Tackling the painful tiny sores inside the mouth

Tiny ulcers inside the mouth can be very irritating and painful, especially for children when they are unable to express what’s causing the pain. When two-year-old Aryan from Bangalore fell sick and refused to eat anything in November 2024, his parents thought it was due to a high fever. Though his fever reduced after two days, his appetite did not get back, and eventually, his parents found out that the culprit was an ulcer beneath his tongue.

Aryan’s mother, Kavitha Jain, a software engineer and Bangalore resident tells Happiest Health that the boy had no ulcers when they first consulted the doctor. “He was prescribed paracetamol syrup, and he got better in two days. He developed an ulcer below his tongue, which had gone unnoticed,” Jain said.

Mouth ulcers in children

When the delicate lining tissue of the mouth breaks, it develops into an ulcer. Though irritating and painful, it's harmless and heals within 7 to 10 days. In medical terms, they are also known as canker sores or aphthous ulcers. These sores can appear swollen and in various colors, including white, red, yellow or grey.

“Any ulcers in children are self-limited, but mouth ulcers may take a while to heal due to the friction and acidic enzymes in saliva. The most common causes in children are viral infections and vitamin deficiencies,” said Dr Vittal Kumar Kesireddy, consultant and in-charge, department of pediatrics, CARE Hospitals, Banjara Hills, Hyderabad.

He noted that while hand, foot and mouth disease (HFMD) is a common viral infection that causes mouth ulcers, other viral infections can also lead to similar ulcers. “During an infection, their immune system would be compromised, making the mucous membrane of the mouth more vulnerable. The most common causes of deficiencies are vitamin B2 or riboflavin, vitamin B12 and vitamin C, especially in children aged between 2-3 years. It could be due to neophobia where the children don’t take new food and miss out on nutritious food, resulting in deficiency,” said Dr Kesireddy.

Avoid irritating the ulcer

Like any parent with a sick child, Kavitha too fed him hot soups that irritated his ulcers even more. “Aryan would cry and spit it out, and that’s when we noticed the ulcer below his tongue. I became more concerned when he stopped drinking milk and even water. The doctor suggested we use a numbing gel, which helped soothe his pain,” said Kavitha.

Who else may get an ulcer?

14-year-old Sannidhi A from Bangalore, who recently got dental braces (metal), started experiencing ulcers due to the friction created by the new aligners. “The ulcers have started since the time I was on braces. It is very tough to chew food and talk,” said Sannidhi. 

“Ulcers due to orthodontic appliances are common in children as they cause irritation,” says Dr Ponnudurai, a pediatric dentist at Sunshine Dental, Chennai. “The other common causes of ulcers are injuries caused by the toothbrush, hard bristles or children’s fall leading to mouth injury,” he said, adding that staying hydrated will keep the tissues wet and reduce the chances of friction.

Dr Ponnudarai said that children can also develop an ulcer by accidentally biting their inside cheek or tongue. “Acidic food, stress or biting of cheeks or lips post dental procedures could also lead to ulcers. Children feel a tingling sensation due to the anesthesia given during the procedure, and that may lead to them biting the area until the effect wears off,” he explained.

Recurrent mouth ulcers in children

Recurrent ulcers in children could either be due to a nutrition deficiency or caused by orthodontic appliances. Dr Kesireddy cautions parents to get their child examined if they have recurrent ulcers, which could be a sign of immunodeficiency. “If a child is getting recurrent ulcers about 3 – 5 times in six months or a year, it is better to get the child examined for immunodeficiency to rule out any underlying conditions,” he said.

Reference Link

https://www.happiesthealth.com/articles/parenting/tackling-mouth-ulcers-in-children