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Primary Herpetic Gingivostomatitis

Course Author(s): American Academy of Pediatric Dentistry

Primary Herpetic Gingivostomatitis

Primary herpetic gingivostomatitis is caused by an initial infection with the herpes simplex virus Type I and characterized by painful, erythematous, and swollen gingivae.

Multiple tiny vesicles first present on the perioral skin, vermillion border of the lips and the oral mucosa. The vesicles soon rupture into large, painful ulcerated areas.

Primary Herpetic Gingivostomatitis:
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Extraoral
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Intraoral

Systemic symptoms of fever, malaise, and cervical lymphadenopathy typically occur first, followed by the appearance of vesicles that progress to ulcers. The most common age of occurrence is 6 months to 6 years. Lesions heal spontaneously in 1 to 2 weeks, with the acute phase lasting 7 to 10 days.

Treatment usually includes rest, antipyretics, and analgesics. A systemic antiviral agent may be prescribed in the early stages to shorten the durations of symptoms and viral shedding.

Dehydration may be a concern, especially in the younger patient, because food or drink on the oral tissues may cause pain. Nevertheless, hydration should be encouraged.

Information to the caregiver should include explanation of the contagious aspects of this disease. Antibiotics are contraindicated, unless secondary infection is present. Steroids are also contraindicated.