Stomatitis in an adult: what causes it and how to cure it

Causes of stomatitis

Stomatitis is both an independent disease and a manifestation of other diseases. The causes of stomatitis can be:

Classification of stomatitis by the World Health Organization7

Catarrhal stomatitis

Characterized by redness, slight swelling, burning of the mucous membrane. It is observed with influenza, acute respiratory viral infections, and drug-induced damage.

Fibrinous stomatitis

It manifests itself as single painful aphthae, which are covered with a white coating. Afta is a superficial defect of the oral mucosa of a round shape. It appears in mild forms of aphthous stomatitis.

Ulcerative stomatitis

manifests itself in the form of deep defects in the oral mucosa - ulcers. Observed in traumatic stomatitis.

Necrotizing stomatitis

Characterized by ulcers that are covered with necrotic plaque. It is observed in ulcerative-necrotizing gingivitis, a complication of measles.

Acute stomatitis

It has pronounced symptoms, as a rule, it appears for the first time or recurs extremely rarely, once every few years. Also occurs due to acute trauma. Patients complain of severe pain, difficulty eating and sometimes even talking, general weakness, fever, and bad breath. Acute stomatitis with incomplete or improper treatment can become chronic.

Chronic stomatitis

Characterized by constant relapses, as a rule, this occurs when the immune system is weakened. May occur as a result of regular, moderate trauma. Clinical manifestations are less pronounced; this type of stomatitis always requires first of all eliminating the cause of the disease.

Table of children's medications against stomatitis by age

Viral stomatitis

Herpetic stomatitis

Caused by the herpes virus of the first, less often the second type.
It accounts for 80% of all stomatitis and occurs mainly in children, less often in adults. The prevalence of herpes simplex virus ranges from 65% to 90%8. Infection occurs through airborne droplets and household contact. More common is recurrent herpetic stomatitis, which is manifested by itching, burning, slight soreness in the oral cavity, then vesicles (bubbles) appear, which burst and heal after 7-10 days.

During primary infection, acute herpetic stomatitis occurs; it is characterized by general symptoms such as fever, weakness, aches in the muscles and joints, the degree of these manifestations depends on the severity of the disease. As a rule, the acute form occurs in children.

Varicella zoster virus infection

The mildest form, in which the mucous membrane of the tonsils is affected. The palatine tonsils are not very enlarged, the mucous membrane of the throat is red, there is no plaque or pus.

Stomatitis with measles

Measles is an acute viral, highly contagious disease that is caused by the Polinisa virus and is transmitted by airborne droplets. The disease is extremely contagious. It is characterized by a rise in temperature, symptoms of ARVI, a rash on the face, neck, and then the whole body. In the oral cavity, Filatov-Koplik spots and stomatitis occur, which is characterized by hyperemia, swelling of the mucous membrane and white plaque. Nowadays, thanks to vaccination, this disease practically does not occur.

Herpetic stomatitis in children

There are several types:

1. sharp;
2. chronic.

This type of damage to the oral mucosa occurs when the herpes virus first enters the human body. Acute stomatitis is typical only for young children. Herpetic stomatitis that occurs repeatedly is called chronic. Herpes stomatitis in an infant appears due to infection of the child by the mother or other people who kiss the baby out of excess of feelings or taste food with the spoon with which he is then fed.

Acute herpes-type stomatitis

The herpes virus enters the baby's body after he reaches the age of six months. At this time, the antibodies the child received from the mother gradually cease to act. In the vast majority of cases (about 90%), the symptoms of stomatitis at such an early age are mild, and only in 10% of children the disease is acute.

Stomatitis in children under one year of age, the treatment of which takes about 2 weeks, is accompanied by weakness in the body, general malaise and muscle pain, which is explained by poisoning of the body. In some cases, the temperature during the first two days of the disease may rise to 40 degrees or higher. The lymph nodes become inflamed, and touching them causes pain to the baby.

A distinctive sign of the disease are small bubbles that appear in groups on the lips, palate, and tongue. The oral mucosa takes on a bright red hue. The bubbles are filled with a clear liquid that gradually becomes cloudy. After about 3 days, the blisters burst, leaving behind erosions covered with a yellow or white fibrinous coating.

