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Gingivostomatitis

What is gingivostomatitis?

Key points

  1. Gingivostomatitis is a common infection of the mouth and gums.
  2. This condition frequently occurs in children.
  3. Tender sores are the primary symptom, but you may also notice bad breath, fever, drooling, or malaise.

Gingivostomatitis is a common infection of the mouth and gums. The main symptoms are mouth or gum swelling. There may also be lesions in the mouth that resemble canker sores. This infection may be the result of a viral or bacterial infection. It’s often associated with improper care of your teeth and mouth.

Gingivostomatitis is especially common in children. Children with gingivostomatitis may drool and refuse to eat or drink because of the discomfort (often severe) caused by the sores. They may also develop fever and swollen lymph nodes.

Contact your doctor if:

  • symptoms worsen or persist more than a few days
  • your child experiences fever or sore throat
  • your child refuses to eat or drink
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Causes

What are the causes of gingivostomatitis?

Gingivostomatitis may occur because of:

  • herpes simplex virus type 1 (HSV-1), the virus that causes cold sores
  • coxsackievirus, a virus often transmitted by touching a surface or an individual’s hand contaminated with feces (this virus can also cause flu-like symptoms)
  • certain bacteria (Streptococcus, Actinomyces)
  • poor oral hygiene (not flossing and brushing your teeth regularly)

Symptoms

What are the symptoms of gingivostomatitis?

Symptoms of gingivostomatitis can vary in seriousness. You may feel minor discomfort, or experience severe pain and mouth tenderness. Symptoms of gingivostomatitis may include:

  • tender sores on the gums or insides of cheeks (like canker sores, they are grayish or yellow on the outside and red in the center)
  • bad breath
  • fever
  • swollen, bleeding gums
  • swollen lymph nodes
  • drooling, especially in young children
  • a general feeling of being unwell (malaise)
  • difficulty eating or drinking due to mouth discomfort, and in children a refusal to eat or drink
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Diagnosis

How is gingivostomatitis diagnosed?

Your doctor will check your mouth for sores, the main symptom of the condition. More tests are not usually necessary. If other symptoms are also present (such as cough, fever, and muscle pain), they may want to do more tests.

In some cases, your doctor may take a culture (swab) from the sore to check for bacteria (strep throat) or viruses. Your doctor may also perform a biopsy by removing a piece of skin if they suspect other mouth sores are present.

Treatments

What are the treatments for gingivostomatitis?

Gingivostomatitis sores usually disappear within two to three weeks without treatment. Your doctor may prescribe an antibiotic and clean the infected area to promote healing if bacteria or a virus is the cause of gingivostomatitis.

There are some actions you can take to relieve discomfort.

  • Take medications prescribed by your doctor.
  • Rinse your mouth with a medicated mouthwash containing hydrogen peroxide or xylocaine. These are readily available at your local drugstore. You can also make your own by mixing 1/2 teaspoon of salt in 1 cup of water.
  • Eat a healthy diet. Avoid very spicy, salty, or sour foods. These foods can sting or irritate the sores. Soft foods may also be more comfortable to eat.

Over-the-counter (OTC) pain relievers may also help. Continue to brush your teeth and gums, even if it hurts. If you don’t continue to practice good oral care, your symptoms could worsen. You’ll also be more likely to develop gingivostomatitis again. Gently brushing with a soft toothbrush will make brushing less painful.

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Complications

Complications of gingivostomatitis

Herpes simplex virus type 1 (HSV-1)

Herpes simplex virus type 1 (HSV-1) can lead to gingivostomatitis. This virus usually isn’t serious, but it can cause complications in babies and those with weakened immune systems.

The HSV-1 virus can also spread to the eyes, where it can infect the corneas. This condition is called herpes simplex keratitis (HSK).

You should always wash your hands after touching a cold sore, as the virus can easily spread to the eyes. Along with pain and discomfort, HSK can cause permanent eye damage, even blindness. Symptoms of HSK include watery, red eyes and sensitivity to light.

HSV-1 can also transfer to the genitals through oral sex when mouth sores are present. Most cases of genital herpes are due to HSV-2. Painful genital sores are the hallmark of HSV-2. It’s highly contagious.

Decreased appetite and dehydration

Children with gingivostomatitis sometimes refuse to eat or drink. This can eventually cause dehydration. Symptoms of dehydration include:

  • dry mouth
  • dry skin
  • dizziness
  • tiredness
  • constipation

Parents may notice that their child is sleeping more than usual or isn’t interested in their usual activities. Contact your doctor if you suspect your child has gingivostomatitis and refuses to eat or drink.

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Prevention

How to prevent gingivostomatitis

Taking care of your teeth and gums may decrease your risk of getting gingivostomatitis. Healthy gums are pink with no sores or lesions. Good oral hygiene basics include:

  • brushing your teeth at least twice a day, especially after eating and before going to sleep
  • flossing daily
  • getting your teeth professionally examined and cleaned by a dentist every six months
  • keeping mouth pieces (dentures, retainers, musical instruments) clean to prevent bacteria growth

To avoid the HSV-1 virus that can cause gingivostomatitis, avoid kissing or touching the face of a person who is infected. Do not share makeup, razors, or silverware with them.

Frequently washing your hands is the best way to avoid the coxsackievirus. This is especially important after using public toilets or changing a baby’s diaper and before eating or preparing meals. It’s also important to educate children about the importance of proper hand washing.

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Outlook

What is the outlook for gingivostomatitis?

Gingivostomatitis can be mild, or it can be uncomfortable and painful. Generally, sores heal in two to three weeks. Treating the bacteria or virus with the right antibiotics or antiviral agents may help to expedite healing. Home care treatments can also help with the symptoms.

Q&A: Home treatments

Q&A: Home treatments for gingivostomatitis

  • What are some home treatments that can help soothe symptoms of mild gingivostomatitis?
  • Home treatments include over-the-counter analgesics (acetaminophen, ibuprofen), local topical anesthetics (Orajel, Anbesol), topical preparations containing glycerin and peroxide (Gly-Oxide), and warm mouth rinses (1 tsp. baking soda to 1/2 cup warm water, 1/2 tsp. salt to 1 cup warm water). These all help to soothe the mucous membrane, as will cool liquids (milkshakes), clear liquids (apple juice), ice chips or popsicles, and soft cold foods (apple sauce, Jell-O). Avoid acidic or carbonated liquids, and salty, spicy, or hard foods. Follow good oral hygiene habits including regular tooth brushing and flossing.

    - Christine Frank, DDS
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