Table of ContentsView AllTable of ContentsSymptomsCausesWhen to Seek Medical CareDiagnosisTreatmentRecoveryPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
When to Seek Medical Care
Diagnosis
Treatment
Recovery
Prevention
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. These ulcerous lesions usually heal within 10–14 days.
Shingles is typically treated with antiviral drugs to reduce the duration and severity of the outbreak. Treatment for oral shingles includes over-the-counter (OTC) painkillers, topical anesthetics, and soothing mouthwashes to ease the pain.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from ©DermNet NZ www.dermnetnz.org 2022
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from ©DermNet NZ www.dermnetnz.org 2022
Chickenpox and Shingles
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.
Symptoms of Oral Shingles
With oral shingles, the reactivation of VZV occurs along a branch of thetrigeminal nerve—either the mandibular nerve that services the lower jaw or the maxillary nerve that services the upper jaw.
Symptoms of oral shingles develop in distinct stages known as the prodromal phase, the acute eruptive phase, and the chronic phase.
Prodromal Phase
The prodromal (pre-eruptive) phase of shingles is the period just before the appearance of blisters. It can last for one to five days, causing nonspecific symptoms that are often hard to recognize as shingles, including:
These symptoms are frequently misdiagnosed as a toothache.
Acute Eruptive Phase
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.
If the eruption occurs along the mandibular nerve, the tongue or gums of the lower teeth can be affected. If it occurs along the maxillary nerve, blisters can develop on the palate and gums of the upper teeth.
In addition to the interior of the mouth, it is not uncommon for blisters to form on the skin of the face, either around the cheek or one side of the jaw.
Shingle blisters can easily rupture and lead tocanker-like soresthat consolidate into larger pitted lesions. During the acute eruptive phase, symptoms can include:
Unlike shingles of the skin, which can crust over and dry once the blisters erupt, the moist environment of the mouth does not allow the oral blisters to dry.
Instead, the ruptured blisters can form moist ulcers that are slow to heal and vulnerable to bacterial infection (includingherpeticgingivostomatitis).
If not treated properly, an infection can lead to severeperiodontitis(gum disease),osteonecrosis(bone death), and tooth loss.
The acute eruptive phase can last two to four weeks and is the period during which the virus is mostcontagiousfor people who’ve never had chickenpox.People who contract the virus from someone with shingles will develop chickenpox, not shingles.
Chronic Phase
The chronic phase is the period during which the blisters have largely healed, but pain can continue. The pain, referred to aspostherpetic neuralgia, can be chronic or recurrent and may include:
The types of sensations can vary and may worsen with jaw movement (such as chewing).
Postherpetic neuralgia may be short-lived and gradually resolve over the course of weeks or months. If the nerve damage is severe, the pain can continue for far longer and even become permanent and disabling.
Between 10% and 18% of people over age 60 who get shingles will develop postherpetic neuralgia, the risk of which increases with age.Generally, less than 2% of people under age 60 who get shingles develop postherpetic neuralgia.
What Causes a Ranula (Cyst Under the Tongue) and How Is It Treated?
What Triggers Shingles in the Mouth?
Shingles only develops in people who have had chickenpox. When a person gets chickenpox, the immune system is able to eradicate the virus from all but isolated nerve clusters called ganglia. If the immune system is intact, it can keep the virus in a state of latency (dormancy) for decades.
Shingles represents a breach in the body’s immune defense during which the virus can spontaneously reactivate and cause disease. Therisk factors for shinglesare many, including:
Advanced age is arguably the single greatest risk factor for shingles. While the lifetime risk hovers between 20% and 30%, the risk increases dramatically after the age of 50. 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. Some studies suggest that males are 70% more likely to get oral shingles than females, although it is unclear why.
Is Oral Shingles Contagious?
Oral shingles is contagious. If you have any type of shingles, you can transmit chickenpox to someone who is not vaccinated or has never had the disease.
