Shingles in the mouth is also called oral herpes zoster or oral shingles.
It is a less common manifestation of shingles that causes an outbreak of blisters in the mouth.
Symptoms of oral shingles include pain, tingling or burning sensations, and blisters that turn into ulcers.
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These ulcerous lesions usually heal within 1014 days.
Shingles is typically treated with antiviral drugs to reduce the duration and severity of the outbreak.
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Once you are infected with VZV, the virus will remain in a dormant state unless reactivated.
If reactivation occurs, the outbreak will be limited to the affected nerve branch, referred to as thedermatome.
The vast majority of cases will be unilateral, meaning limited to one side of the body.
The blisters start as tiny bumps, typically in dense clusters, that quickly transform into painful blisters.
The area of involvement will be clearly defined on either one side of the face or the other.
Shingle blisters can easily rupture and lead tocanker-like soresthat consolidate into larger pitted lesions.
Postherpetic neuralgia may be short-lived and gradually resolve over the course of weeks or months.
What Triggers Shingles in the Mouth?
Shingles only develops in people who have had chickenpox.
Therisk factors for shinglesare many, including:
Advanced age is arguably the single greatest risk factor for shingles.
By age 85, the lifetime risk is no less than 50%.
Although more common in older individuals, shingles does affect people under 50.
It is unknown why some people develop it and others don’t.
This is especially true for oral shingles.
Is Oral Shingles Contagious?
Oral shingles is contagious.
Shingles can only be spread by direct contact with the blisters.
Avoid sharing food or drink and kissing until your blisters have healed.
Early treatment can help shorten the length of the illness and minimize symptoms.
Should I Go to the Dentist With Shingles?
Once the lesions and/or rash have developed a crust, transmission is no longer an issue.
Your mouth will be checked for inflammation and blisters.
Blisters that appear on one side of your mouth can indicate shingles.
You may undergo a full physical exam for signs of shingles elsewhere on your body.
Your healthcare provider may swab the blisters in your mouth forpolymerase chain reaction (PCR)testing.
This test looks for the DNA of the varicella-zoster virus.
There are also blood tests that can detect VZVantibodies.
What Can Be Mistaken for Oral Shingles?
Symptoms include:
What Is the Treatment for Oral Shingles?
The early treatment of oral shingles is key to reducing the severity and duration of an outbreak.
Antiviral Therapy
Shingles is primarily treated withantiviral drugs.
After 72 hours, the benefits of therapy are low.
Some studies have suggested that Valtrex is able to resolve shingles pain even faster than Zovirax.
These are referred to as adjuvant therapies.
Among them, oral corticosteroids likeprednisoneare sometimes prescribed to reduceinflammationand aid with healing.
This may involve OTC painkillers or stronger prescription drugs.
Topical oral anesthetics can also be applied to the sores for short-term pain relief.
This includes OTC and prescription options such as Xylocaine (2% lidocaine hydrochloride) gel.
Alcohol-free antibacterial mouthwashes may not only reduce the risk of bacterial infection but help relieve mouth pain.
In addition to oral care,quitting smokingwill help ease pain and speed healing.
Good oral hygiene further reduces the risk of a secondary bacterial infection.
What Can I Eat?
Eat amechanical soft food dietuntil your blisters have healed and are no longer causing pain.
Recovery
Shingles outbreaks can take up to five weeks to fully resolve.
With the early initiation of antiviral therapy and the appropriate supportive care, resolution times can be cut significantly.
If antivirals are started within 72 hours of an outbreak, the time can be cut to two days.
Moreover, the severity and duration of the outbreak can be reduced.
Age (rather than treatment) comes off as the single most influential risk factor.
Shingrix is recommended for all adults 50 and over.
When used as prescribed, the two-dose Shingrix vaccine can reduce the risk of shingles by 91.3%.
Summary
Oral shingles pops up if the dormant varicella-zoster virus reactivates in the body.
When it affects the mouth, it causes painful blisters.
The blisters may also cause tingling or burning and may make it difficult to eat.
Because symptoms may be mistaken for other diseases, the window of opportunity for treatment may be missed.
Oral shingles is usually diagnosed with a physical exam and tests such as a swab or blood test.
Treatment may include antiviral therapy and oral care.
Shingles can be prevented with two doses of a vaccine called Shingrix.
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