Management of Hand, Foot, and Mouth Disease

Oral Care and Hygiene Management

The American Academy of Pediatrics recommends cleaning the mouth daily with warm saline mouthwashes at least 4 times daily to prevent secondary infection and promote healing 1, 2
The American Dental Association suggests using a soft toothbrush or gentle oral sponge after meals and before sleep to maintain hygiene without causing additional trauma 2
The British Association of Dermatologists recommends applying white soft paraffin ointment to the lips every 2 hours to prevent drying and cracking 3
The American Academy of Pediatrics advises against using alcohol-containing mouthwashes as they cause additional pain, irritation, and impair healing 1, 2
The American Dental Association recommends brushing teeth twice daily with mild fluoride-containing, non-foaming toothpaste 2

The Infectious Diseases Society of America recommends administering acetaminophen or ibuprofen for pain relief and fever control as needed, with a strength of evidence rated as strong 4
The American Academy of Pediatrics advises against using aspirin in children due to the risk of Reye syndrome 4

The American Academy of Pediatrics recommends encouraging ample fluid intake to maintain hydration, as painful oral lesions may reduce oral intake 2
The American Academy of Pediatrics suggests eliminating irritating foods including tomatoes, citrus fruits, hot drinks, and spicy, hot, raw, or crusty foods that can exacerbate oral pain 2

The American Academy of Pediatrics recommends implementing respiratory hygiene/cough etiquette, such as covering the nose and mouth when coughing or sneezing, preferably into the elbow rather than hand 5
The Centers for Disease Control and Prevention advises performing hand hygiene with soap and water or alcohol-based hand rub after contact with respiratory secretions 5, 6
The American Academy of Pediatrics recommends maintaining at least 3 feet separation from other individuals when feasible 5

The American Academy of Pediatrics recommends evaluating treatment response within 2 weeks; if oral ulcers persist beyond 2 weeks, reevaluate for alternative diagnoses 1, 2

The American Academy of Pediatrics advises against using petroleum-based products chronically on lips, as they promote mucosal dehydration and increase secondary infection risk 1, 2
The American Academy of Pediatrics recommends not relying solely on clinical appearance for diagnosis if the presentation is atypical or lesions persist beyond expected timeframes 1

The American Academy of Pediatrics notes that inadequate pain management can impact nutrition and hydration, particularly in young children who may refuse oral intake 2