What is Gingivostomatitis?
Gingivostomatitis is the initial manifestation of a herpes virus infection of the mouth. It usually happens in children less than 5 years old and is characterized by painful, small ulcers on the gums and inner lining of the mouth including the cheeks, tongue, and palate.
Usually, before the lesions appear a child might have 3-4 days of fever, fussiness, headache and disrupted sleep.
Symptoms once the lesions emerge can include:
Bleeding gums
Bad breath
Refusal to eat and drink
Fever
Headache
After the lesions get better, the virus continues to live in the nerves surrounding the face and can emerge later during periods of stress, illness, or sun exposure as ‘cold sores.’
Gingivostomatitis Diagnosis & Treatment
Gingivostomatitis is diagnosed based on medical history and physical exam. Sometimes some of the fluid from one of the lesions can be sent for a culture to confirm the diagnosis.
Usually herpes gingivostomatitis can be managed supportively:
Encourage hydration
Pain control with tylenol and ibuprofen
Give your child cold foods like popsicles or ice cream
Magic mouthwash (maalox, benedryl, viscous lidocaine) is not routinely recommended because it has not been proven to be effective and ingestion of lidocaine can be toxic. Ask if this is appropriate to try this in your child.
Depending on how your child is doing with these supportive measures, your child’s provider might choose to use an antiviral medication. These medications are most effective when given as early in the course of disease as possible.
The most common reason for hospitalization is dehydration. Signs of dehydration include:
urinating less
very fussy or sleepy
marked decrease in activity
few or no tears when crying
wrinkled skin
sunken eyes
See a Doctor in Person If…
Your child has a fever for greater than 7 days
If the rash spreads and worsens
Your child cannot drink because of mouth pain
Your child seems lethargic or unusual tired
If your child is immunocompromised
If the lesions spread to the eye