Dr Phil Kieran: What can I do about my daughter's mouth ulcers?

"Mouth ulcers, known as aphthous ulcers, are shallow with a pink-red or yellowish centre and are usually round or oval - they can be commonly caused by irritation due to poor dental hygiene, smoking, and continuous friction such as sucking lollipops."

Getting your child's diet and brushing routine right can help avoid a trip to the dentist.

My ten-year-old daughter often gets painful mouth ulcers.

She washes her teeth twice daily and only eats sweets during the weekend.

What treatment would you recommend?

Mouth ulcers can be incredibly painful. Most people only suffer from these from time to time and they are short-lived. But for some people like your daughter, they can become a recurring issue. 

Mouth ulcers, known as aphthous ulcers, are shallow with a pink-red or yellowish centre and are usually round or oval. They can be commonly caused by irritation, for example, due to poor dental hygiene, smoking, and continuous friction such as sucking lollipops.

It is normal to get mouth ulcers a few times yearly, particularly if you tend to chew on your lip or bite your cheek.

Also, I have come across several patients who stopped getting ulcers when they switched from using whitening toothpaste, so this may be worth considering.

In your daughter's case, it seems you have already ruled out these possibilities. It may be a good idea to visit your GP to consider blood tests as recurrent ulcers can be a sign of iron deficiency, coeliac disease, or other underlying conditions.

To treat the ulcers, ensure she uses a soft-bristled toothbrush and gentle toothpaste (consider one without SLS, as this can cause irritation for some people). She should also avoid hot or high-acidity drinks (most soft drinks and fruit juices). Painkilling sprays from your pharmacy can also be used if the pain is very severe.

If the blood tests come back normal, the likelihood is that she has a condition called recurrent aphthous stomatitis (RAS). This common condition affects up to 20% of people and often runs in families. Unfortunately, there is no cure, so it will be essential to find out what triggers your daughter's ulcers by close observation. 

If she has RAS, there is a good chance that her symptoms will settle down during or after puberty. So,  although she is more prone to ulcers in the future, she may not get them as frequently.

Most mouth ulcers will go away within 14 days and the pain can be managed with paracetamol. 

I would encourage everyone to ensure their kids learn to brush their teeth well and see a dentist regularly for checkups (to avoid problems and make visiting the dentist less scary for your kids when they are older).

Try to make sure your kids have a healthy diet with plenty of veg and fruit.

And lastly, encourage them not to smoke or to take up vaping.

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