definition

Oral rot is a disease that primarily affects the lining of the throat and mouth. It is triggered by the herpes virus and also called Herpetic gingivostomatitis designated.

The mouth rot is very painful and occurs especially in small children up to the age of 3. Because of the viral pathogen, only a limited number of symptomatic drugs are available. Oral rot is characterized by small blisters on the oral mucosa. Sometimes the vesicles also open and painful small defects in the mucous membrane develop.

causes

The triggering cause of oral rot are viral pathogens from the group of Herpes viruses. In addition to the oral mucosa, herpes infections can also develop on the lips and the genital organs, and can also be evident from shingles on one or more skin areas on the body.

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Over half of the people carry the herpes virus. For many, it will not cause any complaints or illnesses in the course of their lives. In children up to the age of three, however, the herpes virus can trigger mouth rot. In rare cases, mouth rot can affect adults as well.

Read more on the topic: Oral rot in the adult

Symptoms

The first symptoms of oral rot are reddening of the inner lining of the cheek or throat and small, painful blisters, which can also be opened and thus cause defects in the mucous membrane. Also typical for mouth rot are moderate to severe attacks of fever, which can be particularly pronounced at noon and in the evening. The patients usually describe a sour taste and also have an unpleasant bad breath.

Heavy salivation is also typical for the presence of oral rot. As a result, the patients have to swallow more, which also reduces the quality of life. Since it is an infection, the body reacts more or less strongly with its immune system. Lymph nodes swell in typical places, such as under the arms and in the groin and on the neck.
The lymph nodes are also tender on pressure and may be slightly reddened. Sometimes the entire neck can also be tender on the outside. It is important for the doctor to also check the tonsils, since tonsillitis or a lateral cord angina can also be responsible for the symptoms.

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You can find more about the side strand tangina at: Inflammation in the throat

fever

Fever is a frequent accompanying symptom of herpetic gingivostomatitis and usually the person concerned or the parents of the affected child only become aware of the disease when the fever develops. The fever temperature can exceed 40 degrees, but should be under medical observation, as temperatures above 42 degrees are life-threatening. Therefore, antipyretic drugs are used to prevent the fever from rising too much. These are available as suppositories or in juice form for small children, and in tablet form for adults and adolescents. Home remedies such as leg compresses or a chilled washcloth on the forehead can also be used for support

on the tongue

Herpetic gingivostomatitis can affect the tongue and palate as well as the mucous membranes in the mouth and throat. The appearance of erosions and blisters on the tongue is particularly painful because the tongue is constantly in motion and in contact with other structures. Contact with teeth, the floor of the mouth and the roof of the mouth creates constant friction and severe discomfort. Sufferers can treat the tongue with numbing gels to make eating and speaking a little more bearable. Once the disease is over, the symptoms subside completely without scarring.

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diagnosis

The diagnosis is mostly made by the Health survey and through the physical examination deliver. The age of the patient in connection with the typical skin symptoms on the oral mucosa is usually indicative. So are especially young children affected by this infectious disease up to the age of three. Questioning the parents about the onset and duration of the symptoms as well as a look into the throat secure the diagnosis in most cases. If there is any doubt about the disease, a blood test can detect the virus.
Whether the herpes virus can simply be detected in the blood (as in every second person) or whether the virus also triggers the oral disease cannot usually be found out by the laboratory. In this context, however, it is important that a lack of herpes detection in the blood rules out oral rot as a disease in any case. In this case, another cause must be sought.

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Oral rot is so contagious

In the case of "mouth rot" it is important that the person concerned has no contact with other children, especially other children, as otherwise there is a risk of infection. It is passed on through droplet infection, whereby to cough, Sneeze or simple Speak with other people can be enough to infect them.

A local complication is an inflammation of the nail bed, especially in children. This is caused by nail biting and especially by finger sucking in small children. The virus can get onto the nail and infect it. In small children, the disease is usually transmitted through the parents, as they do not take a herpes outbreak seriously, for example on the lip, and kiss the child or share the water glass with the child.

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Oral rot disease during pregnancy is not harmful to the unborn child. However, the immune system of newborns is not yet fully developed. Therefore, those suffering from oral rot should avoid contact with young children.

Doctors and dentists also have to protect themselves from possible transmission of the pathogens with gloves, face masks and protective goggles.

Read more on the topic: Contagion with mouth rot

Which doctor treats mouth rot?

The right doctor for "mouth rot" is first and foremost the dentist. Since the illness is primarily noticeable through accompanying symptoms such as fever and fatigue, the family doctor or pediatrician is usually visited first. As a rule, general practitioners discuss a case of herpetic gingivostomatitis with dentists in order to find a common therapeutic path.

Course of the mouth rot

In the oral cavity there is a characteristic course of "oral rot". First, numerous pinhead-sized vesicles appear in batches on the bright red inflamed mucous membrane. The number is about fifty to over a hundred individual vesicles. However, these only stay for a short time and transform into yellowish, mostly circular depressions, so-called Erosions. They are surrounded by a crimson border and are marked with a Fibrin layer (a protein found in the blood clotting system) covered. At this stage, the affected person experiences severe pain.

