Gingivostomatitis: Causes, Symptoms & Treatment

By Irmanie Hemphill, MD, FAAFP
Medically reviewed
September 7, 2021

Gingivostomatitis is a common and uncomfortable infection of the mouth and gums that can result in swelling and sores.

Though the infection is especially common in children, adults can also be affected.

In this article, I’ll describe the symptoms of gingivostomatitis and the different potential causes.

I’ll also cover the process of diagnosis and treatment options available.

Finally, I’ll describe the potential complications of gingivostomatitis and when you should reach out to your healthcare provider.

What is Gingivostomatitis?

Gingivostomatitis is an infection of the mouth and gums that can lead to swelling and oral lesions that resemble canker sores. 

What Causes Gingivostomatitis?

There are several possible causes of gingivostomatitis, including:

  • Herpes simplex virus type 1 (HSV-1), which also causes cold sores
  • Coxsackie virus
  • Bacterial infection (streptococcus, actinomyces)
  • Poor oral hygiene

Gingivostomatitis in Children or Toddlers

Gingivostomatitis is a common infection in children and toddlers, and the most common cause of gingivostomatitis in children younger than five is herpetic gingivostomatitis, or gingivostomatitis caused by HSV-1. 

In addition to being contagious, herpetic gingivostomatitis is often the first exposure a child has to the herpes virus. 

Common symptoms of herpetic gingivostomatitis in children and toddlers include a high fever and painful blisters or sores on the tongue, cheeks, gums, lips, and roof of the mouth.

Some children also have drooling, pain, and swelling. The pain and sores can also make it difficult to swallow, so they may refuse food and drink during this time. As a result, dehydration can occur.

Because herpetic gingivostomatitis is contagious, infected children should avoid close contact with others, including kissing or sharing food, drinks, or toys.

Thankfully, it usually clears up on its own within two weeks, though your pediatrician may prescribe medicine to help clear the infection or soothe your child’s discomfort. 

Symptoms

The symptoms of gingivostomatitis can be mild or severe:

  • Bad breath
  • Fever
  • General discomfort or malaise
  • Sores on the inside of the cheeks, gums, lips, or roof of the mouth (they may be gray, yellow, or red in color)
  • Swollen, bleeding gums
  • Sore mouth
  • No desire to eat or drink
  • Swollen lymph nodes
  • Drooling (particularly in children)

Diagnosis

Most providers will diagnose gingivostomatitis by examining your mouth for sores or lesions.

In most cases, no additional testing is required to diagnose gingivostomatitis. But if your provider suspects that the cause of your infection is viral or bacterial, they may ask to take a culture, or small piece of tissue, from your sore.

In rare cases, your provider may perform a biopsy to rule out other types of mouth ulcers.

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Treatment

Most cases of gingivostomatitis are mild and will resolve without treatment within two to three weeks. 

During this time, there are several things you can do at home to soothe your symptoms and increase comfort:

  • Take medications as prescribed by your doctor: In some cases, your doctor may prescribe an antibiotic, antiviral, analgesic, or other medication to help clear the infection or ease your discomfort.
  • Practice good oral hygiene: Continue to brush your teeth regularly and brush your gums well to reduce the risk of another infection. If your teeth and gums are extra sensitive during this time, use a softer, more gentle brush. Do not skip brushing your teeth, unless directed to do so by your doctor or healthcare provider.
  • Mouth rinse: Rinse your mouth with warm salt water or mouthwashes that contain hydrogen peroxide or lidocaine to soothe your discomfort.
  • Eat a bland, healthy diet: If you’re experiencing discomfort while eating, try soft, bland foods. Avoid salty, sour, and spicy foods during this time.
  • Try over-the-counter pain medicine: If the pain you’re experiencing is significant, talk to your doctor about which over-the-counter (OTC) pain relievers may help, including acetaminophen (Tylenol) or ibuprofen (Advil).

Potential Complications

Complications of gingivostomatitis can include:

  • Dehydration: This is most often seen in children and toddlers who refuse to eat and drink due to the pain from their sores. Signs of dehydration include dry mouth, dry skin, dizziness, tiredness, and constipation. Talk to your pediatrician about how best to keep your child hydrated during infection.  
  • Herpes labialis: In some cases, herpetic gingivostomatitis can lead to cold sores, or herpes labialis. Roughly one-third of the patients with herpetic gingivostomatitis will develop cold sores, with intermittent breakouts occurring throughout life.
  • Herpes simplex keratitis (HSK): If HSV-1 virus spreads to the eyes, it can infect the corneas.
  • Herpetic whitlow: It’s also possible that the HSV-1 virus spreads to the fingers, causing a painful but easily treatable infection where sores form on the fleshy parts of the fingertips.
  • Eczema herpeticum: A rare but serious skin infection that can be caused by HSV-1.

If you notice persistent symptoms that don’t resolve on their own, especially mouth sores, fever, or additional swelling in the mouth, call a healthcare professional or pediatrician immediately.

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Frequently Asked Questions

Is gingivostomatitis contagious?
Yes, gingivostomatitis is highly contagious. When infected, you should avoid close contact with others, including avoiding kissing and sharing food or drink. For children, this also includes avoiding sharing toys with other children.
What is herpetic gingivostomatitis?
Herpetic gingivostomatitis is gingivostomatitis caused by the herpes simplex virus type 1. It is the most common cause of gingivostomatitis in children younger than five.
How long does gingivostomatitis last?
Most cases of gingivostomatitis are mild and resolve on their own within two to three weeks. Your doctor may prescribe an antibiotic or other medicine during this time to help your body fight the infection and soothe your symptoms.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Irmanie Hemphill, MD, FAAFP

Dr. Hemphill is an award winning primary care physician with an MD from Florida State University College of Medicine. She completed her residency at Halifax Medical Center.