Gingivostomatitis is common among children. It may occur after infection with the herpes simplex virus type 1 (HSV-1), which also causes cold sores.

The condition may also occur after infection with a coxsackie virus.

It may occur in people with poor oral hygiene.

The symptoms can be mild or severe and may include:

• Bad breath
• Fever
• General discomfort, uneasiness, or ill feeling (malaise)
• Sores on the inside of the cheeks or gums
• Very sore mouth with no desire to eat

Your health care provider will check your mouth for small ulcers. These sores are similar to mouth ulcers caused by other conditions. Cough, fever, or muscle aches may indicate other conditions.

Most of the time, no special tests are needed to diagnose gingivostomatitis. However, the provider may take a swab from the sore to check for a viral or bacterial infection. This is called a culture. A biopsy may be done to rule out other types of mouth ulcers.

The goal of treatment is to reduce symptoms.

Things you can do at home include:

• Practice good oral hygiene. Brush your gums well to reduce the risk of getting another infection.
• Use mouth rinses that reduce pain if your provider recommends them.
• Rinse your mouth with salt water (1/2 tsp [3 g] salt in 1 cup [240 mL] of water) or mouthwashes with hydrogen peroxide or Xylocaine to ease discomfort.
• Eat a healthy diet. Soft, bland (non-spicy) foods may reduce discomfort during eating.

You may need to take antibiotics.

You may need to have the infected tissue removed by the dentist (called debridement).

Gingivostomatitis infections range from mild to severe and painful. The sores often get better in 2 or 3 weeks with or without treatment. Treatment may reduce discomfort and speed healing.

Gingivostomatitis may disguise other, more serious mouth ulcers.

Contact your provider if:

• You have mouth sores and fever or other signs of illness
• Mouth sores get worse or do not respond to treatment within 3 weeks
• You develop swelling in the mouth

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Romero JR. Coxsackieviruses, echoviruses, and numbered enteroviruses (EV-A71, EV-D68, EVD-70). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 172.

Shaw J. Infections of the oral cavity. In: Long SS, ed. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 25.

Whitley RJ, Gnann JW. Herpes simplex virus infections. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 345.

Updated by: Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.