Herpetic Stomatitis
Herpetic stomatitis is an acute infectious-inflammatory disease of the oral mucosa, caused by the herpes simplex virus type 1 (HSV-1) and, less frequently, type 2 (HSV-2). In clinical practice, a distinction is made between the primary acute form and the chronic recurrent form. It is one of the most common viral conditions in dentistry, requiring precise diagnosis and a comprehensive treatment approach to prevent frequent recurrences. At Corona Dental Clinic in Barcelona, we apply European protocols, digital diagnostics, and interdisciplinary solutions for this purpose.
Causes and Development Mechanism
The main pathogen is the herpes simplex virus (HSV), which persists for life in the nerve ganglia after primary contact. Primary infection most often occurs in childhood through contact-household or airborne routes. Virus reactivation and the development of recurrent stomatitis occur against a background of decreased systemic or local immunity. Key triggers:
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Immunosuppression: Recent acute respiratory viral infections (ARVI), hypothermia, chronic stress.
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Concomitant conditions: HIV, diabetes mellitus, autoimmune diseases.
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Local factors: Trauma to the mucosa, chronic foci of infection in the oral cavity (periodontitis, caries), avitaminosis (especially deficiency of B and C vitamins).
Symptoms and Clinical Picture
The disease progresses through several stages. After an incubation period (3-7 days), the prodromal phase begins with symptoms of general intoxication: malaise, fever up to 37.5-39°C, enlargement of the submandibular lymph nodes. A burning sensation and hyperemia appear on the mucosa. In the eruption phase, characteristic vesicles (blisters) 1-3 mm in diameter, filled with serous fluid, form. Within 1-2 days, these rupture, forming painful aphthae or erosions covered with a fibrinous grayish-white coating. Children often exhibit hypersalivation (excessive salivation) and refusal to eat or drink due to severe pain.
Diagnosis at Corona Dental Clinic
At our clinic in Barcelona, diagnosis goes beyond standard examination:
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Extended clinical examination with assessment of the condition of the entire mucosa and periodontium.
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Digital imaging: For differential diagnosis and identification of background pathologies, we use cone beam computed tomography (CBCT). It allows for detailed evaluation of bone tissue condition and identification of hidden foci of infection (cysts, granulomas) that can provoke recurrences.
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Laboratory diagnostics: In cases of frequent recurrences or atypical course, PCR analysis of a mucosal scraping for precise virus typing or ELISA blood test to assess immune response (IgG, IgM antibodies) is recommended.
Severity Levels
The treatment strategy directly depends on an objective assessment of severity:
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Mild degree: Up to 5-6 eruption elements, temperature up to 37.5°C, satisfactory general condition. Healing within 5-7 days.
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Moderate degree: 10-20 elements, temperature up to 38.5°C, marked lymphadenitis, symptoms of intoxication. Healing within 7-14 days.
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Severe degree: More than 20 confluent elements, temperature of 39-40°C, severe intoxication, risk of dehydration. Often requires active physician intervention. Healing may take up to 3 weeks.
Modern Treatment: European Approach
Treatment at Corona Dental is always a comprehensive protocol, in accordance with international standards:
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Systemic antiviral therapy: Prescription of medications based on valacyclovir or acyclovir according to an individualized regimen. Maximum effectiveness is achieved when intake is started within the first 48-72 hours.
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Local treatment:
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Pain relief: Application of modern anesthetic gels based on lidocaine/articaine.
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Antiseptic treatment: Rinses with chlorhexidine or miramistin solutions.
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Curettage and professional hygiene: Our hygienists perform gentle removal of plaque and tartar using ultrasound and the Air-Flow system, which is critical for eliminating infection foci.
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Stimulation of regeneration: Use of bioactive healing gels with hyaluronic acid and growth factors.
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Immunomodulatory and supportive therapy: Selection of immunocorrectors (e.g., based on recombinant interferon) and vitamin complexes.
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Treatment under sedation: For children or patients with dental phobia and extensive, painful lesions, we offer comfortable treatment in a state of medicated sleep.
Prevention of Recurrences
Our goal is not only to stop the exacerbation but to achieve stable remission. The preventive plan includes:
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Periodontal support: Regular professional hygiene cleanings to maintain mucosal health.
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Oral cavity sanitation: Elimination of all chronic infection foci (caries, periodontitis).
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Individual recommendations: Selection of home hygiene products, dietary correction.
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Vaccine prophylaxis: In cases of frequent recurrences, the possibility of administering a herpes vaccine is discussed.
Types of Herpetic Stomatitis
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Acute herpetic stomatitis (primary): Sudden onset, pronounced symptoms. More common in children.
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Chronic recurrent herpetic stomatitis: Repeated episodes (from 1-2 to 6 or more times per year) against a background of reduced immunity. Typical in adults.
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Atypical forms (ulceronecrotic, hemorrhagic): Occur in patients with marked immunodeficiency and require special attention.
Location of Eruptions in the Oral Cavity
For herpetic stomatitis, localization on the mucosa, closely attached to the periosteum, is characteristic:
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Typical zone ("herpetic triangle"): Gingival margin (gingival form), hard palate, dorsum of the tongue.
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Other areas: Inner surface of lips, cheeks, palatine arches.
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Generalized forms: In severe cases, eruptions can be generalized, affecting the entire mucosa, including the vermilion border of the lips.
If you experience symptoms of herpetic stomatitis, do not self-medicate. Schedule a consultation at Corona Dental in Barcelona by phone at +34 931 167 510 or +34 626 597 693. Our Spanish and Russian-speaking specialists will perform an accurate diagnosis and develop an effective treatment and prevention plan for you.