When to See a Healthcare Provider
Contact your healthcare provider if you have:
If you suspect you have shingles, it’s important to seek treatment right away. Early treatment can help shorten the length of the illness and minimize symptoms.
Should I Go to the Dentist With Shingles?People with a shingles outbreak (oral or anywhere on the body) should postpone cleanings or other dental work if possible. Once the lesions and/or rash have developed a crust, transmission is no longer an issue.
Should I Go to the Dentist With Shingles?
People with a shingles outbreak (oral or anywhere on the body) should postpone cleanings or other dental work if possible. Once the lesions and/or rash have developed a crust, transmission is no longer an issue.
To diagnose oral shingles, Your healthcare provider will take your medical history, including whether you have been vaccinated for shingles, and ask you about pain and other symptoms.
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 suspect shingles if you are older and don’t have a history of sores in the mouth.
Oral Shingles vs. Other Oral BlistersWhat differentiates oral shingles from other mouth sores is the location of the blisters, the dense clustering of tiny blisters, the severity of pain, and the scalloped edges of the open ulcers.Because oral shingles typically involves only one side of the mouth, this helps to distinguish it from other oral blistering conditions (e.g.,oral herpes).
Oral Shingles vs. Other Oral Blisters
What differentiates oral shingles from other mouth sores is the location of the blisters, the dense clustering of tiny blisters, the severity of pain, and the scalloped edges of the open ulcers.Because oral shingles typically involves only one side of the mouth, this helps to distinguish it from other oral blistering conditions (e.g.,oral herpes).
What differentiates oral shingles from other mouth sores is the location of the blisters, the dense clustering of tiny blisters, the severity of pain, and the scalloped edges of the open ulcers.
Because oral shingles typically involves only one side of the mouth, this helps to distinguish it from other oral blistering conditions (e.g.,oral herpes).
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?
Oral shingles can be mistaken for other diseases, including:
Shingles in the Throat and EsophagusIn addition to shingles lesions in the mouth, oralshinglescan affect the throat and esophagus. Symptoms include:Blistering and rednessSevere sore throat/painful swallowingPain that may extend to the jaw and earAn altered sense of tasteEnlarged lymph nodes in the neck
Shingles in the Throat and Esophagus
In addition to shingles lesions in the mouth, oralshinglescan affect the throat and esophagus. Symptoms include:Blistering and rednessSevere sore throat/painful swallowingPain that may extend to the jaw and earAn altered sense of tasteEnlarged lymph nodes in the neck
In addition to shingles lesions in the mouth, oralshinglescan affect the throat and esophagus. 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. Compared tooral herpes, oral shingles is treated much more aggressively due to the risk of postherpetic neuralgia and other complications.
Antiviral Therapy
Shingles is primarily treated withantiviral drugs. Therapy is ideally begun within 72 hours of an outbreak using one of three oral antivirals: Zovirax (acyclovir), Valtrex (valacyclovir), and famciclovir. 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.
Adjunctive Therapy
In addition to antiviral drugs, there are other drugs used to support the treatment of oral shingles. These are referred to as adjuvant therapies.
Among them, oral corticosteroids likeprednisoneare sometimes prescribed to reduceinflammationand aid with healing. These are generally only considered if the pain is severe, and they are never used on their own without antiviral drugs.
Oral shingles is also commonly treated with analgesics and other pain medications depending on the severity of the mouth pain. 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.
How to Speed Healing
You can do other things at home to aid with the healing of oral shingles and reduce the risk of complications.
Alcohol-free antibacterial mouthwashes may not only reduce the risk of bacterial infection but help relieve mouth pain. These include OTC mouthwashes containing benzydamine hydrochloride, such as Oral-B Mouth Sore Special Care.Those containing menthol (like Listerine) also appear to help.
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.
Some examples of foods that may be easier to eat when you have shingles in the mouth include:
Stick with foods that are cold or lukewarm and avoid overly seasoned foods.
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.
Without treatment, the time between the eruption of a blister and the onset of healing is seven to 10 days. 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.
