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Primary Herpetic Gingivostomatitis In Children

What is primary herpetic gingivostomatitis?

Children with primary herpetic gingivostomatitis (PHGS) develop many painful sores on the lips, tongue, gums, and inside the mouth. The mouth sores make swallowing painful, so your child may not want to eat or drink. The sores usually heal within 2 weeks. Medicines can help relieve the pain and help your child feel better.

What causes primary herpetic gingivostomatitis?

A virus (germ) called herpes simplex (HSV) causes PHGS. The virus spreads easily among young children through saliva (spit), shared toys, drink cups, or eating utensils.

What are the signs and symptoms of primary herpetic gingivostomatitis?

Aside from painful mouth sores, children with PHGS may have any of these symptoms:

  • Fever over 100°F (38°C).

  • More drooling than usual.

  • Sore throat and loss of appetite.

  • Gums that are swollen, red, or bleeding.

  • Bad breath.

  • Headache.

  • Tiredness.

How is primary herpetic gingivostomatitis diagnosed?

Your child's caregiver will ask questions about his symptoms and examine him. PHGS is usually diagnosed based on the exam. The mouth sores of PHGS may look like other diseases. To make sure your child has PHGS, a caregiver rubs a cotton swab over a new sore to collect cells from it. The cells are tested for HSV.

How is primary herpetic gingivostomatitis treated?

Once your child has recovered from PHGS, he may still get cold sores or fever blisters from time to time. Your child may be given any of the following:

  • Pain medicine: Ibuprofen and acetaminophen are medicines you can get without a doctor's order. They may decrease your child's pain and fever. Ask how much medicine your child needs and how often to give it.

  • Numbing medicine: Your caregiver may suggest a mixture of medicines to coat (cover) the sores in your child's mouth. The medicines help reduce pain so your child can eat or drink more easily. If your child is old enough, he may swish the liquid around his mouth and then spit it into the sink. You also can put the medicine on the mouth sores with a cotton swab. Ask your caregiver how to give numbing medicine to your child.

  • Antiviral medicine: This medicine may be given to fight an infection caused by a germ called a virus. Antiviral medicine may help to decrease the number of days your child is sick.

How is primary herpetic gingivostomatitis managed?

  • Clean your child's teeth and tongue: Bad breath and a coated tongue are common problems with PHGS. Gently and carefully brush your child's teeth each day. Ask your caregiver about a rinse to kill germs in your child's mouth.

  • Offer cool, bland foods and drinks: Your child needs to keep eating and drinking while he has PHGS. Applesauce, gelatin, or frozen treats are good choices. Salty or acidic foods and drinks (such as orange juice) may hurt your child's mouth or throat. Do not feed your child hard foods, such as popcorn, chips, or pretzels. Ask your caregiver about nutrient drinks if your child cannot eat.

  • Avoid spreading the virus to others: Your child and his caregivers should wash their hands often with soap and hot water. Do not share food or drinks. Keep toys and utensils clean. If your child is drooling a lot, keep him home from school or day care.

  • Help your child rest: Your child should rest as much as possible and get plenty of sleep.

When should I call my child's primary caregiver?

Call your child's primary caregiver if:

  • Your child's fever returns, even with medicine.

  • Your child develops an upset stomach, diarrhea, rash, or a headache after taking medicine.

  • You have other questions about your child's condition or treatment.

When should I seek immediate help?

Seek help immediately or call 911 if:

  • Your child will not eat or drink.

  • You see fewer wet diapers, or your child urinates less often than usual.

  • Your child has no tears when he cries.

  • Your child has a seizure.

  • Your child is weak or sleepy at all times and is hard to wake up.

  • Your child's breathing is rapid, and his skin feels hot or cold to the touch.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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