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Oral Herpes Stomatitis – Causes, Symptoms & Treatment

Oral herpes stomatitis is a painful viral infection of the mouth caused by herpes simplex virus type 1, most commonly affecting young children.

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Things worth knowing about "Oral herpes stomatitis"

Oral herpes stomatitis is a painful viral infection of the mouth caused by herpes simplex virus type 1, most commonly affecting young children.

What is Oral Herpes Stomatitis?

Oral herpes stomatitis, also known as herpetic gingivostomatitis or stomatitis aphthosa, is an inflammation of the oral mucosa caused by the herpes simplex virus type 1 (HSV-1). It represents the most common form of a primary HSV-1 infection and mainly affects children between six months and five years of age, although it can occur at any age.

Causes

The condition is triggered by a primary infection with herpes simplex virus type 1. Transmission occurs through direct contact with infected saliva or via smear infections, for example through kissing, sharing cutlery or cups, or touching the mouth with contaminated hands. The virus is highly contagious, especially during the early days of the illness.

Symptoms

Symptoms are typically pronounced and can significantly affect general well-being. Common signs include:

Painful blisters and ulcers on the oral mucosa, gums, tongue, palate, and lips
High fever (often above 39 °C / 102 °F), especially at the onset of the illness
Swollen and inflamed oral mucosa
Excessive saliva production and unpleasant bad breath
Chills, fatigue, and general malaise
Pain when swallowing, leading to reduced eating and drinking
Swollen lymph nodes in the neck area

The illness typically lasts one to three weeks and resolves without lasting damage in most cases. After the initial infection, the virus remains dormant in the body and may reactivate later as cold sores (herpes labialis).

Diagnosis

Diagnosis is usually made through a clinical examination of the mouth by a physician or dentist. The characteristic appearance of blisters and ulcers combined with fever and the patient's age is typically sufficient for a clear diagnosis. In uncertain cases, a swab of the oral mucosa can be taken and tested in a laboratory for the presence of HSV-1.

Treatment

There is limited specific antiviral treatment available, so therapy focuses primarily on relieving symptoms:

Pain relievers such as paracetamol or ibuprofen help reduce fever and pain.
Topical anesthetics (e.g., oral gels containing lidocaine) can provide local pain relief.
Adequate fluid intake is essential to prevent dehydration.
Soft, bland foods (e.g., yogurt, porridge, soup) make eating easier.
In severe cases or in immunocompromised patients, an antiviral medication such as aciclovir may be prescribed.

If a child consistently refuses to drink and shows signs of dehydration, urgent medical attention is required, as intravenous fluids administered in a hospital may be necessary.

Prevention

Since HSV-1 is very widespread, a primary infection cannot always be avoided. However, basic hygiene measures can reduce the risk of transmission:

Do not share cutlery, drinking glasses, or towels
Wash hands regularly, especially after contact with infected individuals
Avoid close contact with actively infected persons where possible

References

Robert Koch Institute (RKI): Herpes simplex fact sheet. Available at: www.rki.de
Laskaris G. - Pocket Atlas of Oral Diseases. 3rd edition. Thieme Publishing, 2017.
Leung AKC, Barankin B, Leong KF. - Herpes labialis: An update. Recent Pat Inflamm Allergy Drug Discov. 2020;14(2):80-94. PubMed PMID: 32484122.

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