Mouthful of ulcers

MOUTH ulcers are small, round, or oval-shaped painful lesions that appear in the mouth. They can occur on the inner side of the cheeks or lips, the edge of the tongue, or at the base of the gums.

Mouth ulcers are generally harmless, but they can be a source of great discomfort for children, especially when it makes eating, drinking, talking, and even sleeping difficult. For some, the pain can be so intense that they might refuse to eat, drink or brush their teeth. Some children tend to experience it more often than others.

Mouth ulcers 101

Some children may be prone to developing recurrent mouth ulcers.

This problem sometimes runs in families. The ulcers are usually small (less than 1cm) with a grey or yellow colour and reddish margin. They may be triggered by trauma such as a cut or abrasion due to accidental biting of the tongue, brushing too hard, the rough edge of a tooth, or consuming very hot food and drink.

They can also be triggered by stress, eg during school examinations.

Deficiencies of vitamins and minerals such as iron, folate, and some of the B vitamins may also be associated with the development of these ulcers. Your child may complain of a tingling or burning sensation a day or two before the ulcer appears.

Sometimes, mouth ulcers may be caused by viral infections such as hand, foot and mouth disease, or chicken-pox. These types of ulcers may be associated with fever as well as rashes on other parts of the body.

What you can do

What you can do

Normal mouth ulcers usually heal quickly within a week or two without any treatment.

However, if your child is greatly disturbed by the stinging soreness, there are things you can do to ease your child's pain and promote healing of the ulcer.

Food choices

  • Avoid feeding food that are hard, chunky, very hot, salty, spicy, or acidic (e.g. orange juice).
  • Feed bland foods (e.g. yoghurt, custard) that will not aggravate the pain.
  • Make sure he drinks lots of water.

Relieving the pain

  • Let him suck on ice.
  • Apply pain-relieving oral gel, which can be obtained from the pharmacist, on the affected area.

For quick healing

  • Have him rinse his mouth with mild salt solutions.
  • Encourage him to sleep more.
  • Get your child back to his regular eating habits.
  • When to take your child to the doctor

Sometimes, multiple ulcers or ulcers that do not heal may hint at a hidden problem, such as a viral infection. Take your child to the doctor if you notice these signs or symptoms:

  • When the mouth ulcer gets bigger or deeper.
  • When there are multiple ulcers; this may be indicative of hand, foot and mouth disease or herpes virus infection (cold sore virus).
  • When the ulcer does not heal after two weeks.
  • When there is significant bleeding.
  • When it is accompanied by fever or diarrhoea.
  • When your child has extreme difficulty in eating or drinking.

Dr Mary Marret is a consultant paediatrician. This article is courtesy of Positive Parenting Programme by Malaysian Paediatric Association. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care.