Canker Sores (Aphthous Ulcers) in Children

What are canker sores in children?

Canker sores (aphthous ulcers) are small sores inside the mouth. They are often found inside the lips, on the cheeks, or on the tongue.

What causes canker sores in a child?

The exact cause is not known. But many factors are thought to be involved with the development of canker sores. These are:

• Weakened immune system
• Allergies to food, such as coffee, chocolate, cheese, nuts, and citrus fruits
• Stress
• Viruses and bacteria
• Injury to the mouth
• Poor nutrition
• Certain medicines
• Irritation from orthodontic braces

Canker sores are usually first seen in children and teens from the ages of 10 to 19. For about 3 in 10 children affected, canker sores come back for years after the first outbreak. They can’t be spread from one child to another.

Canker sores that keep coming back may be related to celiac disease, inflammatory bowel disease, or HIV infection.

What are the symptoms of canker sores in a child?

Each child may feel symptoms a bit differently. Below are the most common symptoms of aphthous stomatitis:

• Painful sores in the mouth, usually inside the lips, on the cheeks, or on the tongue
• Sores that are covered with a yellow layer and have a red base
• Trouble eating or talking because of the sores
• No fever (in most cases)

Canker sores usually heal in 7 to 14 days. They tend to come back.

How are canker sores diagnosed in a child?

Your child’s healthcare provider can usually make a diagnosis with a complete health history and a physical exam. But he or she may also order these tests to rule out other causes:

• Blood tests
• Cultures of the sores
• Biopsy of the sore. This means taking a small piece of tissue from the sore and checking it under a microscope.

How are canker sores treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

The goal of treatment is to help ease symptoms. Treatment may include:

• Drinking more fluids
• Taking acetaminophen for any fever or pain
• Getting proper oral hygiene
• Using medicines on the skin to help ease the pain of the sores
• Using mouth rinses to help with the pain

Your child may feel better if he or she does not eat spicy, salty, or acidic foods. These foods may make the mouth more irritated.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if the sores:

• Are very painful
• Last more than a few weeks
• Are very large in size
• Keep coming back

Key points about canker sores in children

• Canker sores are small sores that appear in the mouth.
• They are often found inside the lips, on the cheeks, or on the tongue.
• The exact cause of canker sores is unknown. But they may be linked to things such as food allergies, stress, poor nutrition, or certain medicines.
• The sores are different from other sores and are usually diagnosed simply with a physical exam.
• Treatment may include oral medicine or medicine for the skin to ease pain. Antibiotics won’t work.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.