ulcers are accompanied by ulcers on outer lips or around the mouth. The child may also have a fever with difficulty swallowing. The condition is often caused by the spread of infection from infected adults. The virus usually spreads from kissing the child. It is seen in children between 1 to 5 years of age.
Trauma and Injury in Mouth causing Mouth Ulcer in Children:
Mouth injury and trauma can occur from biting the tongue, biting the cheeks, local irritants in the mouth, certain habits, etc. There may be an injury in the mouth from the incorrect use of toothbrush as well. These injuries often appear whitish when it starts healing (thus can be confused with canker sore). Other trauma in the mouth can be caused by burns from hot food or drinks. Accidents can also lead to mouth ulcers in children.
Other Causes of Mouth Ulcers in Children:
Ulcers can also be caused by allergies or a reaction to certain foods. Certain medications can also cause ulcers in the mouth as a side effect.
Ways to Prevent Mouth Ulcers in Children
In most cases, mouth ulcers in children do not require any active treatment. They generally heal on their own within 1 or 2 weeks. If the cause of the mouth ulcer is identified, the elimination of the cause helps in accelerating the healing process.
Some of the most effective ways to prevent mouth ulcers in children include
- Treating any local irritation in the mouth such as broken teeth, poor restorations, sharp teeth, etc.
- Following the correct way of brushing and using a soft bristle toothbrush
- Avoiding eating food that is known to trigger mouth ulcers
- Avoiding hot food and opt for softer food
- Visiting a dentist regularly for early detection of conditions that can trigger mouth ulcers
It is advised to visit a doctor if there any symptoms are noticed. The physician will obtain a case history followed by a physical examination of the child. Treatment often involves the following measures
- Warm salt water rinses
- A mild painkiller like paracetamol to control pain
- Regular use of antibacterial mouthwashes
- Using local anesthetics in the form of mouthwash, sprays, gels, ointment, etc.
- In the case of viral issues, anti-viral medications such as acyclovir may be prescribed
- Steroids such as corticosteroids may be prescribed, if appropriate
- Doctors may also ask to avoid foods that trigger mouths ulcers, like acidic, spicy, and citric foods.2
Now that you are aware of the causes of mouth ulcers in children and the ways to prevent them, you can manage the condition well.