Herpes simplex primary (children typically contract) determines the acute herpetic gingivostomatitis. It is usually caused by herpes simplex virus type 1 but through the oro-genital contact, may be due to herpes simplex virus type 2 and begins with small blisters that break down quickly, forming ulcers.

oral herpes

When in the early stages is located, may resemble aphthous stomatitis, herpes but always strikes the primary gingiva and may affect other tissues, and aphthous stomatitis never affects the gingiva.


Fever and pain often accompany herpes. The difficulty in feeding and drinking can lead to dehydration. The infection typically lasts from 10 to 14 days. The virus then moves to the semilunar ganglion and can be reactivated by stress, immune system disorders or trauma.

Treatment is symptomatic. It includes systemic analgesics (eg., Paracetamol) and topical anesthetics applied directly with gauze. When large areas are affected, the viscous lidocaine 5% can be used for oral rinsing 5 min before the meal. (Note: must be swallowed as lidocaine numbs the oropharynx, hypopharynx, and sometimes the epiglottis. Children should be observed for signs of inhalation.)

The eruptions occur as secondary herpes simplex cold sores on the edge of the lip or vermilion, much less commonly, as ulceration of the hard palate. Usually, a patient of prodromal sensations, typically an itching or burning of the lip. During the prodromal phase, treatment with acyclovir PO dose of 200 mg five times per day may reduce the duration and severity of the eruptions.

The duration of the injury can be reduced to about a day by applying a salve of penciclovir 1% q 2 h upon awakening. This treatment should be initiated during the prodromal phase or shortly after the onset of the first lesion.

The secondary herpes zoster (shingles) can strike the inside of the mouth. It is a rare condition but should be suspected when there is a clear unilateral distribution of lesions does not occur and herpetiform prodromal oral primary lesion.

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