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Management of recurrent aphthous stomatitis in children

From Volume 42, Issue 6, July 2015 | Pages 564-572

Authors

Jodie A Montgomery-Cranny

BDS(Hons), BSc(Hons), MBCHB(Hons)

Specialty Registrar in Oral Medicine, Charles Clifford Dental Hospital, Sheffield, S10 2SZ, UK

Articles by Jodie A Montgomery-Cranny

Ann Wallace

BDS, MFDS, MClinDent, MPaedDent

Specialty Registrar in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, S10 2SZ, UK

Articles by Ann Wallace

Helen J Rogers

BDS, MJDF RCS(Eng), PGDipConSed, MClinRes, MPaed Dent RCS(Eng)

Academic Clinical Fellow in Paediatric Dentistry, Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK.

Articles by Helen J Rogers

Sophie C Hughes

BDS, MFDS RCS(Edin)

Dental Core Trainee in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, S10 2SZ, UK

Articles by Sophie C Hughes

Anne M Hegarty

BDentSc, MSc(OM), MBBS, MFD, RCSI, FDS(OM) RCS

Consultant and Honorary Clinical Lecturer in Oral Medicine, Charles Clifford Dental Hospital, Sheffield S10 2ZS

Articles by Anne M Hegarty

Halla Zaitoun

BDS, MFDS, MDentSci, FRCS(Paed)

Senior House Officer, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH.

Articles by Halla Zaitoun

Abstract

Recurrent oral ulceration is common and may present in childhood. Causes of recurrent oral ulceration are numerous and there may be an association with underlying systemic disease. Recurrent aphthous stomatitis (RAS) is the most common underlying diagnosis in children. The discomfort of oral ulcers can impact negatively on quality of life of a child, interfering with eating, speaking and may result in missed school days. The role of the general dental practitioner is to identify patients who can be treated with simple measures in primary dental care and those who require assessment and treatment in secondary care. Management may include topical agents for symptomatic relief, topical corticosteroids and, in severe recalcitrant cases, systemic agents may be necessary.

CPD/Clinical Relevance: Children and young people frequently suffer from recurrent oral ulceration; with recurrent aphthous stomatitis being the most common diagnosis.

Article

In simple terms, an ulcer is a full thickness breach of the epithelium. There are numerous causes of oral ulceration in both adults and children, with recurrent aphthous stomatitis (RAS) being the most common cause; it is reported to affect up to 40% of children.1 The degree of pain and psychological distress caused by ulcers is variable and management should encompass acknowledgement of their impact on quality of life.2

RAS represents a genetic predisposition to oral ulceration. Inheritance is thought to be polygenic with no specific genes or HLA types yet identified.3 Identifying those for whom the possibility of undiagnosed systemic disease needs to be investigated and those who do not respond to simple management strategies is of crucial importance to reduce patient morbidity and maintain high standards of care.3

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