According to the American Social Health Association (ASHA), oral herpes affects between 50 and 80 percent of the adult population in the United States. One-third of those people experience periodic recurrences of about one to six episodes per year. Although most people are familiar with symptoms of herpes on and outside the mouth, fewer people are aware that herpes can also cause symptoms inside the mouth.
Pharyngitis
Pharyngitis, or inflammation of the throat, is a common occurrence during the first outbreak of herpes, according to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine"; however, it can sometimes occur during subsequent episodes, especially in people with immune system problems. Symptoms of herpes pharyngitis include sore throat, problems with swallowing and/or inability to eat. Herpes pharyngitis can be caused by "exudative" or "ulcerative" herpes lesions. Exudative pharyngitis is characterized by blisters similar to those seen on the skin while ulcerative pharyngitis is characterized by shallow, clearly-defined "punched-out" lesions. These lesions can affect the back of the throat and the tonsils. Clinically, they may be difficult to differentiate from bacterial and other nonbacterial causes of pharyngitis. Sometimes, especially with ulcerative lesions, herpes pharyngitis can lead to bacterial pharyngitis when lesions become infected by bacteria in the mouth and throat.
Gingivostomatitis
The term gingivostomatitis describes inflammation of the gums (gingiva) and inside the mouth (stoma). In herpes gingivostomatitis, the previously described exudative or ulcerative lesions appear on the hard and soft palate, tongue, gums and lining of the cheeks. In one-third of people, notes Dr. Corey, gingivostomatitis appears after pharyngitis. As with pharyngitis, gingivostomatitis is usually associated with the initial outbreak. However, according to a 2008 report in the "Archives of Internal Medicine," 5 percent of people routinely develop hard palate lesions during recurrent outbreaks.
Bell's Palsy
Occasionally, according to "Harrison's Principles of Internal Medicine," the herpes virus infects the branches of the facial nerves that supply the mouth, producing a syndrome known as Bell's Palsy. Symptoms of Bell's Palsy, notes the National Institute of Neurological Disorders and Stroke, include twitching, weakness or paralysis on one or both sides of the face, drooping of the eyelid and corner of the mouth, drooling, dryness of the eye or mouth, impairment of taste and excessive tearing in one eye. Not everyone will have all of these symptoms. Exact symptoms vary from person to person and range in severity from mild weakness to total paralysis. Symptoms are usually at their worst about 48 hours after onset and may cause significant facial distortion. In most cases, they resolve without treatment, although it may take time. Most people see improvements after two weeks; however, complete recovery, advises MedlinePlus, may take three to six months.
References
- American Social Health Association: Learn About Herpes - Oral Herpes
- Herpes Simplex Viruses; L. Corey; In: "Harrison's Principles of Internal Medicine, 17th edition"; A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson, and J. Loscalzo (Eds); 2008
- The Treatment of Herpes Simplex: An Evidence-Based Review; In: "Archives of Internal Medicine"; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
