Preventing and treating herpetic stomatitis

What is herpetic stomatitis?

Herpetic stomatitis is a contagious infection of the oral mucosa caused by the herpes simplex virus type 1 (HSV-1). The medical term is gingivostomatitis herpetica; the rather unpleasant archaic and unprofessional term "mouth rot" stems from the condition's association with malodorous breath.

Despite herpetic stomatitis not being limited to a specific age group, it nevertheless impacts children aged between ten months and three years the most. And even though the infection tends to cause young patients considerable pain and discomfort, their parents can rest at ease knowing that herpetic stomatitis usually clears up after about a week. Fortunately, there are very rarely any complications.

Herpetic stomatitis is characterised by multiple or individual small blisters in the mouth, commonly referred to as cold sores. They can appear on the gums, tongue, lips and palate or in the throat. The blisters are filled with fluid and eventually burst. Subsequently, mucosal damage ensues with a whitish coating and red borders. The blisters and lesions typically result in discomfort while speaking and eating, thereby restricting the patient's quality of life. 

How is herpetic stomatitis transmitted? 

Unlike aphthae, the blisters that appear with herpetic stomatitis are highly contagious. Hence, the most prevalent cause of herpetic stomatitis is the transmission of the virus from one person to another through tiny droplets of saliva. The viruses contained therein are expelled through sneezing or coughing, for example. Droplet dispersal when speaking normally might also be sufficient to spread the disease from person to person.

Herpetic stomatitis is particularly widespread in nurseries, where it can also be easily transmitted to objects and surfaces, such as toys. This is referred to as a smear infection. In this case, the child's hands touch the mouth, pick up saliva and subsequently transfer it onto a toy. Herpetic stomatitis is highly contagious during acute stages when the blisters in the mouth burst. This is the moment when the highly infectious fluid is released and mixes with saliva. How long is herpetic stomatitis contagious for? As a general rule, the risk of contamination diminishes only once all the blisters have dried up. 

Infected: When does the disease break out? 

Individuals who have contracted herpetic stomatitis typically experience symptoms within the following two to twelve days. This is what is known as the incubation period, signifying the time it takes for the disease to manifest.

During the initial stages, affected individuals, mostly children, usually exhibit general symptoms of illness along with a high temperature. These symptoms can occur even before the oral mucosa is visibly inflamed. It is common for the gums to swell up before the painful inflammation in the mouth becomes evident. 

Duration of herpetic stomatitis: How long does it take for the disease to go away? 

Unfortunately, there is no universal answer to this question. The duration of the disease varies depending on a range of factors in both adults and children, such as the patient's immune system and the type of medication used to treat the problem. In general, however, the chances of self-healing are usually high. In such cases, the blisters tend to dry up and heal without leaving any scars, even when left untreated. Many people naturally wonder how long this will take. As a rough guide, herpetic stomatitis should typically resolve on its own within about a week. 

What causes herpetic stomatitis? Possible factors

As previously mentioned, the herpes simplex virus type 1 serves as the trigger for herpetic stomatitis. There are, however, various factors that can favour the onset of the disease. Inflammation, for instance, often indicates a compromised immune system or a poor nutritional state.

And there are certain risk groups that demonstrate higher susceptibility to herpetic stomatitis, too. These include patients who:  

• Have an HIV infection or are suffering from AIDS.
• Are undergoing chemotherapy or radiotherapy.
• Are being treated with immunosuppressants.

Herpetic stomatitis might also be linked to:

• Systemic diseases
• Flu-like infections
• Sexually transmitted diseases
• Hormonal fluctuations in the menstrual cycle, during pregnancy or puberty
• Chemicals, poisoning and medication (e.g. when administering antibiotics) 

What are the symptoms associated with herpetic stomatitis?

You have already learned about some of the characteristic symptoms that can be associated with herpetic stomatitis. Typically, the infectious disease begins with a high temperature, followed by swelling of the mucosa, leading to the formation of blisters and painful inflammation of the mucosa. The severity of symptoms differs, of course, from person to person. Herpetic stomatitis can, for example, also break out without a high temperature.

The following list provides you with an overview of all the possible symptoms that can occur in connection with herpetic stomatitis: 

• Swollen and reddened oral mucosa
• Individual to multiple painful ulcers and blisters around the mouth, as well as on the lips, oral mucosa, gums and/or palate
• Burning sensation when eating
• Dehydration and malnutrition due to difficulty eating and drinking
• Fever
• Generally feeling unwell
• Acidic, foul smell from the mouth
• Swollen cervical lymph nodes
• Nausea and vomiting

Do you have one or more of these symptoms? Or do you suspect your child has herpetic stomatitis? In such cases, it is best to consult a doctor who can provide the appropriate diagnosis and suggest suitable treatment options. Try not to feel overly concerned by the many online images of herpetic stomatitis. Based on such images, it is not possible – especially not for laypersons – to make any statement about your own or your child's health and well-being.

