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Canker Sores/Aphthous Ulcers/Aphthous Stomatitis

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. 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. 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 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 foods, salty foods, or citrus juices. The lesions will last one to two weeks and resolve. They have a tendency to recur, and things 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 important; otherwise intravenous fluids may be necessary.

ONE DOCTOR'S OPINION:

These are very painful, but self-limited. They will come and go, but 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's going to last one to two weeks no matter what.