Canker sores, (also known as aphthous ulcers) in children can be caused by a variety of factors. Usually, they heal by themselves in a few days to a couple of weeks. It is recommended to manage the pain by giving your child an over-the-counter pain reliever. Dr. Bornstein provides insights on canker sores and suggests ways to support children if they develop canker sores.

Canker sores

DEFINITION: 

Painful sores inside the mouth. 

SYMPTOMS: 

Pain, burning, throbbing inside the mouth. The pain is worse when eating citrus, salty, or spicy foods.

CAUSES: 

Not definitive. It may be caused by a virus called coxsackievirus or may be due to injury, burns, or self-biting.

DIAGNOSIS: 

Seeing the ulcers in the mouth makes the diagnosis.

CONTAGION: 

If viral in origin, it is contagious. Otherwise, it is not.

TREATMENT: 

Treatment consists of pain relief. Using acetaminophen (Tylenol, Tempra) or ibuprofen (Motrin, Advil) can do this. An antacid can be swished in the mouth and spit out. A physician may prescribe a medicine containing diphenhydramine (Benadryl), an antacid (Maalox, Mylanta), and viscous lidocaine, which can numb the area. An oral rinse with chlorhexidine (Peridex) can provide some relief. Triamcinolone (Kenalog) dental paste is a steroid that can reduce swelling and be of some help. The lesions will resolve on their own in one to two weeks. The outcome is excellent.

DISCUSSION: 

Canker sores are very painful ulcers that occur inside the mouth, on the palate, inside the cheeks, on the tongue, and inside the lips. The exact cause is unknown, but it may be due to coxsackievirus A16, which also causes hand, foot, and mouth syndrome. Once the sores develop, only time will heal the lesions. Since these ulcers are painful, pain control is the best medicine. Also, avoid foods that irritate the area. Most people cannot tolerate spicy or salty foods or citrus juices. The lesions will last one to two weeks and resolve. They tend to recur, and things that can cause a recurrence include stress, illnesses such as upper respiratory infections, and certain foods. The foods are different for each person, so looking for a pattern may be helpful. The one complication that can occur in infants and young children is dehydration. These sores are so painful that a child may refuse to drink. Pushing fluids is essential; otherwise, intravenous fluids may be necessary if dehydration ensues.

ONE DOCTOR’S OPINION: 

These are very painful but self-limited. The canker sores will come and go and will probably recur. There’s not much to do even though they make a child miserable. Do anything to make the child comfortable, but it will last one to two weeks, no matter what. I have put infants in the hospital when they cannot drink due to the pain. You have to do your best to push fluids to prevent dehydration. 

This blog was written by Dr. Michael Bornstein, who has 30 years of experience as a pediatrician. 

Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.