The changes in the mucous membrane occur mainly in the anterior and central areas of the oral cavity. At the same time there is a strong one on the entire oral mucosa Gingivitis (= Inflammation of the gums). The gums are fiery red, swollen and covered with a fibrin coating. This ensures the unpleasant bad breath, which is why the disease of herpetic gingivostomatitis is popularly known as Mouth rot referred to as.

The surrounding lymph nodes swell, are plump and hard and very painful to touch. Swallowing difficulties are also possible. The affected person has increased salivation and severe discomfort when brushing their teeth, as the swollen gums cause unpleasant pain every time they are touched. The symptoms, which initially develop rapidly within the oral cavity, usually subside within ten to fourteen days under bed rest and rest; in small children, the disease is often over after a week.

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Read on under: Course of the mouth rot

Forecast of oral rot

The "mouth rot" has a relapsing, very painful course, but usually subsides after two to a maximum of three weeks without any after-effects, without any scars remaining in the oral cavity or the like.

However, care must be taken to protect the body and not to overexert oneself to avoid complications such as myocarditis (Myocarditis) or inflammation of the brain and meninges in children (Meningoencephalitis) risking permanent damage. Furthermore, due to the risk of infecting the pathogen, physical contact should also be avoided until the disease is over.

incubation period

The incubation period of herpetic gingivostomatitis, i.e. the time it takes for a disease to develop from an infection to an outbreak, is four to six days.

Only after this time does the acute illness begin and the first symptoms appear. These include fever, Exhaustion, Vomit and strong Restlessness. Even Tendency to cramp as well as typical changes in the oral cavity with bad Bad breath, reinforced salivation and regional Lymph node swelling occur.

Duration

If the patients are already carriers of the herpes virus, there is often no outbreak of oral rot. However, if several factors, such as stress or other infections, come together in some, the disease breaks out suddenly. The disease progresses rapidly, after a fever painful mucosal defects follow. It reaches its peak after just 2-3 days. Then the healing phase begins, which lasts another 3 days. The duration of the illness should therefore not exceed 7-10 days.

treatment

Because mouth rot is a viral infection, treatment options are very limited and limited to symptomatic treatment. Oral rot is harmless, but since it is accompanied by moderate to severe attacks of fever and pain in the oral mucosa, it can be useful to treat the symptoms. Ibuprofen as a tablet (or juice for children) and paracetamol as a suppository have a fever lowering effect. In addition to reducing fever, these drugs also have an analgesic effect.
Furthermore, the pain in the oral mucosa can be treated with gargle and rinsing solutions. Painkillers effective locally on the mucous membrane in the form of numbing gels and creams can provide relief.
Drug therapy can be supported with chilled chamomile tea, water and milk.
In some cases the use of the antiviral drug can be avoided Acyclovir help fight the virus, but this is not always useful. The decision should always be made by the attending physician.

These drugs are used for mouth rot

Since the classic clinical picture of herpetic gingivostomatitis is the result of an infection with the herpes simplex virus type 1, drugs are used that fight the virus. This group of drugs is called Antivirals designated. The antivirals are only used if the patient's immune system cannot fight the virus on its own. This is a classic antiviral drug for herpetic gingivostomatitis Acyclovir.

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An additional antibiotic is only used if there is evidence of a bacterial superinfection, i.e. an infection with bacteria that is present in addition to the virus infection. In order to contain the accompanying symptoms, antipyretic drugs are still being prescribed. Classically, this includes pain relievers Paracetamol. Depending on the patient group and the doctor's instructions, the maximum dose should never be exceeded. If the pain is severe and persistent, stronger pain relievers, including opioids, may be prescribed.

Furthermore, should against the changes in the oral mucosa with a mouth rinse that Chlorhexidine digluconate at a concentration of 0.2% should be rinsed twice a day. The antibacterial and antiviral effect of the chlorhexidine digluconate ensures faster elimination of changes in the oral mucous membrane and faster regeneration of the oral flora. However, this application should not exceed two weeks.

It is important that the patient tries to clean thoroughly while doing oral hygiene despite the pain so that the symptoms do not get worse. After the "mouth rot" has regressed, the used toothbrush should be replaced with a new one. Furthermore, the affected person must keep strict bed rest and drink plenty of fluids during the illness. As food intake is very painful due to the swelling and reddening of the oral mucosa, oral gels with local anesthesia such as Dynexan or Xylocaine be used, which numb the oral cavity and thus make food intake more bearable.

Home remedies

There are numerous home remedies available, all of which are useful for treating the symptomatic of oral rot. To reduce fever, nettle tea should be drunk as a home remedy and regular calf wraps should be performed. The painful mucosal lesions can be treated well with anti-inflammatory gargle solutions such as chamomile solution.
For this, either chamomile tea or Kamillosan should be poured into a water glass and left to steep for 10-20 minutes. Afterwards, small sips should be held in the mouth for 30-40 seconds and rinsed. The chamomile ensures that the oral mucosa regenerates faster and is also less painful.

Read more on the topic: Home remedies for mouth rot

When do you need antibiotics?

