Canker Sores

Medically known as aphthous ulcers or aphthous stomatitis, canker sores are shallow ulcers that develop inside the mouth, particularly in the lining of the cheeks and lips or on the gums, tongue or palate. The sores are more common in adults than in children, although they may occur at any age. They can develop one at a time or in clusters, and while they are not serious, they can be uncomfortable.

HOW DO CANKER SORES DEVELOP?
Canker sores begin as stinging, red, inflamed spots inside the mouth. Over the next several days, they increase in size and turn into well-defined round or oval ulcers that are grayish-white or grayish-yellow in the middle and bright red around the edges. They cause a burning, stinging pain, which sometimes interferes with eating.

The sores usually disappear within seven to ten days, but they may persist for up to two weeks. When healed, they generally leave no scars. Unfortunately, however, canker sores tend to come back and nothing can be done to prevent their recurrence, which may take place at intervals of weeks or months.

WHAT CAUSES CANKER SORES?
It was once believed that these sores were caused by the herpes simplex virus, the same virus that is responsible for cold sores around the mouth, but this has been disproven. The underlying cause is still unknown. Some physicians now suggest that the sores are triggered by an autoimmune mechanism, in which the body's immune system assaults the tissues lining the mouth by mistake. Other possible causes include local trauma, allergy and stress. The sores also tend to appear more commonly in people with malabsorption disorders and nutritional deficiencies of iron or certain vitamins.

IS MEDICAL ATTENTION NECESSARY?
Yes—or at least at the initial outbreak. Although canker sores are harmless and do not require treatment, other types of mouth sores with similar appearances—including herpes and thrush (which is caused by a yeastlike fungus)—should be treated. A pediatrician should look at any type of mouth sore a child develops to determine the likely cause and recommend appropriate treatment if needed.

WHAT TREATMENTS ARE AVAILABLE?
No treatment can effectively eliminate canker sores, but you can take measures to relieve the symptoms and speed healing. Pain from minor sores can be relieved by rinsing the mouth with a peroxide solution (ask your pediatrician for mixing directions) or lukewarm saltwater. The doctor may recommend application of a corticosteroid cream to soothe more severe sores. Even though the sores are not caused by bacteria, topical application of an antibiotic is sometimes effective against them, possibly because secondary bacterial infection sets in after the ulcers erupt.

GETTING HELP
Call your doctor if your child:

• Develops numerous, large or painful mouth sores

• Develops mouth sores that last more than two or three days and show no signs of healing

• Has trouble eating because of mouth sores

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.