Oral herpes is a condition that affects as much as 80 percent of adults, according to Johns Hopkins Medicine, and is most commonly associated with cold sores. It is caused by the herpes simplex virus 1 (HSV-1), a highly contagious virus that is a different strain from genital or sexually transmitted herpes. When a person is infected by this virus, it remains for the course of his or her life although it may not always be active or visible. Because of the permanence of the condition, it is important that families understand what they are dealing with when it comes to oral herpes.
Early Development of the Infection
Because of the erroneous belief that oral herpes is type of genital herpes, it may be a surprise to some that infection generally occurs very early in life, often before the age of 5. It is in fact considered a common childhood disease according to the American Academy of Pediatrics. The condition is highly contagious and is spread through direct exposure to saliva. Generally infants up to the age of six months are immune to the HSV-1 virus, as they are protected by antibodies from their mother. Beyond this age however, a child may become infected by a simple kiss from someone like a relative, or from sharing things that come into contact with the saliva of someone who is infected, such as eating utensils or even a towel for example. Droplets of saliva that come from one's mouth when speaking or coughing may also be enough to infect someone with the virus. When initially infected, youth between the ages of 1 to 2 years of age are more likely to experience oral problems and sores such as gum swelling, redness, and pain, for example. Saliva production may increase for several days, after which there may be blisters that appear on the inner portion of the infected child's mouth. Other symptoms during this first outbreak may seem flu-like and include headache, fever, swelling of the lymph nodes, and a potential loss of appetite. This initial outbreak is what is known as primary herpes. While any of the above symptoms may occur, one may also have very mild to unnoticeable symptoms. When the latter happen it is referred to as an asymptomatic infection.
After the initial outbreak, or primary infection, oral herpes enters a latency stage in which the virus moves from the infected area to what is called the dorsal root ganglion in the spine. This is an area where there is a wealth of nerve tissue. Once here, the virus reproduces before going dormant. It remains in this latent stage until something happens that triggers it from its dormancy. Once it has been triggered, the person who is infected by the virus suffers from what is called a flare-up. A flare-up may involve outbreaks of cold sores. If a person has a cold sore outbreak, the blisters can appear in various locations in the mouth including on the lips or even on the gums. Cold sores can appear on the outside of the mouth and may even appear on the infected person's chin or beneath the nose. These flare-ups or outbreaks are typically triggered by situations that are either stressful emotionally or physically. Examples of stressful situations may include surgeries, trauma, or illness. One's menstrual cycle may trigger an outbreak as can excess exposure to the sun, abrasions to the skin, and medications, particularly those that weaken one's immune system. This stage of infection is called the recurrence stage.
In many cases, there is no need for special treatment, as oral herpes symptoms will resolve on their own typically within a period of ten days. Outbreaks may be reduced in cases of frequent recurrence with the aid of an antiviral medication prescribed by one's physician. Discomfort in the form of pain or fever may occur as a symptom of the herpes infection. To obtain relief from these types of symptoms, the help of general OTC pain medications such as acetaminophen may be useful. Plenty of bed rest is also helpful, as is feeding the person suffering from the outbreak a nutritious, yet bland diet and cold drinks such as water. Avoid giving acidic drinks that can increase the amount of discomfort or pain. Any ointment that contains steroids should not be used on herpes cold sores as they can exacerbate a viral infection. Other than treating the symptoms of the infection, there is nothing more that one's physician can do as oral herpes has no cure.
The simple answer to preventing infection is to avoid coming into contact with the saliva of others. This is of particular importance when a person has a visible sore or blister on or near the mouth. Even if no visible signs of blistering are noticeable, parents should never allow anyone to kiss an infant on the lips. Parents should talk with their children and instruct them to never share utensils, instruments, soda cans, or anything that comes into contact with the mouth, with other children. These rules should also apply to adults as well. Additional preventative measures that can be taken by adults and kids alike include not sharing toothbrushes or lip balms. In terms of prevention, older kids and adults should be aware of signs that an outbreak is imminent. These signs may include tingling, tenderness, itching and/or burning on and around the mouth. If a parent has a child who is already infected with the herpes simplex virus and is experiencing sores or other signs of a flare-up, the child should be kept at home until the symptoms have resolved themselves. This will help prevent the spread to other children. If an appointment to see the dentist is scheduled during a time when there is an outbreak, one should call to inform the dentist and likely reschedule for a later date.
- Oral Herpes Information and Resources
- Herpes Simplex: Signs and Symptoms
- MedlinePlus: Oral Herpes
- Health Issues - Oral Herpes
- About Oral Herpes
- Everything That You Need to Know About Herpes
- IU Health Center: Herpes
- Mouth Infections
- Oral Herpes
- Fact Sheet: Oral Herpes (PDF)
- Oral Herpes (aka, Cold Sores)
- Herpes Simplex Oral & Genital(PDF)
- Oral Herpes Overview
- Cold Sores
- Diseases and Conditions - Cold Sores
- Cold Sores/Fever Blisters
- University Health Services - Cold Sores
- What are Cold Sores
- Health Topics - Cold Sores
- John Hopkins Medicine - Mouth Infections
- About Cold Sores