A mouthful of answers about canker sores

(Photo provided)

Parents have been asking me a mouthful of questions as to whether or not their child has a canker sore and what to do about it. Well, I don’t want anyone to be sore at me about this topic, so let me provide some information.

Are they contagious?

About 1 in 5 children develop a canker sore or what is known as a mouth ulcer, a small sore inside the mouth not to be confused with cold sores that occur outside the mouth. While cold sores are very contagious, canker sores are not — although the tendency to get them can run in families.

What causes them?

We know that cold sores are caused by the herpes simplex virus, but no one really knows exactly what causes a canker sore, although diet may be a factor. Children who have lower amounts of folic acid, vitamin B12, and iron are more prone to them. A mouth injury may also trigger a canker sore, as does emotional stress — such as around the time of a big test. Sometimes they occur in patients, such as children on chemotherapy, whose immune systems are not normal.

How do you know you have one?

Canker sores will be tiny painful red spots inside the mouth that will tingle or burn before the ulcer appears and then have a white or yellowish coating over it with a red halo around it. They are more apt to be single but can occur in clusters and may be occasionally accompanied by a low-grade fever or swollen glands in the neck.

Should you seek treatment?

The good news is that canker sores are not dangerous. It may take up to two weeks for canker sores to heal, although the pain is usually worse in the first few days. If the pain is severe or your child cannot drink or eat because of the pain, talk to your child’s health care professional who will want to confirm the diagnosis, try to find a cause and help with treatment.

Besides tincture of time, acetaminophen can also help with the pain. Sometimes your doctor may recommend an over-the-counter mouth rinse or medication to put on the sores for relief. Avoiding spicy, salty or tart foods can also reduce the discomfort.

Hopefully tips like these will burn brightly in your mind rather than in your child’s mouth the next time you are worried they have a canker sore.

Lewis First, MD, is chief of pediatrics at the University of Vermont Children’s Hospital of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.


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