Introduction
Mouth ulcers known as Apthous mouth ulcers usually affect the loosely attached soft lining tissues of the oral cavity such as the soft palate, the cheeks, the tongue, under the tongue and part of the gums adjoining the teeth. Now, they can occur in any age but are more commonly seen first in childhood or adolescence. They are more predominantly seen in women. Most of the time it is a benign condition and does not have any significant impact on general health other than causing discomfort from the pain. On rare occasions it may be associated with other systemic illnesses like an inflammatory bowel disease, HIV or Celiac disease.

Cause and risk factors
There is no known definitive cause for these mouth ulcers. There does, however, exist a positive family history of recurrent ulcers in a large number of affected patients implying a possible genetic contribution. Now, there are many trigger factors that prompt the onset of these ulcers in people who have a tendency to get them such as – emotional stress, injury to the mouth that can occur from dental procedures, while brushing, accidental biting into the cheek or tongue or from a fall. Certain foods like chocolates, some sour and citric fruits or caffeinated drinks, could be nutritional deficiencies like vitamin B12, iron and folic acid, certain toothpastes and mouth rinses or hormonal changes of menstruation can trigger this off.

Symptoms and types
These aphthous mouth ulcers can be very sore and exposure to spicy or tangy foods and liquids can exacerbate the pain and burning sensation. These ulcers, they appear as punched out lesions with a grey – yellow base surrounded by red inflamed areas. Now, there are three variations to these Aphthous mouth ulcers. You have the recurrent ulcers, which are the most commonly occurring and can varyingly recur from back to back or you can see just a few episodes in a year. They are small, they are less than 5mm and heal in about 1-2 weeks. You have major ulcers, which are large that is they are greater than 10mm in size and can take weeks or months to heal with a scar. The third variety is the Herpetiform ulcers, which are very small and multiple in number resembling the herpes infection and they heal in about 1-2 weeks.

Diagnosis and management
Usually these mouth ulcers are diagnosed by their clinical appearance and their recurrent pattern and do not require any further investigations. Now, if the ulcers are small, then some general measures can be adopted to manage it. And these measures include – a topical antiseptic and anesthetic oral gels to be applied over the ulcers, avoiding foods and liquids that may irritate the ulcer and instead eat foods that are bland, cold and soft. Your doctor may prescribe a nutritional supplement which may contain vitamin B12, folic acid or iron. Now, it’s important to maintain adequate hydration and nutrition, which may be compromised because of the painful mouth ulcers. You need to rinse the mouth after eating to prevent retention of food in the mouth, which can serve as a source for secondary infection.

Worrying signs
Now, if your child absolutely refuses food and drink secondary to pain in the ulcers, this can lead towards dehydration, if there is weight loss or decreased urine output then your child definitely requires medical attention. Now, if the ulcers are large, they are prolonged and are not improving with the general measures that we just discussed, then you must see your doctor who might want to investigate further to look for any other associated conditions that may be causing it and will prescribe some anti-inflammatory medications for it.
Team Ovum Hospitals