What is Primary Herpetic Gingivostomatitis

Primary herpetic gingivostomatitis is an infection of the mouth, gums, and throat. It is caused by a virus. This is a common infection in children and teenagers.

The infection can cause sores and pain in the affected areas. Symptoms can range from mild to severe. In severe cases, the sores can make it difficult to eat and drink. The symptoms usually get better in 1–2 weeks.

This virus is carried by many people. Most people get this infection early in childhood. After a person is infected, he or she carries the virus forever, but it is usually not active and does not cause symptoms.

It may flare up again and cause cold sores at various times.

What are the causes?

This condition is caused by a virus that is called herpes simplex type 1 (HSV-1). This is the same virus that causes cold sores. The virus is contagious. This means that it can spread from one person to another through close contact, such as kissing or sharing drinks or utensils.

What are the signs or symptoms?

Symptoms can vary from mild to severe. They may include:

• Small sores and blisters on the mouth, tongue, gums, throat, and lips.
• Swelling of the gums or lips.
• Severe mouth pain.
• Bleeding gums.
• Irritability from pain.
• Decreased appetite or refusal to eat or drink.
• Drooling.
• Bad breath.
• Fever.
• Swollen, tender lymph nodes on the sides of the neck.
• Headache.
• General discomfort, uneasiness, or feeling ill.
• Fatigue.

How is this diagnosed?

This condition is usually diagnosed with a physical exam. In some cases, the sores are tested for the HSV-1 virus.

How is this treated?

This condition usually goes away on its own within 2 weeks. Sometimes, a medicine to treat the herpes virus is used to help shorten the illness. Medicated mouth rinses can help with mouth pain.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child aspirin because of the association with Reye’s syndrome.
• Do not use numbing gels or products containing benzocaine in children who are 2 years old or younger.

Eating and drinking

• Have your child drink enough fluid to keep his or her urine pale yellow.
• Give your child frozen ice pops and cool, non-citrus juices. These may help to relieve pain.
• Give your child soft and cold foods. Ice cream, gelatin dessert, and yogurt are good choices.
• Have your child avoid foods and drinks that could irritate sores. These include acidic drinks such as orange juice.
• For infants, continue with breast milk or formula as usual.

Oral hygiene

Help your child practice good oral hygiene by:

• Flossing his or her teeth every day.
• Brushing his or her teeth with a soft toothbrush twice each day.

If brushing is too painful, wipe your child’s teeth with a wet washcloth.

General instructions

• If your child is old enough to rinse and spit, have your child rinse his or her mouth with a salt–water mixture 3–4 times a day or as needed. To make a salt-water mixture, completely dissolve ½–1 tsp of salt in 1 cup of warm water.
• Wash your hands often. Always wash your hands well after handling children who are infected.
• Make sure that your child:
  • Keeps his or her hands away from the mouth area.
  • Avoids rubbing his or her eyes.
  • Washes his or her hands often.
• Keep your child away from other people as told by the child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if your child:

• Refuses to drink or take fluids.
• Has a fever that comes back after being gone for 1 or 2 days.
• Has severe pain that is not controlled with medicines.
• Has symptoms that get worse.

Get help right away if your child:

• Has pain and redness in the eye or on the eyelids.
• Has decreased vision or blurred vision.
• Has eye pain or increased sensitivity to light.
• Has tearing or fluid draining from the eye.
• Is younger than 3 months and has a temperature of 100°F (38°C) or higher.
• Has signs of dehydration, such as:
  • Unusual fussiness.
  • Dry mouth.
  • Weakness and fatigue.
  • No tears when crying.
  • Not urinating at least once every 8 hours.

Summary

• Primary herpetic gingivostomatitis is an infection of the mouth, gums, and throat that is common in children and teenagers.
• The condition is caused by a virus called herpes simplex type 1 (HSV-1). This is the same virus that causes cold sores. The virus is contagious. This means that it can spread from one person to another through close contact.
• The infection can cause sores and pain in the affected areas. Symptoms can range from mild to severe. In more severe cases, the sores can make it difficult to eat and drink.
• This condition usually goes away on its own within 2 weeks. Sometimes, a medicine to treat the herpes virus is used to help shorten the illness. Medicated mouth rinses can help with mouth pain.
• Give medicines, food, and fluids as told by the child’s health care provider. Encourage your child to practice good oral hygiene, including brushing and flossing.