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Trauma
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Often single ulcer in location of irritation May be caused by removable appliance, sharp tooth with identified cause of irritation Self-inflicted ulceration (Pica) can be associated with children with learning disabilities
Removing the cause should resolve the ulcer |
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Viral
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Often multiple painful ulcers Systemic symptoms such as fever, malaise May be associated with nursery/school outbreak Includes: HSV-1, Coxackie virus
Ulcers are usually self-limiting |
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Bacterial Infection
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Pain and halitosis Can coincide with poor oral hygiene and swelling/inflammation of gingiva May have bleeding from the gums Children with underlying immunosuppression are more likely to present with infections
May require antibiotics, support from dentist with oral health |
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Recurrent aphthous stomatitis
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Multiple recurring ulcers May be family history of recurrent ulceration Appearance of ulcers often follow a pattern Triggers include hormonal changes, stress, anaemia/haematinic deficiencies and oral sensitivities Present in major, minor and herpetiform types
Any underlying deficiencies should be corrected |
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Inflammatory conditions
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Associated cobbling of mucosa/lip swelling Include orofacial granulomatosis and inflammatory bowel disease Associated GI symptoms Triggered by allergic reaction, that is, benzoates and cinnamon
Referral to appropriate specialty for further investigation of underlying cause |
