Springdale Mason Pediatrics

Herpes Gingivostomatitis


  • A viral infection of the mouth and lips in young children

Call or Return If

  • Trouble breathing occurs
  • Your child can't drink enough fluids
  • Fever lasts more than 5 days
  • Mouth ulcers last more than 2 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Many small water blisters inside the mouth on the gums, tongue and lips. They quickly break open and become small mouth ulcers (sores)
  • The gums are very red and can bleed easily.
  • Ulcers also occur on the outer lips or skin around the mouth.
  • The ulcers occur equally on both sides of the mouth and lips.
  • The ulcers cause pain that interferes with feeding and swallowing. Poor fluid intake can lead to dehydration.
  • Lymph nodes in the neck are usually swollen and tender.
  • Fever present and may last 5 days.
  • Usually occurs age 1 to 3.


  • Herpes Simplex Virus type 1. The first infection with HSV1 can be severe
  • It usually follows contact with someone who has active cold sores (fever blisters). Often they have kissed the child.

Prevention of Spread to Others

  • Herpes virus is easily spread to other children who have not had it.
  • The virus is mainly found in the saliva and the sores.
  • Avoid sharing drinking glasses or eating utensils. Avoid kissing.
  • Also avoid sharing toys with other children. Reason: most young children put toys in their mouth.
  • The mouth sores are contagious for about 7 days.

After Care Advice

  • The first infection with the Herpes virus can be severe.
  • The mouth ulcers make it hard for your child to drink and eat normally.
  • Your main job is to help your child drink enough fluids.
  • Here is some care advice that should help.
Liquid Antacid for Mouth Pain:
  • For mouth pain, use a liquid antacid such as Mylanta or the store brand. Give 4 times per day as needed. After meals often is a good time. Age: Use for children over 1 year old.
  • For children over age 6, can use 1 teaspoon (5 ml) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
  • For younger children age 1 to 6, put a few drops in the mouth. Can also put it on with a cotton swab.
  • Caution: Do not use regular mouth washes, because they sting.
Avoid Numbing Medicines:
  • Do not use numbing medicines. Reason: They only work for about 20 minutes.
  • Also, during that time your child may chew on their lip by mistake.
  • They may also cause your child to choke and other side effects.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Anti-Viral Drug by Mouth:
  • Oral anti-viral medicine can help the sores go away faster if started early. That usually means within 3 days of when the infection started.
  • If your doctor has prescribed an anti-viral drug, take it as advised.
  • Try not to forget any of the doses.
Antibiotics Not Needed:
  • Antibiotics are not helpful for viral infections.
  • They can only kill bacteria.
Fluids and Soft Diet:
  • Try to get your child to drink adequate fluids.
  • Goal: keep your child well hydrated.
  • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
  • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is more important than eating any solids.
  • For babies, offer fluids in a cup, spoon or syringe rather than a bottle. Reason: The nipple may increase pain.
What to Expect:
  • Fever usually lasts 3 to 5 days.
  • Mouth pain lasts 5 to 7 days.
  • The mouth sores heal up in 10 to 14 days.
Return to Child Care or School:
  • Older children can return to school after the fever is gone.
  • Younger children who can't stop touching their mouth need to stay home for 7 days.
  • Also, they need to avoid sharing toys with other kids for a week.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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