Work

Psychological Factors, Serum Trace Elements, and Clinical Features of Factitious Oral Ulcers in Children and Adolescents: A Cross‐Sectional Study

Year: 2026

Type: article

Abstract: OBJECTIVE: This study examined associations between psychological factors, serum zinc/iron levels, and clinical features of factitious oral ulcers in children (3-16 years). METHODS: A cross-sectional analysis of 69 patients (78.3% male) from two Chinese hospitals assessed ulcer characteristics, pain (VAS), micronutrient levels, and psychological scores (SCARED, DSRSC, CPRS, SDQ). Statistical analysis used nonparametric tests and correlation analysis (SPSS 26.0). RESULTS: Zinc deficiency (37.7%) correlated with longer disease duration (12.0 vs. 6.0 months, p = 0.035) and shorter ulcer-free intervals (60.0 vs. 95.2 days, p = 0.040). Zinc levels inversely linked to emotional symptoms (r = -0.416, p = 0.022) but positively to prosocial behavior (r = 0.526, p = 0.003). Pain intensity associated with anxiety (VAS: 4.0 vs. 3.0, p = 0.025) and psychosocial distress (r = 0.461, p = 0.010). Older children (8-16 years) had longer disease duration (12.0 vs. 3.6 months, p < 0.001) and higher zinc deficiency (47.5% vs. 24.1%, p = 0.048). Iron showed paradoxical associations with emotional symptoms (r = 0.452, p = 0.012) and prosocial behavior (r = -0.382, p = 0.037). CONCLUSION: Zinc deficiency and psychological factors critically influence the chronicity of FOU. Multidisciplinary care combining micronutrient supplementation and behavioral interventions is recommended.

Source: Oral Diseases

DOI: 10.1111/odi.70228