Dental care - common conditions - 0 to 5 years

Mouth ulcers affect 20 per cent of the population. They are painful and tend to recur either as one or multiple lesions, a few millimetres in size. They can show up anywhere in the mouth and usually heal in one to two weeks. It is important that if ulcers do not heal after two weeks, a medical or dental professional should be consulted.

Treatment for mouth ulcers
Mouth ulcers generally heal of their own accord in one to two weeks. There is little which can be done to treat them, but you can help reduce the pain by:

• Reducing the intake of orange juice and other citrus foods
• Eating less salty foods - for example, vegemite
• Applying topical anaesthetic to the affected area, especially before eating.

• Small clusters of vesicles (blisters) that rapidly erupt in the mouth or on gums.
• Yellowish ulcers surrounded by a red halo, which develop after the vesicles burst.
• Red, swollen gums that bleed when touched.
• Fever, malaise (feeling unwell) and irritability.

• Adequate fluid intake
• Bland foods such as yoghurt and custard
• Few or no salty, spicy or acidic foods.

• A tooth abscess - caused by an infection around the root of the tooth, which appears as a pimple on the gum. When the gum is pressed, there may be a discharge of pus. It is important to seek dental advice.
• Measles - which first appears as small white spots that look like grains of salt, surrounded by inflammation. These appear two to three days before the measles rash appears on the body.
• Hand, foot and mouth disease - characterised by blister-like (vesicular) lesions in the front of the mouth and on the hands and feet; sore throat or mouth; and a low grade fever. This disease will heal spontaneously.
• Eruption cysts - for example, a bluish, dome shaped cyst that appears over the erupting tooth. Treatment is not usually required because the cyst bursts when the tooth erupts.
• Geographic tongue - for example, pink to red smooth patches that appear on the tongue. This condition is not harmful and treatment is not usually required other than reducing acidic and spicy foods, as the tongue may be tender.
• Oral thrush - is common in young babies and infants and is a fungal infection that affects the superficial layers of the mouth surface. It appears as milky white patches in the mouth, which cannot be wiped away as easily as milk curd. A child may also have a simultaneous thrush infection in the nappy area and/or a fever and gastrointestinal irritation (this is very rare and may indicate a more general infection). Thrush is treated with antifungal agents applied directly to the affected areas.
• Cellulitis - an infection that spreads across a child’s face, causing a rash and fever. It has the same causes as a tooth abscess, but the infection has the ability to spread. Immediate assessment by a dentist or doctor is required.
• Mucocele - a soft, bluish-grey nodular swelling on the lower lip can be caused by trauma to the lower lip - often from lip biting. These will often burst and heal by themselves. If they persist, treatment may be required.

• Your dental professional (dentist or dental therapist)
• Your doctor
• Your chemist
• Your community health clinic
• Your Maternal and Child Health nurse.

• Mouth ulcers and thrush are often seen in young babies and infants.
• For many mouth lesions, it helps if your child avoids salty, acidic or spicy foods.
• If mouth ulcers don’t heal within two weeks, a medical or dental professional should be consulted.
• Tooth abscess and cellulitis require immediate treatment by your dentist or doctor.

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