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Can you name one thing
almost everyone reading
this note have in common?
Answer: A history of a herpes simplex
a cold sore, and is seen typically in older Treatment is usually palliative.
Caring for this dilemma involves treating We in pediatric dentistry see the age group The primary infection typically has an incuba- the symptoms. Over the counter pain/anti- tion period of 2-12 days. Usually a fever inflammatory/anti-pyretic medications can and sore throat along with small vesicle help the discomfort and lower an elevated sees children has run across this malady. temperature. Rinsing with a compounded formula of 50/50 Benadryl and Maalox 2-3 times a day can help sooth the oral One must always keep in mind that this is a contagious lesions. The topical effect of the Benadryl is enhanced by the Maalox which coats and condition. With both primary and secondary presentations. adheres to the mucosal tissue. Some text-books recommend adding viscous lidocaine The typical patient for a primary infection mucosa marks the beginning. The vesicles to the mixture, but you must be careful of is young, around 3 years old and presents ulcerate rapidly and can increase in numbers with a fairly typical clinical appearance. But to involve the soft palate, tongue and floor of the mouth. Gingival tissue may bleed. not brush well due to the ulcerated oral Inflammation of lymph nodes and a general mucosa, rinsing with liquid chlorhexidine (Peridex) 2-3 times a day can substitute virus. The oral infection is commonly asso- cal time of clinical expression is 10-14 days. for brushing for the short term. Typically ciated the HSV1 variety. Primary herpetic Swollen salivary glands are slower to resolve. gingivostomatitis is the initial infection Parents usually will tell you there is great which can range from sub-clinical to fairly difficulty in eating, carry a temperature and tient hydrated. Caregivers should encour- significant in severity. Secondary herpes is a their children have a hard time sleeping. age fluids as much as possible. Popsicles local reactivation of the virus that produces or ice cubes can aid in comfort and help www.kitsapdfc.com
provide some oral liquid. Once a patient ibuprofen or acetaminophen, keep the oral catch up, especially with a sick child. If de- area clean and comfortable, follow up for hydration is apparent or the symptoms do resolution of the infection. Normally we not resolve, IV fluids and further diagnostic tell parents to expect a 10-14 day course. Office Locations
The gift that keeps on giving.
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One must always keep in mind that this is 1425 NE Franklin Ave.
a contagious condition. With both primary For any inquiry on this topic or any patient and secondary presentations, the blisters Bremerton, WA 98311
and ulcers are sources for viral shedding. Phone: (360) 377-3844
Do not share utensil’s, wash hands fre- Fax: (360) 377-2148
quently, and keep the child from rubbing You can review this discussion archived on their eyes after fingers of hands have been our web site as well as view other pediat- Port Orchard
1931 Pottery Ave.
Hydration, medication, re-evaluation.
Port Orchard, WA 98366
Manage the patient by encouraging fluids, Phone: (360) 876-9507
www.kitsapdfc.com
Dentistry for Children
Dr. Michael Becker, Dr. Katrina Hays, & Dr. Jeff Hays 1425 NE Franklin Ave., Bremerton, WA 98311 Phone: (360) 377-3844 • Fax: (360) 377-2148 www.kitsapdfc.com

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