Canker sores, technically known as aphthous ulcers, are a common source of discomfort for toddlers. These small, shallow lesions appear on the soft tissues inside the mouth, making eating and drinking painful. While they are usually harmless and resolve on their own, the pain can disrupt a toddler’s routine and increase the risk of dehydration. Understanding how to identify and manage these sores safely is the first step toward providing effective relief.
Recognizing Canker Sores and Potential Triggers
Canker sores present as small, round, or oval ulcers with a distinctive appearance: a white or yellowish center surrounded by a bright red border. They typically occur on the tongue, the inside of the cheeks, or the inner surface of the lips. Canker sores are not contagious and are distinct from cold sores, which are viral and usually appear outside the mouth.
While the exact cause of aphthous ulcers is not fully understood, several factors can trigger their development. Minor injuries to the mouth lining are a frequent culprit, often resulting from accidentally biting the cheek or lip, or aggressive toothbrushing. Other common triggers include emotional stress or fatigue, and some children may have a genetic predisposition.
Safe Non-Medicated Relief at Home
The primary goal of home care is to reduce pain and prevent a decrease in fluid and nutrient intake. Hydration is important, as the pain of swallowing can quickly lead to dehydration. Offer cool liquids like water, diluted juice, or milk, and encourage the use of a straw to bypass sensitive areas of the mouth.
Dietary modifications minimize irritation to the ulcer. Avoid acidic foods such as citrus fruits, tomatoes, and vinegar-based products, as well as salty, spicy, or crunchy snacks. These items cause a sharp, stinging sensation when they contact the sore.
Soft, bland foods are the easiest to tolerate and should be offered frequently. Cold items are particularly soothing because the temperature helps temporarily numb the area. Consider offering chilled yogurt, applesauce, ice cream, or popsicles to provide both comfort and calories.
For older toddlers who can manage to rinse without swallowing, a mild saltwater solution or a baking soda rinse can help soothe the tissue. A half-teaspoon of salt or baking soda dissolved in a cup of warm water can be gently swished and then spit out. This rinse may help clean the ulcer and promote healing.
Appropriate Over-the-Counter Pain Management
Systemic pain relievers are often necessary to manage the pain enough for a toddler to eat, drink, and sleep comfortably. Acetaminophen (like Tylenol) and ibuprofen (like Motrin or Advil) are appropriate options for toddlers. Administer the correct dose based on the child’s current weight, not their age, and use the provided measuring device accurately.
Exercise caution with topical numbing agents, as many contain benzocaine, which is a safety concern for young children. The U.S. Food and Drug Administration (FDA) has issued warnings regarding the use of benzocaine products in children, especially those under two years of age. Benzocaine can cause a rare but serious blood condition called methemoglobinemia, which reduces the amount of oxygen carried by the red blood cells.
Unless explicitly directed by a pediatrician, topical products containing benzocaine should be avoided entirely in toddlers. If a topical treatment is recommended, ensure it is specifically formulated and approved as safe for a child’s age group. Never use adult-strength oral pain products on a toddler, as the higher concentration increases the risk of adverse effects.
Signs That Require a Pediatrician Visit
Most canker sores heal naturally within one to two weeks, but certain signs indicate that medical evaluation is necessary. If the sore lasts longer than fourteen days without showing any signs of improvement, a doctor should examine the area. Canker sores that are unusually large, numerous, or that seem to be spreading may also require professional assessment.
A pediatrician visit is warranted if the pain is so severe that the toddler refuses to drink fluids, leading to signs of dehydration such as dry mouth, reduced urination, or lethargy. Watch for indications of a secondary infection, which may present as a high fever or spreading redness and swelling around the ulcer. These symptoms suggest the need for further diagnosis and potentially prescription treatment.