Gingivostomatitis

Definition
Gingivostomatitis is a disorder involving sores on the mouth and gums that result from a viral infection.

Causes, incidence, and risk factors

Gingivostomatitis is characterized by inflammation of the gums and mucosa and multiple mouth ulcers. This inflammation results from viral infections, particularly those that cause common childhood illness such as herpes virus (cold sores and acute herpetic stomatitis), Coxsackie viruses (hand, foot and mouth disease and herpangina).

These viruses cause shallow ulcers with a grayish or yellowish base and a slightly red margin, on the tissues of the gums (gingiva) or the lining of the cheeks (buccal mucosa). The condition is common, particularly among children.

Symptoms

     
  • sores on the inside of the cheeks or on the gingiva (gums)  
  • a fever  
  • general discomfort, uneasiness, or ill feeling  
  • a very sore mouth with no desire to eat  
  • bad breath

Signs and tests
An examination of the mouth shows small ulcers. These ulcers are similar to mouth ulcers caused by other conditions. An underlying infection may be suspected if you have a cough, fever, muscle aches, or other signs.

Normally, no special tests are required for the diagnosis of gingivostomatitis. However, the following tests may be done in some cases:

     
  • A culture of material obtained from the surface of the sore may indicate a viral infection.  
  • A biopsy may occasionally be used to distinguish gingivostomatitis from other types of mouth ulcers.

Treatment

The goal is to reduce symptoms. Practie 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.

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 three weeks.

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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