What Is Herpetic Gingivostomatitis?

Gingivostomatitis, also known as primary herpetic gingivostomatitis (PHG), is a highly contagious infection of the mouth and related tissues. According to the National Library of Medicine, this infection primarily affects children under age six. In most cases, it’s caused by the herpes simplex virus type 1 (HSV-1).

Cases of PHG involve oral lesions that may initially appear like a recurrent herpes simplex infection, canker sore, or skin infection known as erythema multiforme, according to a report in the Journal of Dental Health Oral Disorders & Therapy (JDHODT). Most cases will be asymptomatic, meaning PHG may go undetected, although more severe cases can cause significant symptoms. 

Those more significant symptoms include: 

• Inflammation of the gums, producing a red and swollen appearance 
• Widespread ulcers on the lips, tongue, and other soft tissues in the mouth 
• Swollen or tender submandibular lymph nodes, which are located on either side of the neck under the lower jawbone 
• Fever or chills 
• Malaise and irritability 
• Headache 

Additionally, patients can have difficulty eating and swallowing due to mouth pain, which can lead to dehydration. 

As described in Zitelli’s and Davis’ Atlas of Pediatric Physical Diagnosis in ScienceDirect, patients suffering from acute PHG with symptoms should be advised to rest, drink plenty of fluids, and eat a soft diet supplemented with vitamins D, C, and elderberry. Adult patients should be cautioned to avoid alcohol and tobacco products. 

Since gingivostomatitis is caused by a virus and not bacteria, antibiotics typically will not help patients deal with this infection. According to a study published in the JDHODT, the acute phase of PHG can be treated with hydration, mild analgesics to help manage pain such as acetaminophen, and antiviral drugs like acyclovir or foscarnet. According to the Cleveland Clinic, after taking antiviral medications, pediatric patients may see a reduction of fever in about three days and significant improvement in oral symptoms in about six days. 

This condition is highly contagious, so effective measures must be taken to prevent transmission to others through direct contact.

 While an acute outbreak of PHG can be quite unnerving, especially for a child, keep in mind that these viral infections can be handled with the help of a healthcare professional.  

After a patient's initial bout with PHG, the virus will continue to lie dormant in the body – even if the patient took antiviral drugs. Although there are currently no vaccines to prevent PHG caused by HSV-1, there are ways to manage the virus outbreaks and prevent spreading of the contagious condition. 

If you think your child has any type of abnormal sores or infections in their mouth, consult your healthcare provider to determine the appropriate treatment.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.