Antibiotics are only needed if it is proven that a bacterial infection is present. This occurs very rarely, which is why antibiotics are rarely used. With a swab of the oral mucosa, the spectrum of germs and the causative agents of herpetic gingivostomatitis are identified in the laboratory and then treated in a targeted manner.

Homeopathy for mouth rot

In addition to conventional medical measures against oral rot and in addition to home remedies, there are also some homeopathic approaches that can also help reduce the symptomatic symptoms of this disease. Against high fever should Belladonna, obtained from the deadly nightshade. In homeopathic form, it is taken as globules. Ingestion should several times a day for about 5-7 days respectively.
First of all, it may generally become mild after taking homeopathic medication Initial deterioration come before there is improvement. Keep coming borax and Lachesis used in the symptomatic treatment of oral rot. Above all, they ensure that the mucous membrane defects in the mouth area heal and should lead to a reduction in pain.
Other homeopathic medicines for mouth rot are: Acidum muriadicum and Lycopodium. Both preparations are used for general defects and inflammations in the mouth area.

Schüßler salts against oral rot

Treatment with Schuessler salts, based on homeopathy, can also be used in the case of oral rot disease. When choosing the right Schuessler salt, great accuracy should be placed on the previous patient survey. So it is very important in addition to the beginning and duration of the disease also others Concomitant symptoms to inquire. If in addition to the mucosal lesions and the fever, other symptoms, such as Restlessness or insomnia occur, a different Schüßler salt can be used than if these symptoms are not present.
In the case of oral rot is predominantly Potassium Phosphoricum used. Of this should 3-6 tablets 3 times a day be taken. The intake should be taken over a period of approx. 1-2 weeks respectively. If there is no improvement, the duration of treatment can be extended by a week.

Herpetic gingivostomatitis

with the baby

Herpetic gingivostomatitis or "mouth rot" can occur in newborns. Here caution and direct therapy prevail, as the not yet well developed immune system poses the risk of herpes encephalitis and permanent brain and eye damage can result. It should be carefully observed that there is enough fluid intake and that there is still enough tearing and urine output to rule out dehydration.

In particularly severe cases, antivirals such as Acyclovir used to avoid complications and permanent damage. Anesthetic gels to facilitate food intake and antipyretic drugs as suppositories are also indicated. The pediatrician must determine the exact dosage.

Read more on the topic: Mouth rot in the baby

with the child

Children between two and four years of age are the primary age group with herpetic gingivostomatitis. As with all infectious diseases, an initial infection is relatively mild compared to an adult. In most children with an intact immune system, the "mouth rot" only lasts for a week and then goes away completely.

Learn more about the topic at: Mouth rot in children and toddlers

The herpes simplex virus is usually transmitted by the parents if the child is kissed when a cold sore breaks out or the cutlery and drinking glasses are shared. During the illness, care should be taken that spicy or particularly hot food and drinks are not given in order not to worsen the symptoms. In general, it is important that you drink enough fluids. In the case of children, there is a risk of dehydration due to the pain caused by refusing to drink.

Finger-sucking and nail biting should also be avoided, as otherwise there is a risk of nail bed infection. Cool foods and strict bed rest should be preferred.

Read more about this at: Inflammation of the nail bed on the finger

However, complications like this are feared in children Meningoencephalitis, inflammation of the brain and meninges. Meningoencephalitis occurs primarily in children who have already been weakened by previous infectious diseases such as measles or scarlet fever and whose immune system cannot fight the viruses sufficiently as a result.

in the adult

"Mouth rot" or herpetic gingivostomatitis can also occur in adulthood. As with all infectious diseases actually occurring in early childhood, initial infections as an adult can have a considerably more severe course as a consequence. Infection with type 1 of the herpes simplex virus occurs in adults primarily in patients whose immune system is down-regulated by drugs, such as after chemotherapy or in the case of HIV disease. The same applies to adults as to children. Strict bed rest and avoidance of physical contact with other people apply. You also have to drink a lot to avoid dehydration. Antipyretic drugs and antivirals may be prescribed by the doctor or dentist if symptoms are severe.

during pregnancy

It can happen that women develop mouth rot themselves during pregnancy. Most of the time, they were previously infected by one of their children who was sick themselves. Mouth rot is caused by the herpes virus that almost every second person carries. An outbreak during pregnancy is neither dangerous for the pregnant woman nor for the unborn child. Treatment with acyclovir is only required in the rarest of cases. It should also be borne in mind that healing through acyclovir can take almost as long as the body's own healing through its own immune system.
The symptomatic treatment of women is particularly important. If there is a fever during pregnancy, the fever should be reduced with paracetamol and not with ibuprofen. Chamomile or sage solutions can also help the painful lesions in the mouth area to heal faster and be less painful.

Canker sores in the mouth

The disease of "mouth rot" is earlier than Aphthous stomatitis because medicine at that time suspected a connection with chronically recurring canker sores. In the meantime it has been scientifically proven that chronically recurrent (recurring) canker sores have nothing to do with the disease of herpetic gingivostomatitis, which is why the earlier term is considered out of date and is no longer used. Aphthae have no viral cause and can therefore be clearly differentiated from "mouth rot"


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