Canker sores (mouth ulcers)

What is a canker sore?

Canker sores are common sores that appear inside the mouth, on an area where the skin is not against the bone, such as on the inside of the lips and cheeks or under the tongue. The sores can make eating and drinking difficult for your child.

Canker sores are different than cold sores or fever blisters. Canker sores often run in families and do not appear to spread from one person to another.

Canker sores are also called aphthous ulcers.

Signs and symptoms of canker sores

Signs and symptoms may include:

• the area may tingle a few days before the sore appears
• sores begin as a round yellowish elevated spot with a red halo
• sores eventually develop into a punched-out ulcer with white, yellow or gray thin cover
• sores may appear alone or in bundles

Toddlers and young children may refuse to eat because of the sore's pain and irritation. Some children and adolescents may have fever, swollen lymph nodes and a tired or ill feeling.

Causes of canker sores

Doctors are not certain of the causes of canker sores. There may be many factors, including:

• diet
• trauma
• stress
• nutritional deficiencies (such as folic acid, vitamin B12 and iron)
• infection
  
• menstruation
• allergies
• drug reaction

Sometimes, canker sores appear more often in children with weak or over-active immune systems but usually appear in children with normal immune systems.

Most children with cankers have no identifiable cause for their cankers as these usually appear in healthy children.

There is no cure for canker sores. Most minor canker sores go away on their own without treatment in one to two weeks.

How you can help your child with canker sores

There are ways you can help your child reduce the pain of canker sores. Some of these tips can also help prevent canker sores from coming back. To reduce the pain of canker sores:

• Avoid feeding your child acidic, spicy or abrasive (scratchy or hard) foods, such as potato chips, salted nuts, lemons or tomatoes, which can aggravate tender mouth sores.
• Use toothpastes and mouthwashes that do not contain SLS (sodium lauryl sulfate).
• Do not brush too hard.
• Use only soft-bristle toothbrushes.
• Avoid soft drinks.

How your doctor can help your child with canker sores

Most children suffering from canker sores can be treated at home. However, in some cases your child should see a doctor.

Seek medical assistance right away if:

• Your child is continually getting canker sores. The doctor or other health provider can look into whether your child is getting a balanced diet or if they are missing a certain vitamin. Your child's doctor may also examine your child for an underlying medical condition.
• The sores are not settling down or disappearing after 10 days.
• Some doctors may recommend an anti-inflammatory topical steroid cream or gel to help the healing.