Herpes Gingivostomatitis

    Information, symptoms, prevention, and treatment of herpes gingivostomatitis

    Updated at February 15th, 2024

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    DisclaimerThis material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product or service does not imply endorsement or recommendation of that product or service by CPCMG.


    What is herpes gingivostomatitis?

    • An infection caused by herpes simplex virus. 
    • It causes sores in the mouth, on and around the lips, and less commonly on the chin and cheeks too.   
    • The sores usually heal in 7 days but can take longer.   
    • Once infected, the virus continues to live in the nerves in your child’s face, so your child can have repeat symptoms.   
      • When your child first gets this infection, they might have more generalized symptoms like fever and fatigue. This is called the primary infection.  
      • Subsequent episodes (if your child has the infection again) are usually limited to sores around the mouth and on the lips instead of inside the mouth.   
    • It is spread from person-to-person and most children are exposed between the ages of 6 months and 5 years old. 
      • It can take one week for symptoms to develop.

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    What are the symptoms of herpes gingivostomatitis?

    • Symptoms of primary infection may include: 
      • Fever, fatigue, decrease in appetite and fluid intake. 
      • Ulcers inside the mouth and fluid-filled blisters on and around the lips and possibly on the chin and cheeks. 
        • They are usually painful but might also feel itchy or tingly. 
        • They can take a week or longer to heal completely.  
      • Your child might complain of sore throat, or you might see them drooling more than normal. 
      • Increase in irritability, headaches or bodyaches. 
    • Symptoms of subsequent episodes may include: 
      • Vesicles in the mouth, on and around the lips, and possibly the chin and cheeks. 
      • Pain leading to a decrease in appetite and fluid intake.

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    How do I prevent my child from getting herpes gingivostomatitis?

    • Avoid sick contacts. 
    • Encourage your child to frequently wash their hands. 
    • Clean high touch surfaces regularly, including toys that are put into the mouth and play/exercise equipment. 
    • Avoid sharing food, drink or toothbrushes with other people. 
    • Repeat episodes can be triggered by many factors: 
      • Exposure to intense heat, cold or dryness. 
        • Dress your child appropriately for the weather, keep their skin hydrated and be sure to apply sunscreen.  
      • Times physical or emotional stress. 
        • Help your child with stress coping skills such as deep breathing, mindfulness and talking through their emotions. 
      • Injuries or breaks to the skin. 
        • Discourage your child from picking at their skin and clean any scrapes to prevent infection. 
      • Poorly balanced diet and dehydration.  
        • Encourage your child to choose nutritious foods and drink lots of water.  
      • Having another illness (like the flu or a cold)  
        • Keep your child up-to-date on their flu vaccine.

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    What is the treatment for herpes gingivostomatitis?

    • In some cases, an antiviral called acyclovir might be prescribed. 
    • Usually, the mainstay of treatment is helping your child stay comfortable and hydrated.  
      • You can apply cold compresses or ice packs to the area. 
      • You can give Tylenol or ibuprofen (if 6 months or older) for pain or discomfort.  
      • Encourage your child to stay hydrated. 
      • Avoid salty, spicy, or acidic foods if they irritate the sores. 
      • Soft foods may also help such as apple sauce, yogurt, noodles, soups and cheese. 
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    Call your provider if:

    • You think your child needs to be seen. 
    • Your child is not taking in enough fluids. 
    • Your child is having trouble breathing. 
    • Your child has had a fever for five days. 
    • Your child has sores near their eyes. 
    • Your child’s sores look like they have pus or pus is draining from them. 
    • Your child’s symptoms are getting worse.
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    This publication was adapted from information within American Academy of Pediatrics Patient Education Handouts, UpToDate Guidelines and Healthychildren.org, and https://www.rch.org.au/clinicalguide/guideline_index/HSV_Gingivostomatitis/ 

    Reviewed by: TT D.O, AR D.O. | 12/2023