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Herpetic Gingivostomatitis

What is herpetic gingivostomatitis?

Herpetic gingivostomatitis is a common infection of the mouth and gums that is caused by a virus. It most commonly affects toddlers and young children, but older children can also get this infection.

What is the cause?

Herpes simplex viruses, which also cause cold sores, are the cause of this infection.

The infection is passed from person to person through contact with saliva that contains the virus. It can spread by sharing utensils, cups, and bottles; thumbsucking; and putting toys in the mouth. Often it may spread from someone who has cold sores.

What are the symptoms?

The illness usually starts with a fever. Other symptoms may include:

  • Sores and blisters in the throat, or on the tongue, gums, or lips
  • Swollen, red, or bleeding gums
  • Mouth pain that may make your child irritable and keep him from eating or drinking
  • Drooling
  • Bad breath
  • Swollen glands on the sides of the neck
  • Headache

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child.

How is it treated?

Your child’s healthcare provider may prescribe medicine to help the sores go away more quickly. Since it is caused by a virus, antibiotics do not help.

The fever usually lasts for a few days. The painful mouth sores last 3 to 5 days before they start to get better. It will take about 14 days before the sores completely heal.

After the mouth sores heal, the virus stays in the body and can become active again. If the infection does come back, usually the sores are not as severe. Sores that return on the lips are called cold sores.

How can I take care of my child?

  • Give your child nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label carefully and give your child the correct dose as directed.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
    • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.

Some other things you can do for pain caused by sores in the mouth include:

  • If your baby does not want to breastfeed or suck on a bottle, feed your child with a dropper, spoon, or sippy cup.
  • Give your child plenty of liquids. Avoid sodas and citrus drinks like orange juice that might irritate the sores.
  • Give your child cold foods like ice cream and ice pops.
  • Offer soft, bland foods like mashed potatoes, pudding, applesauce, and macaroni and cheese. Avoid acidic, salty, or spicy foods like tomatoes, pretzels, and tacos.
  • Don’t give your child medicines that make the mouth numb. They may cause choking in a young child.

Help your child keep from spreading the virus. Try to keep your child's hand away from his mouth while he has sores. Tell your child not to rub his eyes so that the eyes don’t get infected.

Ask your child’s healthcare provider:

  • How long it will take your child to recover
  • If there are activities your child should avoid
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when you should bring your child back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent gingivostomatitis?

It can be hard to keep babies and toddlers from getting exposed to the virus. Try to avoid contact with people who have cold sores and don’t share eating or drinking utensils. Good handwashing also helps to lessen the chance that a virus will pass from person to person.

Written by Robert Brayden, MD, Clinical Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2015.2 published by RelayHealth.
Last modified: 2014-10-20
Last reviewed: 2014-10-20
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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