Infectious Mononucleosis, often called “mono,” is a common illness typically caused by the Epstein-Barr Virus (EBV). This viral infection is systemic, affecting the entire body, and is known for symptoms like profound fatigue and fever. Although the primary signs of mono are systemic, the infection can significantly affect the oral cavity, sometimes causing swollen gums.
Mononucleosis and Related Oral Symptoms
Swollen gums (gingivitis) are not a direct symptom of the Epstein-Barr Virus (EBV) itself, but they are a frequent associated symptom arising from the body’s reaction to the infection. The virus targets and infects B-lymphocytes, leading to a massive systemic inflammatory response. This inflammation often exacerbates pre-existing gum irritation, causing noticeable swelling.
The most common oral manifestations involve the throat and tonsils. Patients often experience severe pharyngitis and significant tonsillitis. Less frequently, small red or purple spots (petechiae) may appear on the soft palate. Gum swelling is usually a secondary consequence, tied to the overall physical stress and inflammatory state of the illness rather than a direct viral attack. Studies have detected EBV DNA in gingivitis and periodontitis lesions, suggesting a possible role in their severity.
Secondary Infections and Immune Response
The mechanism behind gum swelling is tied to the temporary stress mononucleosis places on the immune system. When EBV infects B-lymphocytes, the immune system mobilizes T-cells to control the infection, overwhelming the body’s defenses. This intense focus on the systemic viral threat creates an opportunity for opportunistic pathogens to thrive.
The mouth hosts a complex mix of bacteria. When immune surveillance is compromised, this oral flora can multiply unchecked. This imbalance allows bacteria responsible for gum disease, particularly periodontopathic anaerobic bacteria, to rapidly increase. Their unchecked growth leads to acute inflammation and noticeable gum tissue swelling. This secondary bacterial infection, not the virus itself, is the direct cause of swollen, red, and sometimes bleeding gums experienced during mono recovery.
Managing Gum Swelling and Oral Discomfort
Management focuses on supportive care and gentle oral hygiene to control the secondary bacterial infection. Maintain a consistent routine of brushing with a soft-bristled toothbrush and continue flossing gently to remove plaque.
Rinsing the mouth several times daily with a warm saltwater solution can help soothe inflamed gums. Adequate hydration and avoiding irritants like spicy foods, acidic beverages, and tobacco products are also recommended to reduce discomfort. If swelling is severe, causes difficulty eating, is accompanied by pus, or persists after other mono symptoms resolve, professional consultation is necessary. A dentist or physician can assess if targeted therapy, such as a medicated mouthwash, is required.