Primary Herpetic Gingivostomatitis and Teething Difficulty

Resident: Adam J. Bottrill
Date: 26FEB10
Region: Providence
Article title: Herpetic gingivostomatitis and teething difficulty in infants
Author(s): King, David et. al.
Journal: Pediatric Dentistry
Page #s: pp. 82-85
Year: March/April 1992
Major topic: Primary herpetic gingivostomatitis (PHG)
Minor topic(s): Teething
Type of Article: Retrospective investigation

Main Purpose: The aim of this study was to determine whether PHG may be responsible for signs and symptoms commonly attributed to teething in infants.
Overview of method of research: Patient study and comparison. 20 infants with parental diagnosis of “teething difficulty.” 20 infants serving as controls.

Key points in the article discussion:

I. Oral swab obtained from the infants and processed to determine presence of HSV.
A. Temp and oral status recorded.
B. 9 subjects positive for HSV
C. 7 of 9 had temperature
D. All 9 had varying degrees of visible oral infection
E. Of the remaining 11, 5 had temperatures and none had visible infeciton (otitis media, vericella).
F. The control group was negative for HSV, temp AND visible infection.

II. Results: HSV should be included in differential Dx of patients with CC of “teething difficulty”
A. Finding of HSV “highly significant” in the DDX of teething difficulty.
B. 80-90% of adults have serum AB’s to HSV. Many don’t remember having it. This could be due to undiagnosed infant PHG.
C. Infants with teething difficulty should be more closely analyzed for PHG.

Assessment of article: Short and Sweet. Negative on the Shenanigans.