jcda
Cite this article as: J Can Dent Assoc 2014;80:e9
ca
ESSENTIAL DENTAL KNOWLEDGE
Published by
The Canadian Dental Association
jadc
Point of
Applied
Research
Care
DES CONNAISSANCES
DENTAIRES INDISPENSABLES
Publié par
l’Association dentaire canadienne
How to Manage a Pediatric Patient with
Oral Ulcers
Eric T. Stoopler, DMD, FDS RCSEd, FDS RCSEng; Ghada Al Zamel, DDS
Dental Emergency Scenario
This article was originally created for
the JCDA Oasis searchable database.
Visit Oasis Help at jcdaoasis.ca to
access this and other point of care clinical
consults.
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
• Any segment of the pediatric population, from infancy through adolescence
• Children of parents with recurrent oral ulcers due to genetic predisposition
(i.e., recurrent aphthous stomatitis)
• 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
Figure 1: Ulceration on the maxillary
gingiva of a 4-year old female (arrows).
• Well-circumscribed lesions, often depressed, with an epithelial defect covered
by a yellow-white pseudomembrane (Fig. 1)
• Single or multiple ulcers; may present in clusters (herpetiform)
• Intraoral/perioral location: nonkeratinized and/or keratinized oral mucosa,
oropharynx, lips, perioral skin
• Variable size (most commonly measured in millimetres, but may be larger)
• General location: oral/perioral lesion(s) only or with involvement of other
affected surfaces (i.e., skin, genitals, other mucous membranes)
Symptoms
• Pain severity: Can range from asymptomatic to severe discomfort
• Burning
• Irritation
• Pruritis (itching sensation)
• Systemic symptoms, such as fever, malaise, lymphadenopathy, difficulty swallowing and general irritability
jcda
ca | 2014 | Vol. 80, No. 1 |
ESSENTIAL DENTAL KNOWLEDGE
Published by
The Canadian Dental Association
jcdaf
ca
• 43 •