Aphthous Stomatitis (Canker Sores)

A canker sore (aphthous stomatitis) is an illness that causes small ulcers to appear in the mouth, usually inside the lips, on the cheeks, or on the tongue.

The exact cause of this disease is not known. There are many factors that are thought to be involved with the development of canker sores, including:

  • A challenged immune system (distracted with fighting something else)
  • Certain foods may cause the lesions to appear, such as:
    • Coffee
    • Chocolate
    • Cheese
    • Nuts
    • Citrus fruits
    • Potatoes
  • Stress
  • Viruses and bacteria
  • Trauma to the mouth
  • Poor nutrition
  • Certain medications

Aphthous stomatitis is usually seen in children and adolescents from the ages of 10 to 19 years. For about a third of the children affected, lesions continue to reappear for years after the initial outbreak.

The following are the most common symptoms of aphthous stomatitis. However, each child may experience symptoms differently. Symptoms include:

  • Ulcers in the mouth, usually inside the lips, on the cheeks, or on the tongue
  • Ulcers that are covered with a yellow layer and have a red base
  • No fever present (in most cases)
  • Lesions usually heal in seven to 14 days
  • Lesion tend to recur

Aphthous stomatitis is usually diagnosed based on a complete history and physical examination of your child. The lesions are unique and usually allow for a diagnosis simply on physical examination. In addition, you child's physician may order the following tests to help confirm the diagnosis and rule out other causes for the ulcers:

  • Blood tests
  • Cultures of the lesions
  • Biopsy of the lesion -- taking a small piece of tissue from the lesion and examining it microscopically

Specific treatment for aphthous stomatitis will be determined by your child's physician based on:

  • Your child's age, overall health and medical history
  • Extent of the disease
  • Your child's tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

The goal of treatment for aphthous stomatitis is to help decrease the severity of the symptoms. Since it is a viral infection, antibiotics are ineffective. Treatment may include:

  • Increased fluid intake (i.e., water, Gatorade, Pedialyte, popsicles)
  • Acetaminophen (Tylenol) or ibuprofen (Motrin) for any fever or pain. Do not give ibuprofen to children under the age of 6 months old.
  • Proper oral hygiene (brush teeth)
  • Topical medications (to help decrease the pain of the ulcers); use Vaseline on dry lips
  • Mouth rinses (to help ease the pain); salt water (½ teaspoon of table salt mixed with 8 ounces of water)

It is especially important for your child to avoid spicy, salty or acidic foods, or anything else that may cause further mouth irritation.

Last Updated 09/2012