Gingivostomatitis (GM) is a common infection of the mouth and gums. The primary symptoms are mouth swelling and lesions in the mouth that resemble canker sores. This infection may be caused by a virus, bacteria, or improper care of your teeth and mouth.
GM is especially common among children. Children with GM may drool and refuse to eat or drink because of the discomfort caused by the sores. They may also develop fever and swollen lymph nodes.
Contact your doctor if:
- symptoms worsen
- you or your child experiences fever or other ailments
- your child refuses to eat or drink.
GM may occur because of:
- herpes simplex virus type 1 (HSV-1), the virus that causes cold sores
- coxsackie virus, a virus often transmitted by touching a surface or an individual’s hand that is contaminated with feces. This virus can also cause flu-like symptoms
- poor oral hygiene (not flossing and brushing your teeth regularly)
Symptoms of GM can vary in seriousness. Individuals may feel minor discomfort, or they may experience severe pain and mouth tenderness. Symptoms of GM 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
- 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; in children, a refusal to eat or drink.
Your doctor will check your mouth for sores, which are the main symptoms of the condition. Additional tests are not usually needed. However, if other symptoms are also present (such as cough, fever, and muscle pain), he or she may want to do additional tests.
In some cases, your health care provider may take a culture (swab) from the sore to check for bacteria or viruses. If closer examination is needed or if other suspicious mouth sores are also present, your doctor may remove a piece of skin to perform a biopsy.
GM sores usually disappear within two to three weeks, regardless of whether they are treated. For bacterial or viral-caused GM, your doctor may prescribe an antibiotic and may also clean the infected area to promote healing.
There are a number of actions you can take to relieve discomfort:
- Take any medications your doctor has prescribed.
- 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 one-half teaspoon of salt in one cup of water.
- Eat a healthy diet, avoiding 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 pain relievers may also help. Though it may hurt to brush your teeth, you should still brush your teeth and gums if you have GM. If you don’t continue to practice good oral care, your symptoms could worsen and you will be more likely to develop GM again in the future. Gently brushing with a soft toothbrush will make brushing less painful.
Herpes Simplex Virus Type 1 (HSV-1)
GM can be triggered by HSV-1. This virus is not often serious. However, it can cause complications in babies and those with weakened immune systems.
The HSV-1 virus can also spread to the eye, where it can infect the eye’s cornea. This condition is called herpes simplex keratitis (HSK). Individuals should always wash their hands after touching a cold sore, as the virus can easily spread to the eye. In addition to 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 be transferred to the genitals through oral sex when mouth sores are present, causing HSV-2. HSV-2 is characterized by painful genital sores. It is highly contagious.
Decreased Appetite and Dehydration
Children with GM sometimes refuse to eat or drink, which can eventually cause dehydration. Symptoms of dehydration include a dry mouth, dry skin, dizziness, tiredness, and constipation. Parents may notice their child is sleeping more than usual or is not interested in his or her usual activities.
Contact your healthcare provider if your child has GM and is refusing to eat or drink.
GM can be a mild nuisance, or it can be painful and very uncomfortable. Generally, sores heal in two to three weeks. Treating the bacteria or virus with antibiotics or antiviral agents may help to expedite healing. Homecare treatments can also help with the symptoms.
Taking care of your teeth and gums may decrease your risk of getting GM. 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
Healthy gums are pink with no sores or lesions.
To avoid the HSV-1 virus that can cause GM, avoid kissing or touching the face of an infected individual. Do not share makeup, razors, or silverware with an infected person.
The coxsackie virus is best avoided by frequently washing the hands. This is especially important after using public toilets or changing a baby’s diaper and before eating or preparing meals. It is important to educate children about the importance of proper hand washing to avoid getting sick.