Aphthae (Aphthous stomatitis) are small ulcers with round or oval shape on the mucosa in the oral cavity. They often appear in babies and children. They can be found on the inside of cheeks and lips, on the tongue, gums, palate, or even the throat.
The size varies from 1 – 3 mm up to more than 10 mm. They begin as a small reddish area which later becomes an ulcer covered with a light grey membrane, surrounded by a red “halo”. Although they are typically small, they can be very painful and cause loss of appetite or increased body temperature.
In babies they are normally caused by unwashed or not well sterilised bottles, teats or other utensils. A common “cleaning” practice of a pacifier which fell on the ground is licking it clean. This does nothing to clean the pacifier, only adds microbes from the parent and transfers them to the child. Pay special attention how and where you store the pacifiers. If you have an aphtha, do not kiss the baby on the face, hands or feet. Fanatic hygiene is also not recommended, because the baby will not be able to build immunity to the factors of the environment.
At the age of 4 – 6 months, the baby is becoming more and more active and finds the surrounding world more intriguing. Almost everything the little hands get to ends up in its mouth – fingers, a whole hand, blanket, teethers, any toy, or household item. And inevitably a lot of bacteria pass from the object into the baby’s mouth and they may cause aphthae. During teething the risk of oral infections is much greater, because there are ulcers in the mouth where teeth are breaking the gum and the immune system of the child is weakened.
In older children who already maintain a good oral hygiene, the cause for aphthae can be an old toothbrush. It is recommended to change the toothbrush every 2 months or earlier if the child has been through an infectious disease. Unsuitable toothbrush – too had bristles, may cause traumatic ulcers. Bad technique of brushing the teeth with too much pressure can also cause such aphthae.
Other causes are weakened immune system after the intake of antibiotics, certain vitamin and mineral deficiencies.
Aphthae are very painful. Children may reduce their water or food intake, may refuse brushing their teeth or ever refuse speaking. Regardless, aphthae are harmless. They typically heal on their own in 7 to 14 days.
To reduce the pain you may offer cold foods to the little one. Avoid too hot, spicy or sour foods, as well as fruits such as lemons, oranges and pineapples. Make sure the child is well hydrated. You may use locally anti-inflammatory and painkilling substances. They will not boost the healing process, but will alleviate the discomfort.
If the aphtha in the child’s mouth is not accompanied by other symptoms, such as bad smelling breath, increased body temperature, swelling of the lymph nodes, it will heal on its own. If any of the aforementioned symptoms is present however, contact you doctor. If the pain is too strong, consult the child’s dentist, who will prescribe a suitable painkiller. If the aphthae do not heal after two weeks, contact the child’s paediatrician.