Mouth rot (lat. stomatitis aphtosa, stomatitis herpetica or more precisely gingivostomatitis herpetica) is a disease that mostly occurs in young children and causes characteristic changes and discomfort in the oral cavity and gums. The incubation period is approximately two to twelve days.
Symptoms – Complaints
When young children first contract the virus through contact with infected persons, it manifests itself in a very painful condition of the oral cavity. Oral thrush is accompanied by high fever, which may last for several days. The throat lymph nodes swell.Multiple painful vesicles (aphthae) appear on the mucosa and gums. The palate or tongue may also be affected. Gums and oral mucosa swell, which inevitably leads to the affected children hardly eating any food. Furthermore, a typical bad breath (foetor ex ore) occurs.Oral thrush is contagious (infectious) until the blisters in the oral cavity are healed, so similar to the later appearing cold sore.
Pathogenesis (disease development) – etiology (causes)
The cause of the disease is the initial infection with the herpes simplex virus type I (HSV-1). The pathogen is usually transmitted in young children by their parents when they are acutely suffering from cold sores and yet kiss the child, lick the pacifier or drinking bottle, and share cutlery or drinking glasses.
Consequential diseases
After the disease has healed, the viruses are not completely eliminated from the body. They enter the trigeminal ganglion via nerve fibers, where they persist and can become active again and again years later, triggering the typical picture of herpes disease.
Although herpes viruses are carried by a large number of people, they usually only become active when the immune system is weakened. Then the typical herpes blisters, mostly localized on the lip, appear.
Therapy
During the disease, soft, cool foods and chilled drinks should be administered. Spicy, hot, or sour foods will cause additional pain. If the child refuses fluid intake altogether, hospitalization must sometimes be considered to prevent dehydration (dehydration due to lack of fluids).
Pain-relieving gels or ointments can improve symptoms, and fever can be reduced with fever juice or suppositories.
Administration of the viral drug aciclovir may be considered in the first few days after the onset of illness. However, whether it actually leads to an improvement in symptoms or to a milder course of the disease is a matter of controversy.
After about a week, the disease is usually over. Children with oral thrush are contagious and should therefore be kept at home.
After the disease has passed, however, some of the virus remains in the nerve nodules (ganglia) of the body. If the immune system is poor, the disease can usually recur in the form of cold sores and is then contagious again as long as the blisters have not healed.
Parents should take care not to lick their child’s pacifier, drinking bottle or spoon in the case of cold sores – but also in general to prevent the transmission of caries bacteria. Kissing is also taboo during acute blisters. This is a sensible way to protect the child from infection.