Sometimes the gums near the teeth may turn red, so the disease is often confused with gingivitis.

Chronic stomatitis

Once the herpes virus enters the human body, it remains there forever. Symptoms may occur when:

• cold;
• lack of vitamins;
• stressful situations;
• exacerbation of sinusitis, tonsillitis and other chronic diseases;
• injury to the mucous membrane;
• gingivitis or caries;
• habit of breathing through the mouth (lips become dry, causing the skin in the corners of the mouth to crack).

Chronic stomatitis develops in exactly the same way as acute stomatitis, with the exception that the disease does not affect the general condition of the body, because intoxication is minimal.

Herpetic stomatitis in children: how to treat

Types of treatment:

• Use of antiviral agents. Ointments and gels, which are often used to treat herpes on the lip, should not be applied to the oral mucosa. Treatment is possible with suppositories or tablets. The most effective drugs include two drugs. The first of them is “Viferon”, which contains interferons that have an immunostimulating effect. Available in the form of suppositories and gel. There are no age restrictions on the use of the product. The gel should be applied directly to the affected mucous membrane, after drying it with a swab. The treatment period does not exceed one week, provided that the product is regularly applied three times a day. The second is the antiviral drug Acyclovir, which acts on the herpes virus itself, and does not simply increase immunity. The dosage regimen is the same for children over 2 years of age and twice.
• Rinse. It is necessary to use solutions whose action is aimed specifically at suppressing the herpes virus (such popular and cheap remedies as chlorhexidine and various herbal infusions are not suitable). The most effective drug is Miramistin, which should be rinsed three times a day. For greater results, you can apply Viferon a short period of time after rinsing.
• Use of symptomatic remedies. Antipyretic drugs are used when body temperature exceeds 38 degrees. At lower temperatures, such tablets will do more harm, since they will interfere with the formation of natural immunity and the production of interferons.
• Use of immunomodulators. If stomatitis in children, which was treated according to all the rules, makes itself felt again, you can resort to the use of immunomodulators, the most effective of which are:

1. “Immunal” is a basic drug that increases immunity.
2. “Imudon” stimulates the immunity of the oral mucosa. One course lasts 20 days (you need to take 6 tablets every day). 2 courses per year are recommended.
3. Toothpastes with lactoferrin and lysozyme (these substances are contained in special Splat children's toothpastes).

Stomatitis caused by fungi

Candidal stomatitis is a fungal disease caused by fungi of the genus Candida.10 Young children and the elderly are more often affected; people with diabetes and xerostomia (dry mouth), pregnant women and people with weakened immune systems are also at risk. Elderly people wearing removable dentures often get sick.

The main symptom of fungal stomatitis is a burning sensation and the presence of a white, cheesy coating, when removed, a swollen, red mucous membrane appears. The general condition of adults with candidal stomatitis is practically not affected.

Enteroviral vesicular stomatitis (arm - leg - mouth)

Caused by enteroviruses. It also occurs in adults, but in 95.7% of cases children are affected.6 It is characterized by seasonal occurrence (summer - autumn) and group incidence.4 It is observed mainly in children under 10 years of age. Vesicular stomatitis is contagious, so it is recommended to use separate utensils and hygiene products. Characteristics for this disease: temperature 37.5-38, weakness, headache, muscle pain, rash on the palms, soles, as well as blisters on the hard palate and pharynx, which then turn into erosions that are almost not painful.

Bacterial stomatitis

Vincent's ulcerative necrotizing stomatitis

It manifests itself as ulcerations of the mucous membrane, strong odor from the mouth, fever, weakness, pain when eating. In severe forms, ulcerations can occupy almost the entire oral cavity, and the temperature rises above 38°C.

Gonorrheal stomatitis

Caused by Neisser's gonococcus. The mucous membranes of the lips, gums, lateral and lower surfaces of the tongue are mainly affected. The mucous membrane has a brightly hyperemic color and a large amount of gray purulent plaque with an unpleasant odor. But, as a rule, there are no complaints.