Although antivirals can significantly reduce the severity and duration of a shingles outbreak, there is little evidence that they can reduce the likelihood of postherpetic neuralgia.
Age (rather than treatment) appears to be the single most influential risk factor.
This includes people who have been previously vaccinated withZostavax(an earlier generationlive vaccinediscontinued in 2020) or those who have had aprevious bout of shingles.
Summary
Oral shingles occurs when 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. It is important to start antiviral therapy within 72 hours of an outbreak, so don’t hesitate to see a healthcare provider if you develop painful, blister-like bumps in your mouth.
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.
26 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Laing KJ, Ouwendijk WJD, Koelle DM, Verjans GMGM.Immunobiology of varicella-zoster virus infection.J Infect Dis. 2019;219(9):1514. doi:10.1093/infdis/jiy403Arora S, Patil P, Arora G, Mishra R. Herpes zoster:Hand dominance the missing link to unilaterality?Indian Dermatol Online J. 2018;9(3):212-213. doi:10.4103/idoj.IDOJ_15_17Song JM, Seo JS, Lee JY.Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review.J Korean Assoc Oral Maxillofac Surg. 2015;41(6):357-60. doi:10.5125/jkaoms.2015.41.6.357Wollina U.Variations in herpes zoster manifestation.Indian J Med Res. 2017;145(3):294-298. doi:10.4103/ijmr.IJMR_1622_16Hagiya H, Nakagami F, Isomura E.Oral shingles.BMJ Case Rep. 2018;11(1):e228383. doi:10.1136/bcr-2018-228383Chowdhury NH, Biswas AC, Islam MA, Milki FU, Khan SR.Shingles: Extensive clinical presentation of herpes zoster Infection.Bangladesh J Otorhinolaryngol. 2016;22(2):122-5.Gupta S, Sreenivasan V, Patil PB.Dental complications of herpes zoster: two case reports and review of literature.Indian J Dental Res.2015;26(2):214-9. doi:10.4103/0970-9290.159175Crimi S, Fiorillo L, Bianchi A, et al.Herpes virus, oral clinical signs and QoL: systematic review of recent data.Viruses. 2019;11(5):463. doi:10.3390/v11050463Patil A, Goldust M, Wollina U.Herpes zoster: A review of clinical manifestations and management.Viruses. 2022;14(2):192. doi:10.3390/v1402019Centers for Disease Control and Prevention.About shingles (herpes zoster).Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician. 2017;96(10):656-663Centers for Disease Control and Prevention.Shingles facts and stats.John A, Canaday DH.Herpes zoster in the older adult.Infect Dis Clin North Am. 2017;31(4):811-26. doi:10.1016/j.idc.2017.07.016Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).New York State Department of Health.Shingles (herpes zoster).Mortazavi H, Safi Y, Baharvand M, Rahmani S.Diagnostic features of common oral ulcerative lesions: an updated decision tree.Int J Dent. 2016;2016:7278925. doi:10.1155/2016/7278925Centers for Disease Control and Prevention.Laboratory testing for varicella-zoster virus (VZV).American Association for Clinical Chemistry.Chickenpox and shingles tests.Saguil A, Kane S, Mercado M, Lauters R.Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.Am Fam Physician. 2017;96(10):656-663.Kakoei S, Pardakhty A, Hashemipour MA, Larizadeh H, Kalantari B, Tahmasebi E.Comparison the Pain Relief of Amitriptyline Mouthwash with Benzydamine in Oral Mucositis.J Dent (Shiraz). 2018;19(1):34-40.InformedHealth.org [Internet].Shingles: overview.Gnann JW.Chapter 65. Antiviral therapy of varicella-zoster virus infections.Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press.Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database Sys Rev.2014;2:CD006866. doi:14651858.CD006866.pub3GlaxoSmithKline.Package insert - Shingrix (zoster vaccine recombinant, adjuvanted).Dooling KL, Guo A, Patel M, et al.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.MMWR Morb Mortal Wkly Rep.2018;67:103-8. doi:10.15585/mmwr.mm6703a5Singh G, Song S, Choi E, Lee PB, Nahm FS.Recombinant zoster vaccine (Shingrix): a new option for the prevention of herpes zoster and postherpetic neuralgia.Korean J Pain. 2020;33(3):201-7. doi:10.3344/kjp.2020.33.3.201
26 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Laing KJ, Ouwendijk WJD, Koelle DM, Verjans GMGM.Immunobiology of varicella-zoster virus infection.J Infect Dis. 2019;219(9):1514. doi:10.1093/infdis/jiy403Arora S, Patil P, Arora G, Mishra R. Herpes zoster:Hand dominance the missing link to unilaterality?Indian Dermatol Online J. 2018;9(3):212-213. doi:10.4103/idoj.IDOJ_15_17Song JM, Seo JS, Lee JY.Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review.J Korean Assoc Oral Maxillofac Surg. 2015;41(6):357-60. doi:10.5125/jkaoms.2015.41.6.357Wollina U.Variations in herpes zoster manifestation.Indian J Med Res. 2017;145(3):294-298. doi:10.4103/ijmr.IJMR_1622_16Hagiya H, Nakagami F, Isomura E.Oral shingles.BMJ Case Rep. 2018;11(1):e228383. doi:10.1136/bcr-2018-228383Chowdhury NH, Biswas AC, Islam MA, Milki FU, Khan SR.Shingles: Extensive clinical presentation of herpes zoster Infection.Bangladesh J Otorhinolaryngol. 2016;22(2):122-5.Gupta S, Sreenivasan V, Patil PB.Dental complications of herpes zoster: two case reports and review of literature.Indian J Dental Res.2015;26(2):214-9. doi:10.4103/0970-9290.159175Crimi S, Fiorillo L, Bianchi A, et al.Herpes virus, oral clinical signs and QoL: systematic review of recent data.Viruses. 2019;11(5):463. doi:10.3390/v11050463Patil A, Goldust M, Wollina U.Herpes zoster: A review of clinical manifestations and management.Viruses. 2022;14(2):192. doi:10.3390/v1402019Centers for Disease Control and Prevention.About shingles (herpes zoster).Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician. 2017;96(10):656-663Centers for Disease Control and Prevention.Shingles facts and stats.John A, Canaday DH.Herpes zoster in the older adult.Infect Dis Clin North Am. 2017;31(4):811-26. doi:10.1016/j.idc.2017.07.016Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).New York State Department of Health.Shingles (herpes zoster).Mortazavi H, Safi Y, Baharvand M, Rahmani S.Diagnostic features of common oral ulcerative lesions: an updated decision tree.Int J Dent. 2016;2016:7278925. doi:10.1155/2016/7278925Centers for Disease Control and Prevention.Laboratory testing for varicella-zoster virus (VZV).American Association for Clinical Chemistry.Chickenpox and shingles tests.Saguil A, Kane S, Mercado M, Lauters R.Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.Am Fam Physician. 2017;96(10):656-663.Kakoei S, Pardakhty A, Hashemipour MA, Larizadeh H, Kalantari B, Tahmasebi E.Comparison the Pain Relief of Amitriptyline Mouthwash with Benzydamine in Oral Mucositis.J Dent (Shiraz). 2018;19(1):34-40.InformedHealth.org [Internet].Shingles: overview.Gnann JW.Chapter 65. Antiviral therapy of varicella-zoster virus infections.Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press.Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database Sys Rev.2014;2:CD006866. doi:14651858.CD006866.pub3GlaxoSmithKline.Package insert - Shingrix (zoster vaccine recombinant, adjuvanted).Dooling KL, Guo A, Patel M, et al.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.MMWR Morb Mortal Wkly Rep.2018;67:103-8. doi:10.15585/mmwr.mm6703a5Singh G, Song S, Choi E, Lee PB, Nahm FS.Recombinant zoster vaccine (Shingrix): a new option for the prevention of herpes zoster and postherpetic neuralgia.Korean J Pain. 2020;33(3):201-7. doi:10.3344/kjp.2020.33.3.201
