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Gingivostomatitis: What Is It?

Reviewed by Dan Brennan, MD on March 14, 2021

Gingivostomatitis is an infection caused by the herpes virus—the same virus that causes cold sores. Gingivostomatitis is very damaging to the skin, causing ulcers in the mouth and blisters on the lips. It most often occurs in young children.

What Does It Mean?

One in four children who have gingivostomatitis will develop mouth ulcers. 

At first, after infection, your child may not show noticeable symptoms, but ulcers or sores may form over time and become increasingly uncomfortable to your child. They may then develop a fever and become irritable.

Gingivostomatitis is very painful and often leads to drooling, dehydration, and refusal to eat or drink.

The first infection of the virus is always the worst, with the blisters being severe. The virus will remain in your child’s body for the rest of their life. Your child may also have other episodes of herpes (often referred to as cold sores), but typically the condition becomes less severe with age. 

How to Tell if Your Child Has Gingivostomatitis

Gingivostomatitis is a viral infection that causes the following: 

  • Several small blisters on the gums, tongue, and lips that eventually break open and become painful open sores
  • Raw gums that are sore and bleed easily 
  • Ulcers around the outer lips and mouth
  • Swollen, sore lymph nodes in the neck
  • Fever that lasts for several days

What Causes Gingivostomatitis

Gingivostomatitis is caused by the herpes virus known as herpes simplex type 1 (HSV-1), a viral infection that typically spreads through close physical contact. Children are typically exposed to the virus after they are kissed by someone who has the virus or after they pick up a toy that another child with the virus has had their mouth on. In some cases, herpes can be passed on to the child from an infected mother during childbirth.

How to Treat Gingivostomatitis

You can help care for your child at home by making sure they get enough fluids and avoid dehydration. Oral rehydration fluids can help your child replace fluids. Other options include water, milk, rehydration drinks, and ice pops.

You can provide babies with fluids through a dropper instead of a bottle. This is generally more comfortable in their sore mouth. 

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If your child can eat, give them a soft diet. Avoid citrus fruits and salty or spicy foods; these ingredients can be especially painful if they come into contact with sores or blisters. 

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In some cases, your child may not want to eat, but it's important that they get enough to drink, so they don't become dehydrated.

Common signs of dehydration include the following:

  • Dizziness or lightheadedness
  • Headaches and nausea
  • Dark yellow urine (urine should be pale yellow)
  • Fewer wet diapers, going to the bathroom less
  • Dry lips, mouth, and throat

If your child refuses to drink anything and you suspect they are dehydrated, take them to the ER or nearest hospital as soon as possible. Signs of severe dehydration include the following:

  • Not passing urine
  • Weight loss
  • Pale skin
  • Dry mouth and lips
  • Sunken eyes
  • Cold hands and feet
  • No tears while crying

Medication for Gingivostomatitis

Antibiotics aren’t effective for treating gingivostomatitis because they only treat bacterial infections. But there are other things you can do for your child to help relieve their pain.

Mouth pain. A liquid antacid can be a good option to treat mouth pain. You can give it to your child after meals, using it as a mouthwash that the child keeps in their mouth as long as possible, then spits out. You can also put a few drops in their mouth with a cotton swab.

Avoid using regular mouthwash because it can irritate your child's mouth.

Pain medicine. Acetaminophen can help reduce pain and control fever.

Antiviral drug. In some cases, your doctor will prescribe your child an antiviral drug to help reduce sores.

Tips to Avoid Spreading Gingivostomatitis

The herpes virus that causes most cases of gingivostomatitis is very contagious. You can help avoid its spread by not sharing your child’s toys or drink glasses and utensils with other kids and by not kissing them.

Your child's mouth sores will be contagious for about seven days. Their fever can last up to five days, and they may have mouth pain for up to a week. Keep an eye on your child to ensure that they are healing well. They shouldn’t return to school until their fever is gone and they're showing improvement.

WebMD Medical Reference

Sources

SOURCES:

Hopkins Medicine: “Herpes: HSV-1 and HSV-2.”

The Royal Children's Hospital Melbourne: “Herpes Simplex Gingivostomatitis.” 

The Royal Children's Hospital Melbourne: “HSV Gingivostomatitis.”

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