Gingivostomatitis: Causes, Symptoms, and Treatment

Written by Emily Halnon, Kristin Mitchell
Medically Reviewed by Jabeen Begum, MD on June 27, 2025
5 min read

Gingivostomatitis is an infection of the mouth and gums that causes swelling and sores. It can be caused by viruses or bacteria. The most common cause is herpes simplex virus type 1 (HSV-1) — the same virus that causes cold sores. 

If you have poor oral hygiene, you're more likely to get gingivostomatitis. It's very damaging to the skin, causing ulcers in the mouth and blisters on the lips. It most often occurs in young children.

Symptoms of gingivostomatitis can range from mild to severe. At first, after infection, you or your child may not show noticeable symptoms, but ulcers or sores may form over time and become increasingly uncomfortable. Other symptoms can include:

  • Several small blisters on the gums, tongue, and lips that eventually break open and become painful open sores
  • Raw gums that are sore and bleed easily
  • Ulcers around the outer lips and mouth
  • ‌Swollen, sore lymph nodes in the neck
  • A fever that lasts several days
  • Headaches
  • mouth pain that causes loss of appetite
  • headaches
  • dry mouth

  • bad breath

    If your child has herpes simplex gingivostomatitis, other symptoms can include:

  • drooling
  • dehydration
  • irritability
  • less of an appetite 

 One in four children with herpes simplex gingivostomatitis will develop mouth ulcers with their first infection. 

Once herpes simplex virus infection happens, the virus stays in the body for life. Other episodes of herpes (often referred to as cold sores) may occur, but typically the condition becomes less severe with age.

Gingivostomatitis can be caused by viruses or bacteria. 

It's most commonly caused by herpes simplex virus type 1 (HSV-1), which is a viral infection that typically spreads through close physical contact.  In some cases, herpes can be passed on to the child from an infected mother during childbirth.

Coxsackieviruses are another cause. They spread through contact with contaminated surfaces or unwashed hands.

Bacterial causes include Streptococcus and Actinomyces.

 

“Diagnosis is usually made through a physical examination of the mouth,” says Jennifer Spence, MD, a family medicine physician at Overlake Medical Center.

Your doctor may identify the condition based on the appearance of sores, swollen gums, and other clinical signs, Spence says. In some cases, a viral culture, PCR test, blood test, or a biopsy may be performed to confirm the viral cause.

You can help care for your child at home by making sure they get enough fluids and avoid dehydration. Oral rehydration fluids can help your child replace fluids. Other options include:

  • water
  • milk
  •  rehydration drinks 
  • ice pops

You can give fluids to babies using a dropper instead of a bottle. This is generally more comfortable for babies with a sore mouth. 

If your child can eat, give them a soft diet. Avoid citrus fruits and salty or spicy foods; these ingredients can be especially painful if they come into contact with sores or blisters. In some cases, your child may not want to eat, but it's important that they get enough to drink, so they don't become dehydrated.

You should see a doctor immediately if your child experiences:

  • An inability to eat or drink due to pain
  • A high, persistent fever
  • Symptoms that worsen or spread
  • Signs of dehydration (including dry mouth, sunken eyes, cold hands and feet, not passing urine, no tears when crying, or weight loss)

Antibiotics can help to treat gingivostomatitis caused by bacteria, but they don't work if a virus is the cause. Your doctor may prescribe an antiviral medication if your gingivostomatitis is caused by a virus.

There are other treatments you can use to help relieve your child's painful symptoms, including: 

  • rinsing with antibacterial mouth wash
  • taking pain medications, including Acetaminophen which can help reduce pain and control fever
  • rinsing with a warm salt water mixture, swishing it around your mouth a few times a day
  • brushing twice a day and flossing once
  • avoiding hot or salty foods

 

 

Gingivostomatitis usually resolves in one to two weeks, Spence says. But some complications can occur, including:

  • A secondary bacterial infection
  • Dehydration
  • Recurrence of cold sores
  • Trouble maintaining oral hygiene due to pain

The herpes virus that causes most cases of gingivostomatitis is very contagious. You can help avoid its spread by not sharing your child's toys or drink glasses and utensils with other kids and by not kissing them.

Your child's mouth sores will be contagious for about seven days. Their fever can last up to five days, and they may have mouth pain for up to a week. Keep an eye on your child to ensure that they are healing well. They shouldn't return to school until their fever is gone and they're showing improvement.

 To help prevent gingivostomatitis:

  • Maintain good oral hygiene habits, including brushing and flossing.
  • Avoid sharing eating utensils or toothbrushes.
  • Teach your kids not to put dirty hands or objects in their mouths.
  • Manage stress and maintain a healthy immune system.
  • Avoid contact with individuals who have visible cold sores

What is the best medicine for gingivostomatitis?

"For viral cases, oral antiviral medication can be prescribed and is most effective if started early," Spence says. "In mild cases, supportive care may be sufficient. Topical anesthetics like benzocaine or lidocaine may be used to ease pain, especially before meals."

What is the difference between gingivitis and gingivostomatitis?

Gingivitis and gingivostomatitis are two different things. Gingivostomatitis is an infection caused by the herpes virus, while gingivitis is a form of gum disease. 

How do you cure gingivostomatitis?

There is no cure for an infection caused by the herpes virus, including herpetic gingivostomatitis, but there are treatments to help manage symptoms. Gingivostomatitis caused by bacteria can be treated with antibiotics.