Primary Herpetic Gingivostomatitis
Journal Summary:
Primary Herpetic Gingivostomatitis In Young Children
Primary Herpetic Gingivostomatitis are non-plaque induced gingival lesions (AAP Classification 1B). Primary Herpetic Gingivostomatitis (PHG) is an oral infection caused by herpes simplex type 1. PHG is the inital outbreak of the virus. At least 70% of the American population has been infected by this virus. It usually affects a person in early childhood. The virus is passed from person to person through contaminated secretions or lesions.Transmission-potential behaviors seen in young children such as mouth touching, sharing utensils, cups, and bottles; thumb sucking and mouthing toys make children more susceptible. Children ages 2 to 4 are most susceptible to this herpes simplex virus. PHG is a blistering disease that is easily transmitted when the shedding herpes virus comes in direct contact with mucous membranes or broken skin. The majority of PHG infections are asymptomatic or mild enought to go unrecognized. Light cases can be mistaken for teething or other poorly defined illness. In heavy cases, a person may experience fever, malaise, lymphadenopathy, and fragile vesciles. These vesicles usually affect the mucosa inside the lower lip, but they can also appear on the gingiva, buccal mucosa, tongue, and hard palate. Most of the PHG cases are diagnosed based upon clincal findings. The diagnosis can be confirmed by labratory tests. An antiviral therapy with acyclovir has proven effective in treating PHG. Once a person has been infected, the virus is transported to the trigeminal ganglia, where a latent or dormant infection is established that remains for life. Reactivation of the dormant virus can occur. Some factors that may cause reactivation are stress, illness, menses, fever, or immune suppression. When clincally evident, the recurrent infection is rarely of the same magnitude as the primary infection. Antibodies of the virus will remain in circulation, weakening subsequent infections. Generally recurrent infections only cause a single labial lesion widely known as a fever blister or cold sore. This infection is known as herpes labialis. All forms of the herpes simplex virus are very contagious. Avoiding contact with the lesions and thorough hand washing is very important.
References:
Blevins, J. (2004). Primary herpetic gingivostomatitis in young children... this article originally appeared in Pediatric Nursing, 2003, Volume 29, Number 3, pp. 199-201 and is reprinted here with permission of the publisher. Dermatology Nursing, 16(4), 341-344.
AAP Abbreviated Version of the 1999 Classification of Periodontal Diseases and Conditions