CANKER SORES(Aphthous Ulcers)
CANKER SORES (Aphthous Ulcers)
DESCRIPTIONCanker sores are painful ulcers that occur in the lining of the mouth. Ulcers are not cancerous, but they may be contagious. The mouth and adjacent areas are involved. Canker sores can affect both sexes, all ages, but is more common in females.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications (sometimes).
SIGNS & SYMPTOMSUlcers are small, painful, shallow, and covered by a gray membrane. Borders are surrounded by an intense red halo.
Ulcers appear on lips, gums, inner cheeks, tongue, palate, and throat. Usually 2 or 3 ulcers appear during an attack, but 10 to 15 ulcers are not uncommon.
Ulcers may be so painful during the first 2 or 3 days that they interfere with eating or speaking.
Ulcers are preceded by tingling or burning for 24 hours (sometimes).
Mouth ulcers with the following characteristics:
CAUSESEmotional or physical stress, anxiety, or premenstrual tension.
Injury to your child's mouth lining caused by hot food, toothbrushing, or dental work.
Irritation from foods, such as chocolate, citrus, acid foods (vinegar, pickles), salted nuts, or potato chips.
Unknown, but following are the most likely causes:
Recent dental treatment.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should brush teeth at least twice a day and floss regularly to keep the mouth clean and healthy.
Your child should avoid stress if possible. See Appendix 19.
Observe if canker sores develop after your child eats specific foods. Encourage the child not to eat foods that seem to trigger attacks.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory culture of the sores.
POSSIBLE COMPLICATIONSDehydration in severe cases where eating and drinking are limited.
Most ulcers heal without scarring in 2 weeks. Recurrent attacks are common. They vary from a single lesion 2 or 3 times a year to an uninterrupted succession of multiple lesions.
Rinse the child's mouth 3 or more times a day with salt solution (1/2 teaspoon salt to 8 oz. water).
Clean sores frequently with 2% hydrogen peroxide on a cotton applicator.
If your child's canker sore is caused by a rough tooth or braces, consult your dentist. The sore won't heal until the cause is eliminated.
MEDICATIONTopical anesthetics to relieve your child's pain.
Antibiotics, such as tetracycline, to fight infection. Tetracycline is effective if the liquid form is held in the child's mouth for 2 to 5 minutes to coat the ulcers before swallowing. If started early, it prevents pain.
Protective dental paste with a steroid derivative, such as Orabase with triamcinolone acetonide. If applied as soon as the ulcer begins, this prevents pain. Keep the medicine prescribed by your doctor for the child's first attack. Use it immediately at the sign of a recurrent attack. The sooner treatment starts, the milder the attack.
See Medications section for information regarding medicines your doctor may prescribe.
Your doctor may prescribe:
DIET & FLUIDS
No restrictions, except to have the child avoid foods that aggravate ulcers. Encourage your child to drink as many fluids and eat as well-balanced a diet as possible while healing. To minimize pain, let your child sip liquids through straws. Foods that cause the least pain are milk, liquid gelatin, yogurt, ice cream, and custard.
OK TO GO TO SCHOOL?
When appetite has returned and alertness, strength, and feeling of well-being will allow. Keep the child's eating and drinking utensils separate until sores heal.
CALL YOUR DOCTOR IF
Your child's temperature rises to 102F (38.9C) or higher.
Ulcers don't improve in 3 days despite treatment.
Pain is unbearable and isn't relieved by treatment.
A child with canker sores loses weight.