Moreover, herpetic stomatitis might resemble other conditions like oral thrush, particularly in photos, making self-diagnosis somewhat risky. So, if you are uncertain, always consult an expert. Sometimes a high temperature and whining and crying could simply be attributed to an erupting tooth, as teething can be particularly painful for some children. 

The following list provides you with an overview of all the possible symptoms that can occur in connection with herpetic stomatitis: 

• Swollen and reddened oral mucosa
• Individual to multiple painful ulcers and blisters around the mouth, as well as on the lips, oral mucosa, gums and/or palate
• Burning sensation when eating
• Dehydration and malnutrition due to difficulty eating and drinking
• Fever
• Generally feeling unwell
• Acidic, foul smell from the mouth
• Swollen cervical lymph nodes
• Nausea and vomiting

Do you have one or more of these symptoms? Or do you suspect your child has herpetic stomatitis? In such cases, it is best to consult a doctor who can provide the appropriate diagnosis and suggest suitable treatment options. Try not to feel overly concerned by the many online images of herpetic stomatitis. Based on such images, it is not possible – especially not for laypersons – to make any statement about your own or your child's health and well-being.

Moreover, herpetic stomatitis might resemble other conditions like oral thrush, particularly in photos, making self-diagnosis somewhat risky. So, if you are uncertain, always consult an expert. Sometimes a high temperature and whining and crying could simply be attributed to an erupting tooth, as teething can be particularly painful for some children. 

What complications can herpetic stomatitis cause? 

Even though herpetic stomatitis is usually harmless and uncomplicated, there is still the possibility of complications arising. This is particularly true for newborns. In the first two weeks of life, an initial herpes virus infection can take a severe course, progressing into herpes encephalitis – an inflammation of the meninges. Corneal damage can also occur when the eyes become inflamed.

Tip for all parents: If you experience a tingling sensation on your lips or in your mouth and/or feel unwell, wearing a face mask may help prevent potential infection transmission. As a general precaution, never place a soother or drinking bottle in your mouth before giving it to your child. This habit can transfer bacteria and viruses from your mouth to theirs.

And even if it is tempting to cuddle and kiss a new baby: Visitors should avoid close contact to ensure the baby's health and safety.

The all-clear for pregnant women: If a woman contracts the herpes simplex virus type 1 during pregnancy, it might cause cold sores, but the unborn child typically does not get infected. 

Treatment options for herpetic stomatitis

Unfortunately, there is no universal remedy for herpetic stomatitis. The disease is usually treated purely symptomatically at first. This means that unpleasant symptoms, such as pain and a high temperature, are alleviated. We have compiled a summary of what helps or might help make the symptoms more manageable. 

Treatment for babies, toddlers and children

Babies and children affected by herpetic stomatitis should rest and not be physically active – which, of course, is often easier said than done. Additionally, ensuring adequate food and fluid intake can be challenging, particularly as herpetic stomatitis is often linked to severe pain and discomfort, making eating and drinking difficult. Parents should, nevertheless, ensure that their baby or child still consumes a sufficient amount of food and fluids to prevent dehydration. Rinsing the mouth with chamomile tea and taking antipyretics may help alleviate the unpleasant symptoms.

However, if you think your baby or child has herpetic stomatitis, it is advisable to take them to see a paediatrician, especially if you are uncertain or concerned about their condition. Your paediatrician is best suited to advise whether medication is appropriate treatment.

Preschool children should refrain from playing with other children and stay at home during their illness, even if their symptoms are not too severe. This is not because young children are particularly infectious, but rather because they usually do not fully comprehend how pathogens spread and the need to maintain a safe distance from others during the infection period. However, herpetic stomatitis does not have to be reported to local health authorities. 

Treatment for adults

The same principle holds true for adults as it does for babies and children: A doctor determines the correct treatment. There is no one-size-fits-all medication for herpetic stomatitis. Rather, attempts focus on alleviating the often extremely painful symptoms. Medications in the form of gels, for example, which have an anaesthetic and anti-inflammatory effect, can be used for this purpose. Some of these medications also form a "protective film" over the affected area in the mouth.

Important to know: A lot of these medications are not approved for use in children. So, never experiment with them on your own! If babies and children are experiencing severe pain, it is imperative to consult a doctor anyway.

