Article Type : Opinion Article
Authors : Luciana de BCF, dos Santos LCB, do Nascimento ZR, da Cruz AP, da Silva IB, de Santana LMB, Marques KMG, de Lima NS and Maria da Conceicao de BC
Keywords : Herpes simplex, Comprehensive health care,Pediatric dentistry
This
opinion piece is based on experiences during activities at the comprehensive
children's clinics of the UFPE Dentistry Course between 2022 and 2025. With
approximately 832 children up to 9 years of age receiving care, cases of herpes
simplex on the lips and inside the mouth appear to be on the rise. The
difficulty lies in controlling the recurrence of painful symptoms and the
general condition of these children. Possibilities arise here that need to be
properly proven with studies that provide robust evidence. However, there
remains the question of how the immunity of this target audience is doing and
the responsibility of the dental surgeon in the face of this painful,
uncomfortable condition, which can result in greater complications for the
quality of life of this target audience in certain associated contexts. And,
thus, enable strategies in this context.
Herpesviruses,
members of the Herpesviridae family, are double-stranded DNA viruses with a
distinct four-layered structure: a DNA core, an icosahedral capsid, a tegument,
and a lipid bilayer envelope with glycoproteins. Among the more than 200
herpesvirus species, eight affect humans, including herpes simplex virus (HSV)
1 or 2 and varicella-zoster (VZV), which leads to chickenpox as the initial
infection and subsequently to herpes zoster [1]. These viruses are
capable of infecting a wide range of cell types, but they typically establish
latent infections in specific tissues or cells, which can reactivate under
certain conditions, such as stress, fever, trauma, or immune system changes
[1,2]. HSV-1
is highly infectious, with most individuals being exposed to the virus at some
point in their lives, leading to lifelong latency. It is transmitted by direct
contact with lesions or bodily fluids like saliva or genital secretions. Viral
shedding rates are higher in immunocompromised individuals and during the prodromal
stages of infection [2,3]. Oral herpes virus is a very common and often
debilitating infectious disease for patients, affecting oral health and having
important psychological implications. It manifests as primary herpetic
gingivostomatitis (PHGS) in 13-30% of cases, with painful blisters (vesicles)
in the mouth, lips, gums, fever, irritability, excessive salivation, difficulty
eating or drinking, and is common between the ages of 1 and 5. In newborns, the
signs are more severe, such as convulsions, breathing difficulties, jaundice
and lethargy; requiring immediate medical attention and occasionally requiring
hospitalization [2-4]. This opinion piece is justified from the observation of
a growing number of children treated at a dental teaching clinic in the city of
Recife, in north-eastern Brazil, presenting signs and symptoms related to
herpes simplex, with a confirmed diagnosis. This was particularly relevant
between 2023 and 2025, associated with rapidly progressing debilitating
conditions and the need for hospital care. The group of individuals comprised
children up to nine years of age, with the condition observed in both
preschool-aged children (?5 years) and school-aged children (6–9 years). In
addition to signs and symptoms often associated with these viruses, acute
abscesses and cellulitis were observed, with simultaneous involvement of the
upper airways. Surveys have been conducted in search of scientific evidence
that can map these conditions and lead to increased immunity in these children
and a better quality of life.