What is mouth rot?

Oral rot develops after infection with herpes viruses, more precisely with the herpes simplex virus type 1 (HSV 1). Mouth rot is characterized by fever and fluid-filled, painful blisters in the mouth. The mouth rot mostly affects young children between the ages of ten months and three years who come into contact with the virus for the first time. They become infected through droplet or smear infection. Aphthous stomatitis very rarely affects adults. These usually get cold sores when HSV 1 becomes active again. In principle, aphthous stomatitis is possible in adults. Doctors also refer to the mouth rot as aphthous stomatitis (other spelling: aphthous stomatitis). But it also has other names: herpes gingivostomatitis, herpetic gingivostomatitis, herpetic stomatitis or aphthous stomatitis.

 

Symptoms of mouth rot

Mouth rot mostly affects young children, although more than 90 percent develop no symptoms after an initial infection with the herpes simplex virus type 1. Others show the following symptoms, which can vary in severity:

• The mouth rot begins with a high fever, which usually starts suddenly and can last for several days.
• The children feel sick, weak and exhausted.
• Many painful blisters and ulcers form on the lining of the mouth, tongue, gums, roof of the mouth, throat, and sometimes on the lips. They cause burning pain in the mouth. The vesicles contain a highly contagious liquid that contains the viruses.
• The vesicles burst quickly and can become inflamed and festering. Then the typical bad breath arises , which smells putrid. This is where the name "mouth rot" comes from.
• The gums are swollen, red, and sometimes bleed.
• The saliva flows more intensely.
• The lymph nodes on the neck are swollen.
• There may also be nausea and vomiting .
• The children experience severe pain when eating, drinking and swallowing; sometimes they completely refuse to eat because of this.
• Aphtous stomatitis spreads to other parts of the body when children transfer the herpes virus to their noses or upper lip with their fingers. Then vesicles also form there.
   

Causes of mouth rot

Aphtous stomatitis is caused by herpes simplex virus type 1 infection. It belongs to the herpes virus family. This also includes the herpes simplex virus type 2, which usually causes genital herpes, the varicella zoster virus ( chickenpox , shingles ), the Epstein Barr virus ( glandular fever , mononucleosis) and the cytomegaly virus. What all herpes viruses have in common is that they remain in the body for life. A weakened immune system or illnesses cause the virus to become active again. Then usually an unpleasant cold sore develops. Sometimes the herpes breaks out again in other parts of the body.

How do you get infected?

The cause of oral rot is herpes simplex virus type 1 transmission by droplet infection, usually via the saliva. Viruses can be found in the fine droplets that people catapult into the air when they cough, sneeze or speak. The virus penetrates the mucous membrane cells, destroys them and so continues to multiply. Herpes viruses are extremely infectious, especially when the blisters burst. Even the slightest contact with the virus is enough to become infected.

Children become infected with the virus when they maintain close physical contact with infected parents, siblings or playmates. Children can also become infected through a smear infection when they come into contact with contaminated hands or objects, for example through shared eating utensils or drinking cups.

Anyone who has been infected once carries the pathogen for life. If the immune system is weaken, for example due to stress or illness, the virus is reactivated and multiplies. Aphthous stomatitis very rarely affects adults. These usually get cold sores when the virus becomes active again. In principle, aphthous stomatitis is possible in adults.

Antibodies in the blood can tell whether a person is infected with HSV 1. Since this type of virus is very easily transmitted, such antibodies can be detected in a large proportion of the population (more than 80 percent), even if they do not show any symptoms.
 

Duration and course of aphthous stomatitis

An average of two to twelve days pass between infection with the herpes simplex virus 1 and the onset of the disease. This is the incubation period for oral rot. But it can also be significantly shorter or longer. Only then do the first symptoms appear, such as fever and painful blisters in the mouth and throat.

How long does mouth rot last?

The duration of the disease of oral rot varies from person to person: After a week to around ten days, the unpleasant symptoms of aphthous stomatitis are usually over. Sometimes the mouth rot lasts longer. Children with mouth rot should stay home until the fever has subsided and the sores have cleared. Patients who show symptoms of aphthous stomatitis can infect other people until all of the blisters have dried out. However, there is also a risk of infection a few days before the blisters bloom.

How is the mouth rot?

The course of oral rot is usually unproblematic. However, the vesicles can fester if bacteria and viruses lodge in the open wounds of the ruptured vesicles. Some people also spread the herpes viruses to other regions of the body, for example on the lips or in the nose.

Because of the painful blisters in their mouth, many children do not want to eat or drink at all. This creates the risk of drying out (dehydration). A stay in hospital may be unavoidable. There, children receive vital fluids and food via an infusion or, for a limited time, via a feeding tube. This is how doctors prevent the child from becoming dehydrated.

The herpes simplex virus very rarely affects the brain or lungs and causes inflammation there. Such complications usually affect people who first come into contact with the virus as adults.

Otherwise, the aphthous stomatitis usually heals again without complications. After the aphthous stomatitis has subsided, the viruses migrate to the nerve nodes (usually the trigeminal nerve in the face) and fall into a kind of "deep sleep" there. This is where the name "herpes" comes from: The Greek term "herpein" means "to crawl".

Under certain conditions, the herpes viruses become active again, for example if the immune system is weakened. Then there is no new aphthous stomatitis, but usually cold sores.

Treatment of oral rot

If your child has contracted mouth rot, always see the pediatrician first. There is no causal treatment for aphthous stomatitis, which specifically attacks and destroys the herpes simplex virus 1. A therapy that prevents the disease from flaring up again, such as a cold sore, has not yet been found. But doctors can treat the symptoms. They use the following therapies for mouth rot:

• Doctors treat symptoms of oral rot such as fever, pain, and skin inflammation (symptomatic therapy) with antipyretic, anti-inflammatory, and pain reliever drugs. Frequently used pain relievers are ibuprofen and paracetamol.
• Gels and solutions for the mouth that have a local anesthetic effect are very effective. Mouth rinses with the active ingredient chlorhexidine have a disinfectant effect.
• Antiviral drugs, which curb the multiplication of viruses, slow down skin inflammation and relieve pain, help against the spread of the herpes viruses and skin inflammation.
• Antiviral drugs come in the form of ointments and creams; for more severe cases of aphthous stomatitis, the therapy is also available as tablets or infusions. Acyclovir is an antiviral agent in herpetic stomatitis therapy.
   

Home remedies for mouth rot

In addition to cold food and drinks, fever-lowering measures are a good home remedy for mouth rot. The body temperature can be brought down a little with cold calf compresses.

Have your child rinse their mouth with a chamomile solution; Chamomile has anti-inflammatory and analgesic properties. There are ready-made chamomile solutions from the pharmacy that you dilute with water. Otherwise, make chamomile tea, but let it cool down well before rinsing your mouth! Patients take small sips and swirl the solution back and forth in their mouth for a few seconds - then spit it out!