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Intraoral Herpes And Its Ayurvedic Management

Intraoral Herpes And Its Ayurvedic Management

Introduction:

Intraoral herpes is a very common mouth infection caused by the Herpes simplex virus -1(HSV -1). It causes small, fluid-filled blisters to develop around or inside the lips or inside the mouth. These are commonly known as cold sores.

 

It is generally benign viral condition that produces painful and frequently unsightly sores. The virus may cause sores on the lips, bone-bearing tissues such as the gums and the roof of the mouth. After the first infection, the virus goes to becomes dormant in the nervous tissues in the face then it get reactivated by the triggering or causing factors and later cause the cold sores.

 

What are the causes of Intra oral herpes ?

  • Have close personal contact with someone who is infected. Touch something that is infected with the herpes virus, such as infected razors, towels, dishes, and other shared items
  • Parents may spread the virus to their children during regular daily activities.
  • Herpes virus type 2 (HSV-2) most often causes genital herpes. However, sometimes HSV-2 is spread to the mouth during oral sex, causing oral herpes.
  • The infection spreads to others by oral contact. In the presence of active sores, the virus is likely to be shed into saliva. So it is important to avoid oral contact like kissing, sharing food and drinks etc.
  • Individuals with an active herpetic sore or those who are recovering from an outbreak should avoid close contact with infants and those who are immune suppressed.

What are the sign and symptoms of Intra oral herpes ?

Some people get mouth ulcers when they first come into contact with HSV-1 virus. Others have no symptoms. Symptoms may be mild or severe. They often appear within 1 to 3 weeks after you come into contact with the virus and they may last up to 3 weeks.

  • Itching, burning or tingling sensation on the lips or skin around or inside the mouth.
  • Before blisters appear, you may have sore throat, fever, swollen glands or painful swallowing.
  • Appearance of a blisters or a rash on your gums, lips, mouth, throat or palate.
  • Many blisters are called an “outbreak.” You may have red blisters that break open and leak
  • Small blisters filled with clear yellowish fluid
  • Several smaller blisters that grow together into a large blister
  • A blister that gets yellow and crusty as it heals, eventually turning into pink skin

What are the triggering factors for Intra oral herpes ?

  • Menstruation or hormone changes
  • Being out in the sun and excessive heat.
  • Pain
  • Surgery
  • Fever
  • Irritants such as exposure to sun, wind and cold
  • Lack of sleep
  • Immunosuppressant
  • Stress whether emotional or physical

What are the investigations to diagnose Intra oral herpes ?

Diagnosis is primarily based on clinical findings considering history, location, and appearance of lesions. Further investigation is generally not needed.
For patients with atypical lesions or with suspected recurrent intraoral herpes, cytology evaluation, biopsy, and PCR assessment may be considered.

How to differentiate Intra oral herpes with Canker sore ?

Location: Intra oral herpes lesions form on firmly attached, keratinized oral tissues, called as bone-bearing surface, meaning that they’re tightly bound to the bone structure that lies underneath. In comparison, Canker sore form on loose, non-keratinized tissues of the mouth.
Reoccurrence: Intra oral herpes lesions usually reoccur at the same place, But for canker sore it is not the same sight, they can reoccur anywhere in the oral cavity.
Causes: Cause of canker sore is not clearly known, it can be triggered by stress, fatigue, hormones, or facial trauma. But in herpes it is surly HSV-1.
Nature: Herpes sores are contagious unlike canker sores, they are not contagious.

How to prevent outbreak or further spread of intra oral herpes ?

  • Patient education regarding the contagious nature of disease and limit personal contact while lesion is active, especially transfer of saliva and importance of meticulous hygiene.
  • Knowledge of triggers for lesion development and prophylactic treatment may be considered for patients if they are exposed to known triggers
  • Symptomatic relief like ice application or other recommended soothing this like coconut oil etc.
  • Avoid direct contact with herpes sores.
  • Wash items such as towels and linens in boiling hot water after each use.
  • Do not share utensils, straws, glasses, or other items if someone has oral herpes.
  • Avoid hot beverages, spicy and salty foods, and citrus.
  • Gargle with cool water very often.
  • Do not have oral sex if you have oral herpes, especially if you have blisters. You can spread the virus to the genitals. Both oral and genital herpes viruses can sometimes be spread even when you do not have mouth sores or blisters.

What is Ayurvedic Treatment for Intra oral Herpes ?

Now a day lifestyle is drastically changed. Due to increased pollution,Fast life style, junk food habit and addictions problems of oral health are arising progressively. Therefore there are increased problems regarding bad oral hygiene. The lakshanas (sign & symptoms) of Mukhapaka can be co-related with Intra oral herpes explained in modern medical science.
Mukhapaka is a condition characterized by vedana (pain) & shopha (inflammation) yukta vrana (wound or ulcer) in the mukha guha pratyangas (oral cavity).

Hance Mukhapaka can be correlated with a disease entity intra oral herpes, in which ulcers are very common with recurrent episodes.

Charak, Sushrut & Madhav nidan has told 3 types of mouth ulcer and vagvata has explained 5 types according to dosha involvement as below :

  1. Vataja Mukhapaka
  2. Pittaja Mukhapaka
  3. Kaphaja Mukhapaka Vaghbata
  4. Raktaja
  5. Sannipataja mukhapaka.

Pathophysiology may be explained as follow : due to the causative factor dosha get vitiated and get lodged in to the dhatus (tissues) at oral cavity and produce ulcers or sores.

Line of treatment in mouth sores:

  • Incase of acute conditions Shamana line of treatment is followed.
  • Incase of its chronic condition Shodhana is recommended.
  • Third line of treatment in Rasayana to strengthen the immune system.

Shamna ( palliative treatment ): . In recent originated and mild mouth ulcers, local applications and coolants (Sheetala dravya prayoga) are suggested.
Mouth gargling (gandusha) and oral medicaments (kavala) yield considerable results in healing of sores. Reduce the inlamation by local applications of kalkas (pastes) made up of coconut oil , butter, neem, chandna, daruhaldi, khadira, Madhu , Yastimadu, tila etc.Also with the oral herbal supplements like, Amla, Tulsi , Guduchi, Neem Shalaki , Mulethi etc

Shodhna ( purificatory treatment ):In the severity of mouth ulcers and in its chronic condition Shodhana (purificatory therapy) is recommended. Body is prepared for panchkarma therapies and complete detoxification is performed for achieving the dosha balance and removing the toxins from the body.

Rasayana (Rejuvenation): Reduced immunity, leading to recurrent episodes of mouth ulcers. Ayurvedic rejuvenation treatment is administered with medicines like , Giloy, Brahma Rasayana, Amalaki Rasayana etc.This boosts the immune system and disease can be managed in the dormant state only

A Few pictures of healed sores of Intra Oral herpes :

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