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Gingivostomatitis

Definition

Gingivostomatitis is an infection of the mouth and gums that leads to swelling and sores. It may be due to a virus or bacteria.

Causes, incidence, and risk factors

Gingivostomatitis is common, especially 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 another infection from normal mouth bacteria.

Antibiotics may be needed. 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 1 cup of water) or over-the-counter mouthwashes like hydrogen peroxide or Xylocaine may be soothing.

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

Support Groups

Expectations (prognosis)

Gingivostomatitis infections range from mild and slightly uncomfortable to severe and painful. The sores generally get better 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:

• You have mouth sores and fever or other signs of illness
• Mouth sores get worse or do not respond to treatment within 3 weeks

Prevention

References

Schiffer JT, Corey L. Herpes simplex virus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 136.

Modlin JF. Coxsackieviruses, echoviruses, newer enteroviruses, and parechoviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 172.

Christian JM. Odontogenic infections. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 12.