Canker sores in kids can be painful sores as they interfere with drinking and eating. These tiny, noncontagious lesions on the oral mucosal layer are also called aphthous ulcers or mouth ulcers. Most canker sores resolve on their own within one or two weeks (1). These may occur at any age but are more often seen in children and adolescents (2). Rinsing the mouth may help reduce the symptoms. However, it is recommended to consult a doctor and treat the underlying cause if your child keeps having canker sores. Continue reading to know more about canker sores’ causes, symptoms, treatment, and prevention and how to differentiate them from cold sores.
Causes Of Canker Sores In Children
The exact cause is not clear in most cases. Hereditary and environmental factors, such as certain food or allergens, can cause recurrent canker sores.
- Dietary deficiency of iron, folate (folic acid or vitamin B9), cobalamin (vitamin B12), or zinc
- Accidental cheek bite
- Mucosal damage from incorrect brushing of teeth
- Injuries due to orthodontic braces
- Food allergies or sensitivities, commonly to coffee, nuts, eggs, chocolates, and fruits, such as citrus fruits and strawberries
- Sensitivity to compounds, such as sodium lauryl sulfate and alcohol found in oral hygiene products
- Hormonal changes in puberty
- Emotional stress
- Constipation can be a possible reason.
The following diseases and conditions that affect the immune system can also be the reason for canker sores (5).
- Autoimmune conditions, such as celiac diseaseiXAn autoimmune and genetic condition characterized by an immune reaction to gluten, the protein found in barley, rye, and wheat , inflammatory bowel diseasesiXA group of disorders that leads to intestinal swelling and chronic pain (ulcerative colitis and Crohn’s disease), and Behcet’s diseaseiXA rare disease that causes swelling in blood vessels and tissues
- Infection from certain pathogens, such as Helicobacter pylori, and immunocompromised conditions, such as HIV/AIDS
Note: Canker sores are not seen in herpes virus infection, which may cause cold sores in the mouth and lips.
Signs And Symptoms Of Canker Sores In Children
Pain is the primary symptom of canker sores. The child may have a burning or tingling sensation associated with the sores. Sometimes, burning can be felt before the lesions appear on the oral mucosal layer (3).
Canker sores are round or oval-shaped lesions with yellow or white-colored center surrounded by red borders. They are seen under the tongue, inside the cheek, on the soft palate, or the gums.
Is It A Canker Sore Or A Cold Sore?
Cold sores or fever blisters can occur in clusters of many sores. These may merge to form large ulcers and lack proper borders and shapes. Cold sores are often seen on the lips, unlike canker sores, which mostly occur on the oral mucosal layer.
Cold sores due to herpes simplex virus type 1 are common among kids. These sores last for three weeks and heal without scarring. Fever, itching, sore throat, and swollen lymph nodesiXSmall, bean-shaped structures that help the body fight infection and disease by filtering lymph fluid are often associated with herpetic cold sores (6).
Should Parents Worry About Canker Sores?
Occasional canker sores that heal within a week or two are not significant causes of concern in children.
Seek pediatric consultation in the following situations.
- Mouth sores lasting more than two weeks
- Recurrent or frequent canker sores
- Large canker sores
- Excessive pain
- Sores present on lips
- High fever and a feeling of sickness
- Sores interfere with eating and drinking
If you are unable to differentiate canker sores from cold sores, ask your child to avoid touching sores and teach them hand hygiene techniques since cold sores are contagious. Consult a pediatrician to determine the type of sores.
How Are Canker Sores Diagnosed?
Doctors can identify canker sores by visual inspection (3). If your child has severe and frequent sores, additional examinations are conducted to identify the underlying cause. Healthcare providers will choose the required tests based on other symptoms and individual factors.
If the canker sores are due to injuries caused by misaligned teeth or dental appliances, then the pediatrician may refer the child to a dentist.
Treatment For Canker Sores In Children
Minor canker sores are cured within a week or two without any treatment. Large sores may require medical care, which can include the following (7).
- Over-the-counter remedies for pain relief such as topical creams, gels, mouthwash, or pastes could help minor sores. Topical products with active ingredients, such as benzocaine, fluocinonide, or hydrogen peroxide, may also enhance healing.
- Mouth rinses containing corticosteroids are prescribed by a doctor to reduce pain and inflammation if multiple or more extensive sores are present.
- Vitamin and mineral supplementations are often prescribed to maintain oral health if dietary deficiencies are the cause for canker sores.
