Herpetic Gingivostomatitis in Children

Children are susceptible to various bacterial and viral infections in their lives, some more often than not. Just like a cough and cold, having a sore mouth or ulcers can occur due to a variety of reasons. However, if it is more severe than usual and hurts more than a usual ulcer might, there is a chance your child might have contracted the gingivostomatitis virus. Since Herpetic Gingivostomatitis in children is very common, knowing what it is and how to avoid it will ensure good oral health in children and save them from unnecessary pain.

What Is Gingivostomatitis?

This long and complicated name is given to a disease that infects the gums and mouth of the child. If children fail to take proper care of their teeth, do not brush well, or rinse their mouths, viral and bacterial infections can cause this disease to take place. A strong reason to cause primary herpetic gingivostomatitis is the presence of the virus HSV-1, which results in sores inside the mouth.

Gingivostomatitis Causes

• The primary culprit in causing this disease to occur is the herpes simplex virus type 1, which is also named as HSV-1. All the sores you see in the mouth are usually caused by this virus.
• Another virus that is responsible for this disease is the coxsackievirus. Majorly present in unclean hands or surfaces, especially having faeces and unhygienic conditions around, this virus finds its home there and transmits easily.
• Overall, if dental hygiene and the general cleanliness of the mouth are not maintained, viruses and bacteria find it easy to infect the child.

Gingivostomatitis Symptoms

• Tiny sores, having a diameter as small as 1mm and as large as 5mm, can be observed in the mouth. These are usually red coloured towards the outer edges and dark in the centre.
• Most areas of the mouth, such as the inner portion of the cheeks, the surface of the gums, and the back portion of the mouth, are all covered in sores.
• There is substantial inflammation of the gums, and in some cases, bleeding can be observed as well.
• The sores cause tremendous pain in the mouth in every area present.
• The child may have a high fever as the body is trying to combat the external infection.
• With sores and infection present in the mouth, your child may have bad breath, too.
• The lymph nodes surrounding the neck can be swollen to quite some degree.
• If the case is severe, the child’s eyes might get too sensitive to light and even get watery to a large degree.
• The tendency to drool increases more than usual.
• The pain and discomfort in the mouth cause reduced appetite and refusal to eat or drink.

Diagnosis of Gingivostomatitis in Kids

Diagnosing gingivostomatitis is pretty straightforward since the signs and symptoms of it are pretty evident and can easily be spotted. The doctor will first check your child’s mouth for sores and observe their appearance. Checking for fever will be another way to make the diagnosis better. If there are other conditions, such as intense coughing or body ache, there might be chances of other diseases being present, too. A blood test might be recommended in such cases, along with taking a swab from the mouth to check for bacteria culture. In extreme cases, doctors tend to take a skin sample from the mouth to check for the presence of other types of sores.

Complications

Given that the primary culprit in most cases of gingivostomatitis is HSV -1 or herpes simplex virus type 1, it is necessary to understand how the virus might take the infection further within the body.

While taking care of the child and touching the sores, if the hands are not cleaned properly, and the child is handled, there are chances of infection reaching the genital area as well, leading to a specific type of genital herpes.

With an immense amount of pain and discomfort in the mouth, most children don’t feel like eating or drinking anything at all. This can lead to a reduced appetite and dehydration in the body. The mouth and the skin will start getting dry. With no food in the body, your child may feel constantly tired and dizzy at times or even suffer from constipation. Less food in the body will impact the physical strength of the child, making them fatigued and causing them to sleep longer than usual.

Treatment

Since gingivostomatitis is a viral infection, the usual method of administering antibiotics will not work on your child unless there are bacterial sores present as well. Most sores disappear in a couple of weeks or so, even if the disease is left untreated. For proper relief from the symptoms, certain treatment measures need to be undertaken.

Herpetic Gingivostomatitis Treatment

• Since the sores just fade away gradually, it is important that the diet the child consumes does not counteract it. Refrain from giving any food items that have a strong flavour or are sour and spicy. Such items will interact with the sores, causing them to be irritated and start hurting again. Go for a liquid diet with soft food items.
• The disease can be completely treated only when the prescribed medication is taken consistently without fail. Make sure no doses are skipped throughout the phase.
• It is important to keep high oral hygiene of the child. Supervise the child when he brushes his teeth. If the pain is still evident, replace the usual brush with one having soft bristles.
• Certain doctors may recommend rinsing the mouth using mouthwash, which contains hydrogen peroxide. This is for medicinal purposes and helps maintain a clean mouth.

Prevention

• Brushing teeth twice a day reduces the chances of oral herpes in children.
• Flossing teeth gets rid of any food particles stuck between the teeth, keeping the mouth clean.
• Get a dental checkup done twice a year to ensure everything is fine.
• If your child plays a musical instrument with his mouth, ensure he rinses his mouth after he’s done playing.

Gingivostomatitis in toddlers is extremely painful for them and a troublesome time for parents as well. Although treatment techniques are present, preventive measures are the easiest form of mitigating any risks from such infection from happening at all.

References/Resources:

1. Aslanova. M, Ali. R, Zito. PM; Herpetic Gingivostomatitis; StatPearls [Internet]; NCBI; https://www.ncbi.nlm.nih.gov/books/NBK526068/; January 2023

2. Goldman. RD; Acyclovir for herpetic gingivostomatitis in children; Can Fam Physician; Pubmed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4865337/; May 2016

3. Herpes simplex gingivostomatitis; The Royal Children’s Hospital Melbourne; https://www.rch.org.au/kidsinfo/fact_sheets/Herpes_simplex_gingivostomatitis/

4. HSV Gingivostomatitis; The Royal Children’s Hospital Melbourne; https://www.rch.org.au/clinicalguide/guideline_index/HSV_Gingivostomatitis/

5. Keels. MA, Clements. DA; Herpetic gingivostomatitis in young children; UpToDate; https://www.uptodate.com/contents/herpetic-gingivostomatitis-in-young-children; April 2022

6. Heliotis. I, Whatling. R, Desai. S, Visavadia. M; Primary herpetic gingivostomatitis in children; BMJ; https://www.bmj.com/content/375/bmj-2021-065540.full; December 2021

7. A to Z: Gingivostomatitis, Herpetic; Children’s Mercy Kansas City; KidsHealth; https://kidshealth.org/childrensmercy/en/parents/az-gingivostomatitis.html

8. How to Treat Herpetic Gingivostomatitis in Kids; Smiles for Kids; https://www.smiles-for-kids.com/clinical-updates-set-1/ef3zlgwe8pft87s38ztd7zb9kteahw; October 2016

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