What to do for oral ulcers (mouth ulcers) with swollen gums in a 2-year-old for 5 days?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: April 24, 2025 • View editorial policy

From the Research

For a 2-year-old with mouth ulcers and swollen gums lasting 5 days, the most appropriate course of action is to consult a pediatrician immediately, as persistent symptoms in a young child warrant medical attention. In the meantime, relief can be provided by offering cold, soft foods like yogurt, applesauce, or ice pops that won't irritate the ulcers, keeping the child hydrated with cool water or diluted juice, and avoiding acidic drinks that may cause pain 1.

Key Considerations

  • Gently cleaning the area with a soft cloth and warm saltwater (1/4 teaspoon salt in 1 cup water) can help soothe the ulcers.
  • For pain relief, children's acetaminophen (Tylenol) can be given according to package instructions based on the child's weight, as recommended by recent guidelines 1.
  • It's crucial to avoid adult oral numbing gels, which may contain benzocaine, not recommended for young children due to potential risks 2.
  • The ulcers might be caused by hand, foot, and mouth disease, accidental trauma, or other viral infections common in toddlers.

Monitoring and Follow-Up

  • Most mouth ulcers heal within 7-10 days, but if the child has difficulty drinking, shows signs of dehydration, develops a fever, or if symptoms worsen or don't improve after a week, immediate medical care should be sought.
  • Recent evidence suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen are recommended for managing acute dental pain in children, with a conditional recommendation and very low certainty of evidence 1.
  • The use of opioids, such as codeine and tramadol, is contraindicated in children for managing acute pain, according to the US Food and Drug Administration 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.