When a young child suddenly has a fever, then painful blisters and ulcers all over the mouth and swollen gums, the cause is often herpetic stomatitis, also called primary herpetic gingivostomatitis. MedlinePlus, from the National Library of Medicine, explains it is a viral infection of the mouth caused by the herpes simplex virus (HSV), the same virus behind cold sores. It’s very uncomfortable, but children usually recover fully.
What causes it
MedlinePlus says young children commonly get herpetic stomatitis when they are first exposed to HSV, and the first outbreak is usually the most severe. The virus spreads easily between children. An adult’s cold sore can pass it to a child, but often you won’t know how your child was infected. About 60% of the population carries HSV.
These ulcers are not the same as canker sores, which aren’t caused by a virus. See canker sores vs cold sores. MedlinePlus notes gingivostomatitis can also follow infection with a coxsackie virus, or occur with poor oral hygiene.
Symptoms
- fever, often as high as 104°F (40°C), which may start 1 to 2 days before blisters and ulcers
- blisters on the tongue, cheeks, roof of the mouth, gums and the border of the lip
- ulcers once the blisters pop
- swollen gums and mouth pain
- drooling, difficulty swallowing and irritability
- bad breath and a coated tongue
The pain may make a child refuse to eat or drink (MedlinePlus).
Diagnosis
A provider can usually diagnose it by looking at the sores. Lab tests are sometimes used to confirm it (MedlinePlus).
Treatment
A provider may prescribe acyclovir or a related antiviral, which may speed recovery, or a numbing medicine (viscous lidocaine) for severe pain. MedlinePlus cautions that lidocaine can numb the whole mouth, making swallowing hard and raising the risk of burns from hot food or choking, so use it carefully.
Home care
- Offer cool, noncarbonated, nonacidic drinks such as water, milk shakes or diluted apple juice. Dehydration can happen quickly in children.
- Offer cool, bland, easy-to-swallow foods: frozen pops, ice cream, mashed potatoes, gelatin or applesauce.
- Use acetaminophen or ibuprofen for pain as directed. Never give aspirin to a child under age 2 because of the risk of Reye syndrome.
- Gently brush your child’s teeth every day. See how to brush your teeth.
- Make sure your child rests and sleeps plenty.
What to expect
MedlinePlus says your child should recover completely within 10 days without treatment. The virus stays in the body for life, usually inactive. If it reactivates, it most often causes a cold sore. A repeat episode inside the mouth won’t be as severe as the first.
When to call a provider
- Your child has a fever followed by a sore mouth and stops eating and drinking, because dehydration can come on quickly.
- The infection spreads to the eye. MedlinePlus says this is an emergency that can lead to blindness.
Dehydration warning signs are a reason to act fast. See what counts as a dental emergency.
Preventing spread
- Keep children away from close contact with anyone who has a cold sore. If you have one, don’t kiss your child until it’s gone.
- While your child has symptoms, have them wash hands often and keep toys clean and unshared.
- Don’t let children share dishes, cups or utensils, or kiss other children.
Frequently asked questions
Is it the same as hand, foot and mouth disease?
No. Herpetic stomatitis is caused by herpes simplex. A related coxsackie virus illness, herpangina, causes ulcers in the mouth and throat with fever.
How long is my child contagious?
Follow your provider’s guidance. MedlinePlus advises the spread-prevention steps above while your child has symptoms.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Child drinks water from a glass held by an adult” by Shixart1985, via Wikimedia Commons, licensed CC BY 2.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.