Stomatitis in Children: What It Is, Types, and Signs in a Child

Sores, plaque, or redness on a child's oral mucosa are a common cause of parental concern. Below is a reference explanation: what is called stomatitis, what forms exist, and which signs to use as a guide.

What stomatitis in children is

Stomatitis is inflammation of the oral cavity and lips. It manifests as redness of the mucosa, single or multiple ulcers, and sores on the gums, lips, and tongue. The mechanism is not fully understood: most likely, the immune system reacts to molecules it does not recognize, and lymphocytes attack the mucosa.

Stomatitis itself is not contagious, but the cause that triggered it may be contagious — such as the herpes simplex virus. Ordinary ulcers resolve on their own within one to two weeks; an ulcer that persists longer than three weeks should be shown to a doctor or dentist.

Types of stomatitis in a child

The aphthous type is recognized by aphthae: round, painful ulcerations with a white or beige fibrin plaque in the center and a red rim around it. They usually heal within 1–1.5 weeks and leave no scars.

The herpetic type is more severe: the temperature rises sharply, the child is drowsy, vesicles appear on the mucosa and rupture after about three days, gingivitis develops, saliva becomes viscous; the whole episode lasts about eight days. The catarrhal type causes swelling, soreness, and white or yellow plaque; it is associated with hygiene, Candida fungi, and gastrointestinal diseases. The traumatic type occurs after injury to the mucosa, and the allergic type occurs as a reaction to an irritant. Vesicular stomatitis is contagious.

What stomatitis looks like in the mouth and on the tongue

The lesions are located on the inner side of the cheeks and lips, under the tongue, on the tongue, and in the posterior part of the pharynx. A typical ulcer is small, round, with a red edge and a gray or white center, painful, and the surrounding tissue looks healthy. In an advanced form, there are many ulcers, and fever and worsening of general condition are added.

Stomatitis is confused with herpes on the lips: the latter appears on the lips and around the mouth, begins with tingling, itching, or burning, and sometimes looks like a group of small pinhead-sized sores. Dry mouth or increased salivation, tissue sensitivity, bleeding gums, and bad breath are also mentioned.

Stomatitis in an infant and a newborn

In an infant, it is harder to suspect the problem: the child cannot say where it hurts, so the examination and assessment are performed by a doctor. Dehydration (with diarrhea, vomiting, lack of water, prolonged fever) is named among the predisposing factors.

Why stomatitis occurs in children

The causes are divided into local and general. Most commonly cited are:

• biting the cheek, burns from hot food or drink, a hard toothbrush, an irritating toothpaste, a sharp tooth edge, braces, poorly fitting dentures;
• viruses and fungi — herpes, enteroviruses, Candida; several ulcers at once occur in hand, foot, and mouth disease (with a rash on the hands and feet), in food allergy, and in intolerance;
• deficiency of iron, zinc, folic acid, vitamins B and D, unbalanced nutrition;
• fatigue, stress, anxiety, hormonal fluctuations, heredity, smoking;
• medications that reduce salivation, some NSAIDs and beta-blockers.

General backgrounds also include diseases of the digestive tract — gastritis, duodenitis, colitis, helminthic infestation — as well as reduced immunity, in which secondary infection is possible. A separate cause is insufficient or excessive oral hygiene.

When a child should be shown to a doctor

Examination is the main method: there are no specific tests for stomatitis, and biopsy and cultures are not used. The doctor assesses the appearance of the ulcers, their location, and whether they recur. Reasons for a visit include an ulcer that persists longer than three weeks, looks different from previous ones, has become larger, is located closer to the posterior wall of the pharynx, bleeds, reddens, or hurts more — this can be a sign of infection. A doctor should also be seen when ulcers are present on the skin or genitals, as well as with painful, red, or swollen joints. Multiple ulcers, fever, and worsening of general condition have been noted in children with advanced forms, and these are assessed by a doctor.

Stomatitis by itself is not a reason to call an ambulance; 103/112 — for life-threatening conditions.

This material is for reference: it describes what can occur with stomatitis in children but does not replace a doctor's consultation — parents choose the approach together with a dentist or pediatrician.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer