Viral stomatitis: what it is, symptoms, and how it differs from other conditions

You've noticed painful blisters or sores in your mouth — and your first thought is: what is this, anyway. Viral stomatitis is indeed one of the common causes, but far from the only one. Let's calmly, without panic, sort out what is happening and when it's time to see a doctor.

What viral stomatitis is

Stomatitis is inflammation of the oral cavity and lips. It may include redness of the mucosa and cause single or multiple ulcers. Sores appear on the mucosa, on the gums, or on the lips; sometimes dry mouth and sensitivity of the soft tissues are added.

The mechanism is not fully understood. Most likely, the immune system reacts to molecules it cannot recognize, and lymphocytes attack the area of the mucosa. Local factors cited include oral hygiene and gastrointestinal diseases — gastritis, duodenitis, colitis.

Stomatitis itself is not contagious. But the cause that triggered it may be contagious: with herpes, stomatitis occurs as a consequence of the reaction to the herpes simplex virus. The incubation period is 2 to 4 days.

Herpetic stomatitis and the herpes virus: how they are related

Herpes simplex virus comes in two types. HSV-1 most often causes eruptions around the mouth and on the face; HSV-2 usually causes genital herpes but can also affect the oral cavity. The virus is transmitted through direct contact, and some people have no symptoms at all.

In others, itchy and painful blisters appear at the site where the virus entered, then they heal. In most people, flare-ups occur several times a year, becoming less frequent over time.

Herpetic stomatitis is recognized by a sharp rise in temperature and drowsiness; blisters appear on the oral mucosa and rupture after about 3 days. The picture is accompanied by gingivitis and viscous saliva, and the illness lasts about 8 days.

Main symptoms of viral stomatitis in adults

Adults experience such eruptions differently: some notice only a sore, others react with fever. What may be part of the picture:

• blisters and sores on the mucosa of the cheeks, tongue, gums, or lips;
• pain and sensitivity when eating and talking;
• redness and swelling of the mucosa, white or yellow coating;
• increased salivation, sometimes dry mouth and bad breath;
• rise in temperature and drowsiness in the herpetic form.

Ordinary mouth ulcers are not contagious, and they are confused with cold sores. A cold sore appears on the lips or around the mouth, often starting with tingling, itching, or burning. Sometimes it looks like a cluster of small pinhead-sized sores inside the mouth.

Vesicular stomatitis and herpetic stomatitis: what the difference is

Vesicular stomatitis is caused by an RNA-containing virus of the genus Vesiculorus, family Rhabdoviridae. Vesicular stomatitis is contagious. A separate variety is enteroviral vesicular stomatitis, caused by enteroviruses.

In herpetic stomatitis, the disease is accompanied by gingivitis, that is, inflammation of the gums, and viscous saliva.

How a doctor makes the diagnosis

First the doctor reviews the medical record and asks questions, then examines the oral cavity. There are no separate tests such as biopsy or culture to identify stomatitis. What matters most is the appearance of the ulcers, their location, and the fact that the condition recurs.

A clue: the tissue around the ulcer usually looks normal, and there are no pronounced general symptoms — neither high temperature nor feeling unwell. In advanced forms, especially in children, there may be multiple ulcers, fever, and deterioration of the condition.

Possible complications and when to see a doctor

In people with weakened immunity, a secondary infection may set in. The virus itself is dangerous for newborns and for those whose immunity is reduced.

Ordinary ulcers resolve within one to two weeks. You should see a dentist or doctor if an ulcer persists longer than 3 weeks, looks different from previous ones, has become larger or moved closer to the back of the throat, bleeds, reddens, and hurts more — this may be a sign of infection. A long-healing ulcer is sometimes a sign of oral cancer.

A separate reason is ulcers not only in the mouth but also on the skin or genitals, as well as painful, red, or swollen joints. Multiple ulcers occur in hand-foot-and-mouth disease with a rash on the hands and feet, lichen planus, Crohn's disease, and celiac disease.

Viral stomatitis by itself is not a reason to call an ambulance; 103/112 — for a life-threatening condition (for example, signs of stroke or heart attack, severe shortness of breath, loss of consciousness).

This material is for reference: it helps you understand what is happening, but does not replace a doctor's consultation — you will still need to show your mouth to a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer