Mouth ulcers

What is...

What are mouth ulcers?

Mouth ulcers, also called aphthous ulcers or canker sores, are open sores on the inside of the cheeks, lips or tongue.

Some children seem to get canker sores after eating certain foods while others may get them after using toothpaste with foaming ingredients.

Sometimes ulcers occur at the site of minor trauma in the mouth, for example, biting the inside of the cheek or scraping the cheek with a hard piece of food such as a lollipop.

Most mouth ulcers are not contagious.

Viruses are responsible for some mouth ulcers, but often the cause is unknown. Among the most common viruses causing mouth ulcers are the chicken pox virus and the coxsackie virus.

Ulcers caused by the herpes virus are different from canker sores. Commonly called cold sores, these ulcers develop on the outside of the mouth around the lips, and are very contagious and easily spread.

Mouth ulcers can occur at any age, although they are more common in older children, adolescents and adults.

Symptoms

Symptoms and signs

When aphthous ulcers do occur, the child will complain of pain in his mouth. You may be able to see one or more ulcers on the mucus membranes of the mouth.

They often have a grey "punched-out" center with a white or yellow edge and are surrounded at the edges by redness.

The ulcers will bleed easily, for example when brushing the teeth, and usually last for several days. Occasionally, they may last for 1-2 weeks before they disappear.

Viral infections that cause mouth ulcers may be accompanied by a fever and the child may just not feel well.

During a herpes infection that causes cold sores, a high fever, difficulty swallowing, and general soreness in the mouth will also accompany the mouth ulcers.

The child may also have ulcers on the lips and on the skin around the mouth.

Occasionally the lymph nodes around the neck will be swollen.

Unlike most viruses, the herpes virus stays in a person's body forever, and it gets reactivated or comes back from time to time throughout life.

When the herpes virus is reactivated, cold sores may be seen again. These begin with a tingling or numb feeling around the mouth, followed by a blister that will eventually burst open and scab over.

Cold sores often reappear when the person has a cold or another infection, after too much exposure to sunlight, because of stress, or in connection with menstruation.

Complications

Complications

Mouth ulcers are for the most part harmless and heal by themselves, but the pain can be severe.

In rare cases, small children may refuse to drink and become dehydrated (not enough fluids in their body). This is especially common during an initial herpes simplex infection, but it can also occur with chicken pox.

Children with cold sores caused by the herpes virus could spread the virus to their eyes, causing a dangerous infection.

If you suspect any of these complications has happened, consult a doctor immediately.

Home treatment

Treatment / What you should do

If your child has a mouth ulcer, you can relieve pain by giving your child acetaminophen or ibuprofen.

The child should avoid acidic, spicy, or salty food or drink, such as orange juice or tomato sauce, as this may sting. It may also be easier to get your child to drink using a straw.

Some children experience relief when pressing an ice-cube against the ulcer. Popsicles often help relieve pain and provide the child with necessary fluids.

It may be necessary to use an anesthetic (numbing) ointment or gel for a short period of time.

If your child is not drinking and you suspect that he is dehydrated, you should consult a doctor immediately.

If you suspect that your child has cold sores caused by the herpes simplex virus, you should consult a doctor.

The physician will determine whether it is appropriate to prescribe an anti-viral medicine such as acyclovir for the treatment of herpes.

Prevention

Prevention

Because most mouth ulcers do not have a known cause, they cannot be prevented. However, if your child seems to get mouth ulcers in the same spot inside the mouth, the sharp edge of a tooth could be the cause. If this is the case you should have the child evaluated by a dentist.

Adults can infect a child with cold sores through direct contact or through saliva.

Adults can possibly prevent the spread of ulcers caused by the herpes virus. If you have a cold sore, it is important to wash your hands well before touching your child. Also, avoid direct contact with your sores, like happens with kissing your child.

This is especially important with newborns and children who have problems with their immune systems.

If your child has a cold sore, you should make sure that he does not rub the sore and then touch his eyes, as this could spread the virus and cause a dangerous infection.

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