A child has several shallow mucosal lesions on the buccal mucosa and tongue that are surrounded with an erythematous halo and covered by yellow plaques. What will the primary care pediatric nurse practitioner recommend?

A child has several shallow mucosal lesions on the buccal mucosa and tongue that are surrounded with an erythematous halo and covered by yellow plaques. What will the primary care pediatric nurse practitioner recommend?

• A. Chlorhexidine gluconate
• B. Diphenhydramine and Maalox
• C. Oral acyclovir
• D. Topical antiviral medication

Answer: (A)

These shallow oral ulcers with a red halo and yellow base are most consistent with aphthous stomatitis (canker sores), a common, noncontagious condition in children. The goal is to relieve pain, keep the mouth clean, and prevent secondary infection while the ulcers heal on their own over 1–2 weeks. Chlorhexidine gluconate mouthwash acts as an antiseptic rinse that reduces oral bacteria around the lesions, helps prevent infection, and can improve comfort and healing time. The other options don’t fit as well. Antiviral therapies (oral acyclovir or any topical antiviral) are used for herpes simplex virus stomatitis, which usually presents with different features such as fever, gingival inflammation, and vesicular lesions that progress to ulcers. Diphenhydramine with Maalox is not a standard, evidence-based treatment for aphthous ulcers. So chlorhexidine gluconate is the most appropriate first-line recommendation for this presentation.

These shallow oral ulcers with a red halo and yellow base are most consistent with aphthous stomatitis (canker sores), a common, noncontagious condition in children. The goal is to relieve pain, keep the mouth clean, and prevent secondary infection while the ulcers heal on their own over 1–2 weeks. Chlorhexidine gluconate mouthwash acts as an antiseptic rinse that reduces oral bacteria around the lesions, helps prevent infection, and can improve comfort and healing time.

The other options don’t fit as well. Antiviral therapies (oral acyclovir or any topical antiviral) are used for herpes simplex virus stomatitis, which usually presents with different features such as fever, gingival inflammation, and vesicular lesions that progress to ulcers. Diphenhydramine with Maalox is not a standard, evidence-based treatment for aphthous ulcers. So chlorhexidine gluconate is the most appropriate first-line recommendation for this presentation.