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Laing KJ, Ouwendijk WJD, Koelle DM, Verjans GMGM.Immunobiology of varicella-zoster virus infection.J Infect Dis. 2019;219(9):1514. doi:10.1093/infdis/jiy403Arora S, Patil P, Arora G, Mishra R. Herpes zoster:Hand dominance the missing link to unilaterality?Indian Dermatol Online J. 2018;9(3):212-213. doi:10.4103/idoj.IDOJ_15_17Song JM, Seo JS, Lee JY.Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review.J Korean Assoc Oral Maxillofac Surg. 2015;41(6):357-60. doi:10.5125/jkaoms.2015.41.6.357Wollina U.Variations in herpes zoster manifestation.Indian J Med Res. 2017;145(3):294-298. doi:10.4103/ijmr.IJMR_1622_16Hagiya H, Nakagami F, Isomura E.Oral shingles.BMJ Case Rep. 2018;11(1):e228383. doi:10.1136/bcr-2018-228383Chowdhury NH, Biswas AC, Islam MA, Milki FU, Khan SR.Shingles: Extensive clinical presentation of herpes zoster Infection.Bangladesh J Otorhinolaryngol. 2016;22(2):122-5.Gupta S, Sreenivasan V, Patil PB.Dental complications of herpes zoster: two case reports and review of literature.Indian J Dental Res.2015;26(2):214-9. doi:10.4103/0970-9290.159175Crimi S, Fiorillo L, Bianchi A, et al.Herpes virus, oral clinical signs and QoL: systematic review of recent data.Viruses. 2019;11(5):463. doi:10.3390/v11050463Patil A, Goldust M, Wollina U.Herpes zoster: A review of clinical manifestations and management.Viruses. 2022;14(2):192. doi:10.3390/v1402019Centers for Disease Control and Prevention.About shingles (herpes zoster).Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician. 2017;96(10):656-663Centers for Disease Control and Prevention.Shingles facts and stats.John A, Canaday DH.Herpes zoster in the older adult.Infect Dis Clin North Am. 2017;31(4):811-26. doi:10.1016/j.idc.2017.07.016Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).New York State Department of Health.Shingles (herpes zoster).Mortazavi H, Safi Y, Baharvand M, Rahmani S.Diagnostic features of common oral ulcerative lesions: an updated decision tree.Int J Dent. 2016;2016:7278925. doi:10.1155/2016/7278925Centers for Disease Control and Prevention.Laboratory testing for varicella-zoster virus (VZV).American Association for Clinical Chemistry.Chickenpox and shingles tests.Saguil A, Kane S, Mercado M, Lauters R.Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.Am Fam Physician. 2017;96(10):656-663.Kakoei S, Pardakhty A, Hashemipour MA, Larizadeh H, Kalantari B, Tahmasebi E.Comparison the Pain Relief of Amitriptyline Mouthwash with Benzydamine in Oral Mucositis.J Dent (Shiraz). 2018;19(1):34-40.InformedHealth.org [Internet].Shingles: overview.Gnann JW.Chapter 65. Antiviral therapy of varicella-zoster virus infections.Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press.Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database Sys Rev.2014;2:CD006866. doi:14651858.CD006866.pub3GlaxoSmithKline.Package insert - Shingrix (zoster vaccine recombinant, adjuvanted).Dooling KL, Guo A, Patel M, et al.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.MMWR Morb Mortal Wkly Rep.2018;67:103-8. doi:10.15585/mmwr.mm6703a5Singh G, Song S, Choi E, Lee PB, Nahm FS.Recombinant zoster vaccine (Shingrix): a new option for the prevention of herpes zoster and postherpetic neuralgia.Korean J Pain. 2020;33(3):201-7. doi:10.3344/kjp.2020.33.3.201
