Herpes simplex
Herpes simplex infections
- These infections are best managed by symptomatic relief (i.e. nutritious diet, plenty of fluids, bed rest, use of analgesics and antimicrobial mouthwashes).
- Antimicrobial mouthwashes control plaque accumulation if toothbrushing is painful and also help to control secondary infection.
- Treat infections in immunocompromised patients and severe infections in non-immunocompromised patients with a systemic antiviral agent, the drug of choice being aciclovir.
- Give patients analgesics regularly to minimise oral discomfort.
- Refer immunocompromised patients with severe infection to hospital.
- Bell’s palsy is sometimes associated with herpes simplex; refer to a specialist or the patient’s general medical practitioner for treatment.
More about Herpes simplex infections
Primary herpetic gingivostomatitis [as a result of herpes simplex virus (HSV)] is best managed by symptomatic relief [i.e. nutritious diet, plenty of fluids, bed rest, use of analgesics and antimicrobial mouthwashes (either chlorhexidine or hydrogen peroxide)]. The use of antimicrobial mouthwashes controls plaque accumulation if toothbrushing is painful and also helps to control secondary infection in general.
Treat infections in immunocompromised patients and severe infections in non-immunocompromised patients with a systemic antiviral agent, the drug of choice being aciclovir. Give patients analgesics regularly to minimise oral discomfort; a topical benzydamine hydrochloride (oromucosal) spray might provide additional relief from oral discomfort and is particularly helpful in children. Refer immunocompromised patients (both adults and children) with severe infection to hospital.
Mild infection of the lips [herpes labialis (cold sores)] in non-immuncompromised patients is treated with a topical antiviral drug (aciclovir cream).
Bell’s palsy is sometimes associated with herpes simplex. Refer patients with Bell’s palsy to a specialist or the patient’s general medical practitioner for treatment.