Commonly Occurring Viral Diseases

Dental clinicians need to be aware of possible viral diseases, how they are manifested, and how they can be spread. Updated information on some of the common types is discussed in the article “Spreading the Facts on Viral Diseases” in the Journal of Practical Hygiene. Herpes Simplex (primary herpetic gingivostomatitis) usually occurs in children from ages 6 months to 6 years. The tongue, gingiva, lips, and oral mucosa are generally affected with painful ulcers. Swallowing may be difficult, fever may be present, and lymph nodes may be swollen. Rest and liquids, pain medication, and antiviral therapy are the usual courses of treatment for this infection. Recurrent oral herpes simplex (cold sore/fever blister) will occur on the vermillion border of the lips and will stay contagious until crusting of the lesion has completed. Causes for this viral infection are stress, anxiety, fatigue, hormones, and trauma. Sunscreen can help prevent outbreaks, and frequent hand washing reduces the spread of the disease. Topical treatment now comes in the form of Abreva and Herpecin-L. While recurrent oral herpes is generally extraoral, intraoral lesions can occur on the hard palate and gingiva. The disease will usually run its course in 7 to 10 days. However, if necessary, antiviral therapy with acyclovir may help with treatment. 

Another virus, which presents similarly to the herpes simplex, is the coxsackievirus, which is responsible for herpangina and hand, foot, and mouth disease. Both are milder than herpes simplex, although herpangina presents intraorally on the soft palate with fever, sore throat, and difficulty swallowing. Hand, foot, and mouth disease presents with ulcers on the tongue and in the mouth, skin lesions on the hands and feet with sore throat, fever, and difficulty swallowing. Both of these diseases may last 7 to 10 days, and generally, management of fever and pain can be accomplished with ibuprofen or acetaminophen. The human papilloma virus manifests as a condyloma acminatum. When this lesion occurs in the oral cavity, contact must have been made with a genital lesion. Oral condylomas present as pink, broad masses with finger-like projections (think raspberry). Due to the infectious nature of this lesion, surgical excision is necessary to reduce the chances of spreading the disease. Be aware that when this lesion occurs in children, possible sexual abuse may have occurred.