Mouth sores in babies and children can develop for different reasons, such as trauma, canker sores or a viral infection. Small, limited sores usually heal within one or two weeks. If there is fever, a rash, an inability to drink or repeated sores, a medical assessment is needed.
Canker sores are not contagious. However, some infections such as hand, foot and mouth disease can spread. The aim of home care is to prevent fluid loss, reduce irritation and keep up gentle oral hygiene.
What Is a Mouth Sore in Babies and Children?
A mouth sore is a break in the surface of the tissue that lines the mouth. It can appear on the inside of the lips and cheeks, on the tongue, near the gums or on the palate.
The sore usually has a white or yellow center with redness around it. Pain can make speaking, chewing and swallowing harder. In babies, restlessness during feeding may be more noticeable.
Not every white patch is a mouth sore. Oral thrush can cause raised, cream-colored plaques on the tongue and cheeks. A cold sore on the outer lip is also different from a classic canker sore.
How Can You Recognize Mouth Sores and Canker Sores in Babies?
A canker sore in a baby is usually a round or oval sore on the soft tissues inside the mouth. Its center may be pale and its edges red. It can appear alone, or several sores may develop.
Because a baby cannot express pain, changes in behavior are important. The following signs may suggest tenderness inside the mouth:
- Crying during breastfeeding or bottle feeding
- Stopping a feed early or refusing it altogether
- Touching the mouth and being clearly unsettled
- Disturbed sleep patterns
- More drooling than usual for their age
- Avoiding solid foods
If there is fever, widespread gum redness or many blisters, the problem may not be a simple canker sore. Viral infections may need to be assessed by a pediatrician.
White plaques that leave a red surface underneath when wiped may suggest oral thrush. Trying to scrape the plaques off can cause bleeding and irritation.
Why Do Mouth Sores Happen in Children?
A mouth sore in a child is not the sign of one single disease. The number, location and duration of the sore and the symptoms that come with it help to identify the likely cause.
| Possible Cause | Distinguishing Findings | Assessment |
|---|---|---|
| Trauma and irritation | Usually a single sore; a history of biting, hard food, a sharp tooth edge or hard brushing | If the source of irritation continues, a dental examination is needed |
| Canker sore | A round or oval, painful sore inside the mouth with a red border | If it recurs often, underlying causes can be investigated |
| Hand, foot and mouth disease | Fever, sore throat, loss of appetite and a rash on the hands or feet along with mouth sores | Fluid intake and general condition are monitored closely |
| Herpetic gum and mouth infection | Fever, many small sores, red gums that bleed easily | Assessment by a pediatrician or a dentist is needed |
| Herpangina | Fever, sore throat and sores mostly at the back of the mouth | A clinical assessment tells it apart from other infections |
| Oral thrush | Raised, cream-colored white plaques on the tongue or cheeks | After diagnosis, age-appropriate treatment is planned by a clinician |
| Nutritional or systemic problems | Recurrent sores together with poor growth, long-lasting diarrhea or other body findings | If needed, blood tests and a specialist assessment are arranged |
Sores Caused by Trauma
Biting the cheek or tongue, hard foods and sharp tooth edges can cause a single sore. Orthodontic appliances can also irritate the tissues of the mouth.
One situation we often see in our clinic is a sore that keeps coming back in the same spot because of mechanical irritation. A dental examination is needed so the sharp edge can be smoothed.
Recurrent Canker Sores
The exact cause of canker sores cannot always be identified in every child. Trauma inside the mouth, a family tendency and stress can be triggers in some children.
Frequently recurring canker sores may go along with conditions such as iron, folate or B12 deficiency. Celiac disease and bowel diseases can also be considered during the assessment. Not every canker sore means a vitamin deficiency.
Viral and Fungal Conditions
Viral infections usually come with several sores, fever or a rash. Oral thrush looks more like a white plaque than a classic ulcer. The exact distinction is made with an oral examination.
How Is Hand, Foot and Mouth Disease Told Apart From Mouth Sores?
Hand, foot and mouth disease is a contagious viral infection seen in children. The first signs may be fever, sore throat, tiredness and loss of appetite. Painful sores may then develop inside the mouth.
Spots and small blisters may appear on the palms, soles, buttocks or around the groin. Despite the name of the disease, not every child is affected in all three areas. In some children the mouth sores are more noticeable.
The illness usually improves within seven to ten days. Because pain in the mouth can reduce fluid intake, the main risk is dehydration. Small babies and children whose general condition worsens should be watched more closely.
Because hand, foot and mouth disease is viral, routine antibiotics do not remove the cause of the illness. Treatment is planned by a clinician according to the symptoms and the child's general condition.
Hands should be washed with soap and water after changing a diaper. Cups and forks should not be shared, and frequently touched toys should be cleaned. Follow the pediatrician's advice about close contact.
What Helps a Mouth Sore in a Child?
The answer to what helps a mouth sore in a child depends on the cause of the sore and the child's age. The measures that can be taken at home mostly aim to reduce pain and keep fluid intake up.
Keep Up Fluid Intake
Offer small amounts of fluid at frequent intervals. Age-appropriate cool drinks can ease the pain. In babies who are breastfed or formula fed, the normal feeding routine should be kept up as far as possible.
If the child refuses fluids completely, contact a health service instead of forcing them. Passing less urine, a dry mouth and fewer tears may suggest fluid loss.
Choose Soft, Non-Irritating Foods
Soft foods such as yogurt, purée and warm soup are easier to eat. The food must suit the child's age and swallowing ability.
Avoid very hot, spicy, sour, salty or hard foods. Acidic fruit juices and fizzy drinks can sting the sore.
Keep Up Oral Hygiene Gently
Oral care should not be stopped completely. Use a soft-bristled toothbrush and do not press on the sore. Do not wipe a baby's oral tissues harshly.
In children who can spit safely, a gentle salt-water rinse under adult supervision can be considered. Babies and children who might swallow the mixture should not use a mouthwash.
Use Medicines Only on Professional Advice
Painkillers and products applied inside the mouth are not suitable for every age group. The choice of medicine should be made by a clinician according to the child's age, weight and health.
Gels and mouthwashes containing a local anesthetic can create a swallowing risk in babies. Do not use over-the-counter products without asking a pediatrician, dentist or pharmacist.
What Should Not Be Done at Home?
- Do not place a painkiller tablet or any other medicine on the sore; a tablet burns the lining of the mouth.
- Do not scrape or squeeze the sore, and do not burst the blisters.
- Do not apply alcohol, cologne or similar irritants inside the mouth.
- Do not use leftover antibiotics or antiviral medicines.
- Do not put herbal mixtures or products of unknown content in a baby's mouth.
- Do not force the child to eat solid food; give priority to fluid intake.
Irritating home remedies can increase pain and delay healing. Masking the symptoms can also make it harder to assess the cause of the sore.
When Should You See a Dentist or Doctor?
If any of the following signs are present, a medical assessment should be obtained without delay:
- The child cannot drink or suck
- A clear decrease in urine or in the number of wet diapers
- Marked tiredness, drowsiness or difficulty waking the child
- Difficulty breathing or an inability to swallow saliva
- High fever or a general condition that keeps getting worse
- A widespread rash, peeling skin or sores around the eyes
- Mouth and skin sores that start after a newly used medicine
If the sore does not clearly heal within two weeks, an examination should be arranged. Sores that last longer than three weeks, grow, bleed or recur often should not be put off.
If sores also appear in the genital area or on the skin, tell the pediatrician. Joint pain, long-lasting diarrhea, weight loss or growth problems should also be assessed.
Children with a condition that affects the immune system should be seen earlier. For children receiving cancer treatment or immunosuppressive treatment, contact the relevant health care team.
How Are Diagnosis and Treatment Planned?
During the examination, the onset of the sore, how often it recurs and where it is located are assessed. Fever, rash, trauma, medicines used and feeding problems are also asked about.
A laboratory test is not always needed for a typical, short-lived canker sore. Blood tests may be requested for sores that last a long time or recur often. The decision to test is based on the child's other symptoms.
In traumatic sores, the sharp tooth edge or appliance irritation is dealt with. Treatment for canker sores aims to reduce pain and support healing. Prescription oral products should be used only after an examination.
In viral illnesses, fluid support and monitoring of symptoms come first. In some viral infections, specific treatment may be considered only for certain patients. This decision is made by the pediatrician.
If oral thrush is suspected, antifungal treatment can be planned after the diagnosis is confirmed. Vitamin or mineral supplements should only be given when a need is identified.
How Can the Risk of Recurrent Mouth Sores Be Reduced?
- Use a soft-bristled toothbrush suited to the child's age.
- Prevent hard pressure during brushing.
- See a dentist if you notice a sharp tooth edge or a broken filling.
- Support a balanced diet and do not give vitamins at random.
- Note the date and duration of recurrent sores and any symptoms that come with them.
- Do not share items that touch the mouth, such as toys, cups and forks.
- Keep up hand washing, especially after using the toilet and changing diapers.
Mouth sores in babies and children are usually temporary. However, the appearance of a sore alone is not enough to make a diagnosis. If there is fever, a rash or difficulty feeding, a professional assessment matters.
Frequently Asked Questions
Why do babies get mouth sores?
Mouth sores in babies can be caused by trauma, canker sores, a viral infection or oral thrush. If there is fever, several sores or refusal to feed, an assessment by a pediatrician is needed.
Can babies get canker sores?
Yes, babies can get canker sores. However, findings such as white plaques, widespread blisters and fever may point to a different condition, so an examination may be needed.
What helps a mouth sore in a child?
Cool fluids, soft foods and gentle oral care can reduce discomfort. Medicines and products applied inside the mouth should be used only on a clinician's advice.
How is hand, foot and mouth disease recognized?
Fever and sore throat may be followed by sores inside the mouth and a rash on the hands or feet. Because not every area is affected in every child, the final assessment is based on all the symptoms.
Are mouth sores in children contagious?
Canker sores and sores caused by trauma are not contagious. Hand, foot and mouth disease and some viral infections can spread to others.
How long does a mouth sore in a child last?
Small canker sores and traumatic sores usually heal in one or two weeks. Sores that do not clearly improve within two weeks or that last longer than three weeks should be examined.
Are oral thrush and canker sores the same thing?
No. A canker sore looks like an open sore, while oral thrush usually forms raised, cream-colored white plaques on the tongue and cheeks.
When does a child with a mouth sore need urgent care?
Urgent care is needed if the child cannot drink, is passing less urine, is hard to wake or has trouble breathing. A widespread rash and a steadily worsening general condition are also important warnings.
Sources
- What Is a Mouth Sore (Canker Sore)? – Turkish Ministry of Health, Mudanya State Hospital
- Hand, Foot and Mouth Disease – Turkish Ministry of Health, Kaş District Health Directorate
- Mouth Ulcers – NHS
- Hand, Foot and Mouth Disease – NHS
- Canker Sore: Symptoms and Causes – Mayo Clinic
- Oral Ulcers in Children: A Clinical Narrative Overview – PubMed Central