Gingivostomatitis

• Causes, incidence, and risk factors

  Gingivostomatitis is common, particularly among children. It may occur after infection with the herpes simplex virus type 1 (HSV-1), which also causes cold sores. See: Herpetic stomatitis

  The condition may also occur after infection with a coxsackie virus. See: herpangina

  It may occur in people with poor oral hygiene.

• Symptoms
  The symptoms can be mild or severe and may include:

  • Bad breath
  • Fever
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Sores on the inside of the cheeks or gums
  • Very sore mouth with no desire to eat
• Signs and tests

  An examination of the mouth shows small ulcers. These ulcers are similar to mouth ulcers caused by other conditions. Your health care provider may consider other conditions if there are signs of a cough, fever, or muscle aches.

  Normally, no special tests are needed to diagnose gingivostomatitis. However, the doctor may take a small piece of tissue from the sore to check for a viral or bacterial infection. This is called a culture. A biopsy may occasionally be done to rule out other types of mouth ulcers.

• Treatment

  The goal is to reduce symptoms. Practice good oral hygiene. Even if there is bleeding and it is painful, thorough but gentle brushing of the gums is important to reduce the chances of additional infection from normal mouth bacteria.

  Antibiotics may be required. The dentist may need to clean infected tissue (a process called debridement).

  Medicated mouth rinses may be recommended to reduce pain. Salt water (one-half teaspoon of salt in one cup of water) or over-the-counter mouthwashes like hydrogen peroxide or Xylocaine may be soothing.

  The diet should be well balanced and nutritious. Soft, bland (non-spicy) foods may reduce discomfort during eating.

• Expectations (prognosis)

  Gingivostomatitis infections range from mild and slightly uncomfortable to severe and painful. The sores generally resolve in 2 or 3 weeks with or without treatment. Treatment may reduce discomfort and speed healing.

• Complications

  Gingivostomatitis may disguise other, more serious mouth ulcers.

• Calling your health care provider

  Call your health care provider if mouth sores are accompanied by fever or other signs of illness, or if mouth sores worsen or do not respond to treatment within 3 weeks.

Review Date: 3/3/2009

Reviewed By: James L. Demetroulakos, MD, FACS, Department of Otolaryngology, North Shore Medical Center, Salem, MA. Clinical Instructor in Otology and Laryngology, Harvard Medical School. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.