ORAL MEDICINE : How to manage a pediatric patient with oral ulcers


Oral ulcers are a common clinical problem in the pediatric population.

Generally, an ulcer is defined as a well-circumscribed lesion with an epithelial defect covered by a fibrin clot (a pseudomembrane), giving the ulcer a yellow-white appearance.

Presentation

Population

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a. Any segment of the pediatric population, from infancy through adolescence

b. Children of parents with recurrent oral ulcers due to genetic predisposition (i.e., recurrent aphthous stomatitis)

c. Young children in group settings (e.g., daycare, shared play areas) developing oral ulcers secondary to an infectious (i.e., bacterial and/or viral) etiology due to the increased risk of oral fluid transfer in those settings

Signs

a. Well-circumscribed lesions, often depressed, with an epithelial defect covered by a yellow-white pseudomembrane

b. Single or multiple ulcers; may present in clusters (herpetiform)

c. Intraoral/perioral location: nonkeratinized and/or keratinized oral mucosa, oropharynx, lips, perioral skin

d. Variable size (most commonly measured in millimetres, but may be larger)

e. General location: oral/perioral lesion(s) only or with involvement of other affected surfaces (i.e., skin, genitals, other mucous membranes)

Symptoms

a. Pain severity: Can range from asymptomatic to severe discomfort

b. Burning

c. Irritation

d. Pruritis (itching sensation)

e. Systemic symptoms, such as fever, malaise, lymphadenopathy, difficulty swallowing and general irritability

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°jcda.ca
°Canadian Dental Association
°Eric T. Stoopler, DMD, FDS RCSEd / Ghada Al Zamel, DDS



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