Herpetic gingivostomatitis

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Herpetic gingivostomatitis (HG) is a mouth infection caused mainly by herpes simplex virus type 1 (HSV-1). It’s usually the first outbreak of herpes and is most common in children, though older kids and young adults can get it too.

What it looks like and feels like
- Symptoms often start with fever, lack of appetite, irritability, and feeling unwell.
- Many tiny blisters form on the gums, lips, and inside the mouth. These break open to create painful ulcers with a yellow-gray coating.
- Other signs may include swollen jaw or neck glands, bad breath, and not wanting to drink or eat.

How it happens
- HSV-1 spreads through direct contact with saliva or mouth secretions, especially when someone has an active outbreak.
- After infection, the virus travels to a nerve ganglion and can stay dormant. Reactivation later causes cold sores (herpes labialis).
- The illness is very contagious, even before a person shows symptoms.

Who’s affected
- Most common in children aged about 6 months to 5 years, but anyone can get it.
- The virus is widespread globally; many people are infected in childhood.

Diagnosis
- Usually diagnosed by looking at the mouth and considering symptoms. Other conditions with similar mouth sores may need to be ruled out.

Treatment and what to expect
- Treatment is mostly supportive:
- Pain relief and medicines to make eating and drinking easier.
- Fluids to prevent dehydration.
- Good oral hygiene and gentle mouth care.
- Antiviral medicines (such as aciclovir, valaciclovir, or famciclovir) can help if started early but do not cure the infection or stop recurrences.
- Antibiotics are only used if a bacterial infection develops.
- In severe cases, medicated mouth rinses with soothing ingredients can help.

Prevention and recovery
- Try to avoid sharing utensils, cups, and saliva with anyone who has an active outbreak.
- Practice good hand hygiene and keep sick children away from others when contagious.
- Most healthy people recover within 1–2 weeks. Recurrences are common and can be triggered by stress, illness, or sun exposure.
- Severe dehydration is a risk in young children, so keep up fluid intake.