Laing KJ, Ouwendijk WJD, Koelle DM, Verjans GMGM.Immunobiology of varicella-zoster virus infection.J Infect Dis. 2019;219(9):1514. doi:10.1093/infdis/jiy403
Arora S, Patil P, Arora G, Mishra R. Herpes zoster:Hand dominance the missing link to unilaterality?Indian Dermatol Online J. 2018;9(3):212-213. doi:10.4103/idoj.IDOJ_15_17
Song JM, Seo JS, Lee JY.Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review.J Korean Assoc Oral Maxillofac Surg. 2015;41(6):357-60. doi:10.5125/jkaoms.2015.41.6.357
Wollina U.Variations in herpes zoster manifestation.Indian J Med Res. 2017;145(3):294-298. doi:10.4103/ijmr.IJMR_1622_16
Hagiya H, Nakagami F, Isomura E.Oral shingles.BMJ Case Rep. 2018;11(1):e228383. doi:10.1136/bcr-2018-228383
Chowdhury NH, Biswas AC, Islam MA, Milki FU, Khan SR.Shingles: Extensive clinical presentation of herpes zoster Infection.Bangladesh J Otorhinolaryngol. 2016;22(2):122-5.
Gupta S, Sreenivasan V, Patil PB.Dental complications of herpes zoster: two case reports and review of literature.Indian J Dental Res.2015;26(2):214-9. doi:10.4103/0970-9290.159175
Crimi S, Fiorillo L, Bianchi A, et al.Herpes virus, oral clinical signs and QoL: systematic review of recent data.Viruses. 2019;11(5):463. doi:10.3390/v11050463
Patil A, Goldust M, Wollina U.Herpes zoster: A review of clinical manifestations and management.Viruses. 2022;14(2):192. doi:10.3390/v1402019
Centers for Disease Control and Prevention.About shingles (herpes zoster).
Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician. 2017;96(10):656-663
Centers for Disease Control and Prevention.Shingles facts and stats.
John A, Canaday DH.Herpes zoster in the older adult.Infect Dis Clin North Am. 2017;31(4):811-26. doi:10.1016/j.idc.2017.07.016
Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).
New York State Department of Health.Shingles (herpes zoster).
Mortazavi H, Safi Y, Baharvand M, Rahmani S.Diagnostic features of common oral ulcerative lesions: an updated decision tree.Int J Dent. 2016;2016:7278925. doi:10.1155/2016/7278925
Centers for Disease Control and Prevention.Laboratory testing for varicella-zoster virus (VZV).
American Association for Clinical Chemistry.Chickenpox and shingles tests.
Saguil A, Kane S, Mercado M, Lauters R.Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.Am Fam Physician. 2017;96(10):656-663.
Kakoei S, Pardakhty A, Hashemipour MA, Larizadeh H, Kalantari B, Tahmasebi E.Comparison the Pain Relief of Amitriptyline Mouthwash with Benzydamine in Oral Mucositis.J Dent (Shiraz). 2018;19(1):34-40.
InformedHealth.org [Internet].Shingles: overview.
Gnann JW.Chapter 65. Antiviral therapy of varicella-zoster virus infections.Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press.
Chen N, Li Q, Yang J, Zhou M, Zhou D, He L.Antiviral treatment for preventing postherpetic neuralgia.Cochrane Database Sys Rev.2014;2:CD006866. doi:14651858.CD006866.pub3
GlaxoSmithKline.Package insert - Shingrix (zoster vaccine recombinant, adjuvanted).
Dooling KL, Guo A, Patel M, et al.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.MMWR Morb Mortal Wkly Rep.2018;67:103-8. doi:10.15585/mmwr.mm6703a5
Singh G, Song S, Choi E, Lee PB, Nahm FS.Recombinant zoster vaccine (Shingrix): a new option for the prevention of herpes zoster and postherpetic neuralgia.Korean J Pain. 2020;33(3):201-7. doi:10.3344/kjp.2020.33.3.201
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