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Watch Your Mouth

Gingivostomatitis in children is a self-limiting, non-life-threatening disease, which can cause a considerable amount of pain and discomfort, especially in young children.

Gingivostomatitis is almost always caused by infections due to the herpes simplex type 1 (HSV-1) virus or the Coxsackie’s virus. Practically all cases in children are manifested in the form of tiny sores that can show up on the lips, inside of the cheeks, on the gums, on the tongue, on the roof of the mouth and even on the tonsils. These sores are classically red on the edges and yellow or grey towards the middle. In some cases, the sores are few and small, and may even go unnoticed. In severe cases, the sores may be larger and appear all over the mouth. After the blisters pop, ulcers will form.

Other symptoms include high fever before blisters appear, trouble swallowing, drooling, pain and swelling. Also, because the sores make it difficult to eat and drink, dehydration can occur. The painful mouth sores last three to five days before they start to get better. Gingivostomatitis is usually self-limiting, and clears up on its own in 10 to 14 days.

After the mouth sores heal, the virus stays in the body and can become active again. If the infection comes back, the sores are not as severe.

The virus is readily transmitted through direct contact with saliva that contains the virus. It can spread, for example, by sharing utensils, cups and bottles; thumb sucking; and putting toys in the mouth. Often, it may spread from someone who has cold sores.

Ensuring adequate hydration and analgesia are the mainstays of treatment. Medicines may be prescribed to speed up the recovery and fight the herpes virus or to numb the mouth. Pain relievers and a diet of mostly cold, non-acidic drinks are recommended. Once a person is carrying the herpes simplex virus, repeated cold sore outbreaks may occur when the immune system is weakened. Treatments are reserved for children with underlying problems.

Things to remember
It is vital to make sure that your child continues to drink. He or she may not feel like eating much. Give non-acid fluids as acid fluids will sting; so avoid juice. Give milk or water instead. Ice cream, frozen yoghurt, and cool apple sauce are other options. Occasionally, children will get dehydrated and need to have an intravenous line placed to maintain their fluid intake until the viral infection settles itself. A mouthwash with anti-inflammatory and pain-relieving properties can help. Paracetamol may help keep your child at ease if he or she is miserable.

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