The most likely age to start treatment is around 12 or 13 years old once all their permanent teeth have come through and almost always involves using braces to straighten crooked, crowded or sticking out teeth. Braces are also used to close gaps between teeth and help the top and bottom teeth to meet when the child closes their mouth.  There are different types of braces, some are fixed, some you can take out at night, to eat a meal or to clean them, as well as some which you only wear at night.
What are the main causes?
A child’s mouth is very sensitive to change, and it will take a few days to get used to wearing a brace. This is when mouth ulcers and sore spots are most likely to develop, as the brace rubs against the cheeks, lips and gums. The orthodontist will need to check the braces every 6–8 weeks, to replace worn-out rubber bands, check on the progress of the teeth, and make adjustments to the wires to make sure teeth are being pulled in the right direction. Mouth ulcers may also occur after these adjustments have taken place.
What are the symptoms?
A mouth ucler is:
- round or oval in shape
- usually red or yellow in colour
- swollen arount the edge
Most mouth ulcers and sore spots caused by braces appear on:
- inside of the lips
- inside of the cheeks
What are my treatment options?
If parts of a brace are causing pain and discomfort, a children’s sugar-free painkiller such as ibuprofen or a children’s paracetamol suspension may help. If sore spots and mouth ulcers develop, the dentist or orthodontist can provide some clear wax to place over the part of the brace that is causing the problem. This should not be used at night.  A mouth ulcer gel suitable for children can be used at any time of the day or night (but no more than every 3 hours).
What can I do about it?
The main goal for treating your child’s mouth ulcer is to relieve their pain and discomfort. There is a product in the bonjela range, suitable for children over 5 months, as well as adults and the elderly.
- Keep the teeth and braces clean, to help prevent dental decay and inflamed gums. Food may build up in the brackets and in between the teeth and will need careful cleaning to remove it.
- Eating the wrong foods can damage or even break the brace so avoid hard foods such as whole apples, raw carrots, French bread and crusty rolls, which could break the wires and brackets on the braces. Also avoid sticky, chewy (including gum) and sugary foods.
- Avoid fizzy drinks and natural fruit juices as these are often high in sugar and can be acidic, which can lead to tooth decay and stain the brackets.
- Continue to visit the regular dentist while treatment is ongoing, to make sure that the teeth and mouth stay healthy.