If the previously mentioned medications prove ineffective in adults, the doctor might proceed to the next step: Employing local corticosteroids. With herpetic stomatitis, these potent anti-inflammatory drugs can be administered as a gel directly to the affected areas. 

Home remedies and alternative methods

Sometimes simply not feeling helpless against the pain commonly associated with herpetic stomatitis can be hugely beneficial. If you are inclined to take action yourself, exploring home remedies might offer some relief. For example, you could carefully rinse your mouth with cooled camomile tea. Sage, thyme or peppermint are also considered good home remedies for herpetic stomatitis. Generally speaking, you cannot go wrong with these options – unlike randomly selected mouthwashes from a chemist's or pharmacy. You need to be very careful with these products. For instance, if you use a mouthwash with alcohol, it can potentially irritate and dehydrate your mucosa.

If you have a high temperature, you can also attempt self-care. Many people find relief using leg compresses, for example. But please always take a high temperature seriously – especially in children – and promptly seek medical attention.

Alternatively, there are suitable homoeopathic globules for herpetic stomatitis available on the market. If you are considering treating herpetic stomatitis homoeopathically, it is important to note that there is, as yet, no scientific evidence to back up the effectiveness of these small globules.

If you are currently suffering from herpetic stomatitis, you can also make your life a little easier by avoiding certain foods during this period. This includes hard foods like bread, biscuits or rolls. You should also steer clear of hot and spicy or sour foods.

Here is a list of foods to consider avoiding when experiencing acute symptoms:

• Fruit and vegetable juices
• Citrus fruit
• Vinegar
• Chilli, pepper or too much salt
• Onions
• Bell peppers
• Tomatoes
• Carbonated drinks
• Alcohol  

Foods that often cause less discomfort with herpetic stomatitis are, for example: 

• Mashed potatoes or other soft, vegetable-based purees
• Pasta and rice
• Custard pudding
• Yoghurt
• Ice cream

As some of these foods are suitable for your diet when suffering from herpetic stomatitis but are also very high in sugar, you should make sure to keep a close eye on your oral hygiene. This is, of course, difficult when your mouth is inflamed. If the pain is too severe, it is okay to temporarily stop cleaning your teeth with a brush and instead just rinse your mouth thoroughly with water. However, as soon as you are able to, you should resume your regular oral hygiene routine. 

Proper prevention – avoiding herpetic stomatitis

Obviously, it is best if herpetic stomatitis does not develop in the first place. The good news: You can take proactive steps and actively influence this. How? Find some useful tips below: 

Strengthening your immune system

Herpetic stomatitis is more likely to develop when your immune system is compromised. In this respect, you can do a few things to boost your defences. Maintaining a balanced diet is, for example, absolutely essential. Make sure you get enough vitamins and fibre. Also, raw foods rich in nitrates are believed to aid in preventing inflammation. So, incorporating leafy greens, like lettuce, rocket or raw spinach, into your diet is thus a great idea.

Regular exercise also helps fortify your defences against viruses and bacteria. But do not worry, this does not mean you have to run a marathon. Moderate exercise, for example a long walk, can do wonders for your overall health and immunity. And it also helps to reduce your stress levels. Since taking care of your mental well-being is just as important as a good night's sleep for maintaining overall health. 

Paying attention to oral hygiene 

Keeping your teeth and gums in great shape can restrict the spread of inflammation. So, make a habit of regularly removing food debris and plaque from your teeth. The most important thing is, of course, brushing your teeth. Additionally, regular professional dental cleaning sessions, once or twice a year, can also effectively remove stubborn tartar.

And then there are the spaces between our teeth that are often overlooked! Just like the outer surfaces of the teeth, the interdental spaces also need to be cleaned regularly. This is best done with interdental brushes, which you can easily use and incorporate into your daily tooth brushing routine.

Instructions: Cleaning interdental spaces

Taking the right preventative actions as parents

As explained above, as a parent you should never place your child's soother or drinking bottle in your mouth to prevent the spread of pathogens. When breastfeeding, mothers should clean their nipples thoroughly beforehand to prevent any transmission of pathogens to their baby's mouth. Although some might find it practical: Cleaning your child's face with your saliva is also a no-go. 

What are the symptoms associated with herpetic stomatitis?

You have already learned about some of the characteristic symptoms that can be associated with herpetic stomatitis. Typically, the infectious disease begins with a high temperature, followed by swelling of the mucosa, leading to the formation of blisters and painful inflammation of the mucosa. The severity of symptoms differs, of course, from person to person. Herpetic stomatitis can, for example, also break out without a high temperature.