Mouth sores can make eating, drinking and even talking difficult for children. They might become fussy, skip meals or complain about pain.
“Mouth sores are small painful spots of bumps or erosions that can form anywhere inside your mouth, like on your gums, tongue, inner cheek or lips,” said Scott Olson, MD, a pediatrician with Banner Children’s. “They might look red, white or yellow and may make it difficult to eat, drink or talk.”
While some sores may go away on their own, others may need attention and care. Read on to understand the most common causes of mouth sores in children, what symptoms to watch for and tips for caring for your child.
Common causes of mouth sores in children
“Children often get mouth sores as part of a viral infection,” Dr. Olson said. “They are generally harmless (benign) and are self-limited (tend to get better on their own).”
Along with viral infections, there are many other causes of mouth sores in children. Below are some of the most common causes:
1. Hand, foot and mouth disease (HFM)
“Hand, foot and mouth is one of the most common viral causes of mouth sores in children,” Dr. Olson said. HFM is caused by the coxsackie virus, which belongs to a group of viruses called nonpolio enteroviruses. It is common in young children under five years old.
Symptoms: HFM causes tiny bumps, blisters or sores in the mouth and on the hands, feet and sometimes the butt. It also involves fever and loss of appetite and energy.
How it spreads: The virus spreads through contact with fluids from blisters, coughing, sneezing or touching things that have the virus on them. It can also spread through poop if someone touches a contaminated surface and then touches their mouth.
2. Herpangina
Herpangina is a viral illness mostly affecting children between three and 10 years old. Enteroviruses like coxsackie also cause it.
Symptoms: Herpangina causes small, painful sores in the back of the mouth or throat. Fever, sore throat and headache may also occur.
How it spreads: Herpangina spreads through coughing, sneezing or contact with contaminated surfaces.
3. Cold sores
Cold sores or fever blisters are caused by the herpes simplex virus (HSV). The most common strain is HSV-1. Children and adults can get them.
Symptoms: You may notice tingling or itching before the blister appears. The sores often appear as tiny, fluid-filled blisters around the mouth. They can break and form a crust.“HSV can also cause widespread swelling of the gums and lips (gingivostomatitis) during the first infection,” Dr. Olson said. Children may also have a high fever and painful ulcers.
How it spreads: Cold sores spread through saliva or close contact. Sharing utensils, cups, towels or kissing can also pass the virus.
4. Canker sores
Canker sores are small ulcers that form inside the mouth. Unlike cold sores, they are not contagious. “Stress, injury to the mouth or possible food sensitivities can trigger canker sores,” Dr. Olson said.
Symptoms: A canker sore is a round or oval ulcer with a white or yellow center. It may be found inside the lips, cheeks or gums. The area around the sore may be red and painful.
Less common causes of mouth sores
Some mouth sores may be caused by less common conditions, including:
- Thrush: A fungal infection that causes white patches in the mouth.
- Allergic reactions: Certain foods, medications or dental products can trigger mouth sores.
- Vitamin deficiency: Lack of B vitamins, zinc or iron can lead to sores.
Tips for managing mouth sores at home
Many mouth sores go away in a week to two weeks with no treatment. You can do the following at home to ease your child’s symptoms:
- Ensure hydration: Offer water, milk or electrolyte drinks. Avoid citrus juices.
- Choose soft foods: Yogurt, applesauce and mashed potatoes are gentle on sore mouths.
- Manage pain: Acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) can reduce pain and fever. Always follow the dosing instructions. Don’t give aspirin to your child unless directed to do so by your child’s provider.
- Rinse gently: A saltwater rinse can help clean the mouth and soothe sores. Mix half a teaspoon of salt with one cup of warm water. Dr. Olson also recommends baking soda rinses, honey water or aloe vera to relieve sores.
- Avoid irritants: Spicy, salty or acidic foods can make sores worse. Skip carbonated drinks as well.
When to see a health care provider
Most mouth sores in children are not serious and heal on their own. However, contact your child’s health care provider if:
- The sores last longer than two weeks.
- Your child is unable to drink fluids and shows signs of dehydration.
- Your child has a high fever (Read “Fevers: What to Do and When to Worry.”)
- Your child has a weakened immune system or underlying health conditions.
- Sores spread beyond the mouth to a rash on the body.
- The sores keep coming back (recurrent mouth sores).
“Though rare, recurrent oral ulcers can result from an underlying inflammatory condition, so talk to your child’s provider if sores are occurring frequently or are associated with poor growth,” Dr. Olson noted.
If your child has trouble breathing or swallowing or becomes unresponsive, call 911 and have them treated in the emergency department.
Preventing mouth sores in children
While not all mouth sores can be prevented, here are steps to reduce the chances:
- Teach good handwashing habits.
- Avoid sharing utensils or drinks.
- Keep toys and surfaces clean.
- Make sure your child eats a balanced diet. “A diet rich in vitamin C and zinc supports overall oral health,” Dr. Olson said.
Bottom line
While painful, mouth sores in children are usually not a cause for major concern. Focus on keeping your child hydrated, providing soft foods and managing pain. Watch for signs that might require medical attention. With time and proper care, your child can recover quickly and return to normal activities.
