Oral herpes - Cold Sores

Oral herpes is a viral infection, which occurs due to exposure to Herpes Simplex Virus (HSV). It is also known as Fever Blisters or Cold Sores.

Herpes affects individuals by contact with those who have been previously infected with this virus. It can also occur from self by spreading from one part of body to another. The main entry of virus is from broken skin/cuts/abrasions etc., but it can also occur due to exposure to body fluids such as saliva. This can be by:

  • Sharing eating utensils/drinking glasses or razors.
  • Kissing an infected person, or touching that person's saliva.
  • A parent who has a cold sore often spreads the infection to his child.
  • From one body part to another by cut skin.

Oral herpes can occur with varying symptoms based upon the age of patient and the type of attack. The first attack (primary exposure) can often be asymptomatic, but some patients, it can present with nonspecific symptoms such as:

  • Fever
  • Malaise
  • Swelling of gums
  • Oral ulcers

The primary infection often is seen in children. The virus once enters your body often stays for life. Often your body develops immunity against this virus. However, recurrent infections are estimated to occur in 15% to 40% of individuals harbouring latent virus. In these conditions, various trigger factors such as: sunlight, trauma, menstruation, fever, immunosuppression, and even irritation by dental instruments can trigger a secondary attack. In such situations, it can present as:

  • pain, burning, tingling, feeling of tauntness or itching prior to the clinical appearance.
  • Small blisters develop in clusters, usually along the skin of the nose and the lips.
  • The blister like lesions often fuse to form larger vesicles which subsequently ulcerate and form shallow ulcers with mild erythema.
  • Pain generally is present only within the first 2 days.
  • The ulcers heal with a characteristic brown encrustation of the lesion.
  • The fluid from the blister can be collected and stained for evaluation.
  • The fluid specimen is carefully obtained and transported to lab, for viral growth.
  • Blood investigation to note the development of immunity can also be done.

Unfortunately, currently no cure for HSV infection. However, often when the infection occurs, the aim is to reduce pain, prevent spread of infection and reduce the chances of multiple attacks. Often a topical antiviral agent can be prescribed by your dentist. This reduces the recurrence of the lesion and is believed to reduce the duration of infection.

  • Soft bland diet: prevent the burning and tingling sensation.
  • Keep hydrated: drinking lots of water can help manage systemic symptoms such as weakness.
  • Lip balms and lotions with a sun protective factor (SPF) of at least 15 are useful for preventing sun-induced infections.
  • It is important to understand that during presence of blisters, you are highly contagious. Avoid exchange of saliva, interpersonal use of razors etc. it is even advised not to undergo any dental treatment during the infection.

Last updated on 11 December, 2018.

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