- Oral medications such as Carafate (sucralfate) or colchicine are used to treat severe canker sores.
- Oral steroid medications are often given to control severe inflammation.
- Chemical or instrumental cautery is required for severe cases of canker sores.
Seek help from a doctor specializing in pediatric dentistry to choose the best method to cure canker sores in your child. Treatment may vary if any underlying disease or condition is detected. The sores may heal by themselves during the treatment of the underlying condition.
Home Remedies For Canker Sores
The following home care measures and lifestyle changes may help heal canker sores in children.
- Apply ice to reduce pain and swelling
- Avoid irritants like acidic, hot, and spicy food that may increase pain
- Rinse mouth with saltwater or baking soda rinse
- Use a soft toothbrush with sodium lauryl free toothpaste
- Eat soft and non-abrasive foods to avoid pain
A father of two and blogger who goes by the name ‘The Cool Science Dad’ shares effective tips that helped his daughter alleviate pain caused by canker sores. He recalls, “My wife and I talked with our daughter and gave her some tips on how to deal with the pain. It’s usually only painful when eating or rubbing the inside of your lips against teeth. I gave her some tips on certain foods (acidic foods such as some fruits, ranch dressing that bothered her yesterday, etc.) to avoid that can irritate the sore and cause pain and also that chewing on the other side of her mouth can help (i).”
Prevention Of Canker Sore In Children
The following tips may help reduce the risk of canker sore in children (8).
- Follow a balanced diet that included mixed nutrients
- Follow healthy oral hygiene habits
- Seek dental care for misaligned teeth and follow dentist recommendations while using dental appliances
- Avoid foods that cause allergies
You may also give your kid vitamin and mineral supplements if it is recommended by the pediatrician.
Frequently Asked Questions
1. Is my child sick if they are getting canker sores?
If your child has severe canker sores or they get recurrent aphthous stomatitis, you must consult your pediatrician to check if they have any nutritional deficiency or other issues (10).
2. Are canker sores more common in children?
It cannot be said that canker sores are more common in children. However, children or teens between the ages of 10-19 may have outbreaks of canker sores (11).
3. Are canker sores a virus?
No, canker sores are not caused by viruses. Therefore, they are not contagious (12).
Canker sores in kids are lesions in the oral mucosaiXThe inner layer of the mouth, which also covers the cheeks and lips that are usually not a significant cause of concern. However, they may cause pain during eating and drinking. Nutritional deficiencies, food allergies, or cheek bites may cause canker sores, which resolve in about a week or two. Speak to a doctor if the sores persist longer or become painful. The doctor may prescribe topical gels, mouthwashes, dietary supplements, dietary changes, or medications. Proper oral hygiene and a balanced diet may help prevent canker sores in children.
Infographic: Common Reasons For Mouth Ulcers In Children
Children may experience sores and mouth ulcers due to several other diseases, which usually present other notable symptoms. See the infographic below to understand better the various conditions that can cause mouth ulcers in children.
- Children’s canker sores are painful oral lesions that are not contagious and can interfere with eating and drinking.
- Various factors can cause canker sores in children, including dietary deficits, unintentional cheek bites, food allergies, infections, and autoimmune diseases.
- Canker sores in children usually appear as round or oval lesions with red borders and yellow or white centers.
- Treatment options for children with canker sores include topical or oral medications, pain relievers, and home remedies.
- To prevent canker sores, parents should help their children reduce stress, practice good oral hygiene, and maintain a healthy diet.
- Parents should seek medical attention if their child’s mouth sores last more than two weeks, recur frequently, are large, painful, on the lips, or accompanied by a fever.
Uncover important information baout canker sores in children including ways to prevent them from affecting your child, in this video.
Personal experience: Source
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4. Zinc; University of Rochester
5. Mohamed Nasser Elsheikh and Magdy ElSayed Mahfouz, Prevalence of Helicobacter pylori DNA in Recurrent Aphthous Ulcerations in Mucosa-Associated Lymphoid Tissues of the Pharynx; JAMA Otolaryngology-Head & Neck Surgery
6. Herpes – oral; MedlinePlus; The United States National Library of Medicine
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8. Mouth ulcers; Betterhealth; The Victoria State Government
9. Mouth Ulcers; Seattle Children’s Hospital
10. Canker Sores; KidsHealth
11. Canker Sores (Aphthous Ulcers) in Children; Cedars Sinai
12. Everything You Ever Wanted to Know About Canker Sores; Cedars Sinai