• Reassure the individual or parent that gingivostomatitis (inflammation of the gums and mucous membranes of the mouth) is self limiting.
• Treat symptomatically:
• Offer paracetamol or ibuprofen to relieve pain and fever.
• Encourage adequate fluid intake to avoid dehydration.
• Consider offering topical benzydamine for additional pain relief.
• Offer chlorhexidine mouthwash to help control secondary infections and to control plaque accumulation if brushing of teeth is painful.
• The use of a lip barrier preparation (e.g. Vaseline^®, Lypsyl^®) may be useful to prevent lip adhesion.
• Provide advice to minimize transmission:
• Avoid touching the lesions, other than when applying medication.
• Wash hands with soap and water immediately after touching lesions.
• Avoid kissing until the lesions have completely healed.
• Do not share items that come into contact with lesion area (e.g. lipstick or lip gloss).
• Avoid oral sex until all lesions are completely healed.
• Children with gingivostomatitis who are generally well do not need to be excluded from nurseries and schools.
• Consider oral antivirals for immunocompetent individuals with severe gingivostomatitis. The optimum timing and dose of oral antiviral treatment are uncertain. Consider seeking specialist advice before prescribing.
• Seek specialist advice if:
• Symptoms are not improving after 5 days.
• The affected person is pregnant, a neonate, or is immunocompromised.
• Admit the person if they have difficulty drinking and are at risk of becoming dehydrated. Intravenous fluids may be required.

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