In the mouth, a drained blister may look like a white patch, and sometimes can be mistaken for thrush or a fungal infection by those unfamiliar with EB. Most blisters in the mouth will rupture when a child eats or drinks.
If a blister is large or “in the way” and fails to drain while the child is sucking or smacking, your medical provider may want you to drain the blister. This should be done while carefully cradling the child in a position that will allow any fluid from the blister to drain out of the mouth, not toward the back of the throat. Often, one parent will place the child face down on the lap while the other parent carefully drains or opens the blister, allowing the fluid to drain out of the mouth.
For oral lesions that result from mouth blisters, your provider may prescribe “Magic Mouthwash,” a combination of one part viscous lidocaine, one part liquid diphenhydramine (Benedryl®) and one part liquid aluminum hydroxide/magnesium hydroxide (Maalox®) as a swish-then-spit preparation — i.e., swish one teaspoon for one minute and then spit out. This can be used every four hours to soothe the pain of these lesions. For children unable to swish and spit, Magic Mouthwash may be applied to the area with a toothette (small sponge on a stick). This must be done with caution, because the viscous lidocaine may numb the gag reflex and allow choking. For this reason, use of Magic Mouthwash in infants and young children usually is not recommended.