Canker sores in children: Symptoms and treatment

Canker sores are painful sores that form inside the mouth. Most people get their first canker sore during their teenage years. About 2-4 canker sores can develop at the same time.

Around the rain 1 out of 10 humans develop canker sores. While anyone can develop canker sores, teenagers and women are more likely to experience them.

Small children can get canker sores. The ulcers can negatively affect eating, drinking and sleeping.

Typically, canker sores can go away without medication. However, they can cause a lot of discomfort for younger people and may in some cases require treatment. Treatment may involve topical or oral medications to relieve pain and speed healing.

This article will discuss canker sores in children, including symptoms, causes, diagnosis, and treatment.

Canker sores are non-contagious mouth ulcers. They can appear as white-reddish inflamed spots on the lips or inside the cheeks. Less commonly, canker sores can develop on the tongue, gums or corner of the mouth.

While canker sores affect both adults and children, most cases occur in the early years of life. According to a 2020 review, the peak period for canker sores is between 10 and 19 years.

Doctors may also refer to canker sores as recurrent aphthous stomatitis (RAS). The course of the condition is similar in children and adults.

Pain is the most common symptom of canker sores. They can also cause a burning or tingling sensation in the part of the mouth where the ulcer develops.

When the cancerous wound is visible, it appears as a whitish spot.

The exact symptoms of canker sores vary depending on their type. Three types of canker sores can occur in children:

  • Minor canker sores: This is the most common type, accounting for about 80% of cases. Small canker sores are usually a few millimeters in diameter and have slightly raised, reddish edges. They generally heal within 1-2 weeks and hardly leave a scar.
  • Larger canker sores: This type accounts for about 10% of cases. Larger canker sores are 1-3 centimeters in diameter and affect the tissue in the gums. They can last for 6 weeks and can lead to scarring.
  • Herpetiform canker sores: This type accounts for approximately 5% of cases. The sores look like pinhead sores, which doctors may associate with herpes infection. However, these sores do not involve the herpes virus. Herpetiform canker sores can heal within 2 weeks and hardly leave a scar.

Other serious symptoms include:

Children can get a canker sore once or rarely – for example from biting their lip.

However, they may also experience recurrent canker sores which may form 3-6 times a yearwith 2-4 lesions developing at a time.

Experts do not know the exact cause of canker sores. However, the following factors can increase a person’s risk of developing one:

Some children may develop multiple canker sores as a symptom of an underlying condition or weakened immunity.

Doctors can diagnose canker sores by examining the lesions and taking a medical history.

They may perform other tests to potentially rule out underlying conditions that could be causing canker sores. These conditions may also require medical attention.

Tests may include:

  • Blood work: This may include taking a complete blood count and assessing the levels of folic acid, iron, ferritin and vitamins.
  • Microbiological tests: These can help determine the cause of the canker sore. For example, healthcare professionals may use the Tzanck smear test or the polymerase chain reaction assay to detect viruses, bacteria, or fungi.
  • Skin biopsy: A biopsy involves taking a sample from the area around the wound and looking for changes in the structure of the tissue. This can be beneficial in diagnosing persistent canker sores, which are those that last longer than 2 weeks.

Learn more about the difference between cold sores and cold sores.

Canker sores usually heal on their own within a few days. However, several treatment options can help relieve pain and reduce the frequency of canker sores.

A doctor may prescribe medication for a child based on:

  • the child’s age and general state of health
  • the severity of the condition
  • the child’s tolerance or specific allergies to certain medicines

Treatment may include:

  • Mouthwash: Products containing triclosan and chlorhexidine can help prevent the growth of bacteria near the wound and reduce inflammation in the area.
  • Current medication: Medicines can be applied directly to the wound to reduce pain. Topicals are available in the form of sprays, gels and creams.
  • Oral medications: Over-the-counter (OTC) medications such as acetaminophen (Tylenol) can help with pain management. Oral corticosteroids, such as prednisone (Rayos), can also reduce pain and promote faster healing in certain cases, such as when a child has significant, recurring canker sores.
  • Cauterization: This procedure uses laser therapy or silver nitrate solution to reduce pain and speed healing.

Learn more about some home remedies for canker sores.

Approaches that a caregiver can take to relieve pain include:

  • make a mixture of half a teaspoon of salt and 8 ounces of water for a child to use as a mouthwash
  • applying a paste of sodium bicarbonate directly to the wound
  • dab milk of magnesia directly on the wound with a cotton swab and make sure the child avoids eating and drinking for 30 minutes afterwards
  • ensure that the child avoids eating abrasive foods such as nuts and seeds
  • avoid potentially irritating foods, such as acidic, salty or spicy foods
  • ensure that the child uses a soft toothbrush
  • encourage the child to practice good hygiene and supervise them if necessary
  • give the child OTC pain relievers such as Tylenol

Canker sores will likely resolve on their own. In some cases, however, children may need medical attention if:

  • the wound does not heal by itself 2 weeks
  • the inflammation is serious
  • they have large or multiple wounds
  • they experience other symptoms besides the wound
  • ulcers recur very often

Canker sores are painful sores that are common among children. In most cases, they go away on their own. However, some children develop multiple, frequent ulcers that can negatively affect their quality of life.

Several treatment options are available to reduce pain and the frequency of ulcers. A caregiver can take different approaches to help relieve symptoms, such as encouraging the child to practice good hygiene or giving the child OTC medications for pain.

Caregivers should take a child to a doctor if ulcers persist for a long time or cause severe symptoms.

Canker sores in children: Symptoms and treatment

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