Acute streptococcal gingivostomatitis

It is characterized by general damage to the gums, severe pain, fever, enlargement and tenderness of the lymph nodes. The mucous membrane of the mouth and tonsils is hyperemic, abscesses may form.

Acute pseudomembranous candidal stomatitis (thrush)

Acute pseudomembranous candidal stomatitis (thrush) occurs:

• Light shape
• Medium-heavy forms
• Severe form

The main symptom of the disease is a white or yellow coating.

With a mild form

The plaque is located in islands, most often on the tongue and cheeks. Children are restless, sleep poorly, and suck the breast sluggishly. Older children may complain of a burning sensation. The plaque is easily removed; underneath there is a bright red mucous membrane. The disease lasts no longer than 7 days.5

Moderate form

The plaque is located on the cheeks, tongue, hard palate, and mucous membranes of the lips. Under the plaque, erosions form, which sometimes bleed. The plaque is more difficult to remove. Lymph nodes are sometimes enlarged and painful. The duration of the disease is 10-15 days, there are relapses.

Moderate form

The plaque is dirty gray, almost cannot be removed, and is located on the tongue, cheeks, soft palate, tonsils, pharynx, and mucous membranes of the lips. Cheilitis appears in the corners of the mouth - inflammation of the lips. The oral mucosa is dry and inflamed. The child’s health is impaired, the child refuses to eat, and the temperature rises. Lesions in the genital area, neck folds, and between the fingers are also common. The disease is long-term, with frequent relapses.

Traumatic stomatitis

Traumatic stomatitis develops as a result of mechanical, thermal or physical trauma. This type of stomatitis occurs:

• superficial (burn of the mucous membrane by hot tea)
• deep (burn with a strong alkali or acid, strong biting of the mucous membrane)

Acute mechanical stomatitis: rare, it can be caused by trauma to the mucous membrane when biting the cheek, tongue, lip while eating, an attack of epilepsy, a blow, trauma during dental treatment and other traumatic factors.

It is manifested by pain, hyperemia, swelling at the site of injury, erosion. With secondary infection, the wound can develop into long-term non-healing ulcers. Most often, traumatic stomatitis is acute, but can also be chronic, for example, constant biting of the cheeks under stress, chronic injury from braces, a sharp tooth edge, or a bad crown. As a result of trauma, painful erosions or ulcers with jagged edges form on the mucous membrane, which can become infected.

The cause of physical injury is most often a thermal burn due to contact with hot liquid, inhalation of steam, or exposure to fire, the latter, as a rule, accompanied by damage to the respiratory tract. The lesion is most often located on the tip of the tongue, lips, and the front of the palate. The mucous membrane becomes swollen, red, painful, and blisters may form, which then burst. With deep damage, the mucous membrane dies, and the damage involves muscles and even bone.

Chemical stomatitis occurs when burned with acid or alkali. In everyday life, this is most often acetic acid; also at a dental appointment, burns can occur with various drugs (phenol, formaldehyde, alcohol, hydrofluoric acid, etc.). The depth of damage depends on the damaging substance and its concentration, and the duration of exposure. First, the mucous membrane becomes bright red and painful, and with severe lesions, foci of necrosis then appear within a few hours.

In case of burns with acids, alkalis, or thermal burns, it is recommended to call an ambulance!

Symptoms of the disease

Symptoms depend on the type of pathology, but there are common clinical manifestations. As a rule, the disease does not begin acutely. The mucous membranes become red, swelling, pain, and a burning sensation appear in the affected area. You can see what stomatitis looks like in the photo.

If it is a bacterial infection, then after a day an ulcer appears at the site of infection with a red halo radiating from the center. The ulcer is covered with a white coating. During this period, salivation increases and an unpleasant odor appears. Pain bothers the patient not only when eating, but also at rest.

Pimples and ulcers appear anywhere in the oral cavity; in severe cases, stomatitis develops in the throat. Stomatitis on the tongue is especially painful, since there are many nerve endings there. Some types are characterized by bleeding gums.

With further development of the pathology, the temperature may rise, the lymph nodes may enlarge, and symptoms of intoxication may appear - weakness, nausea, lack of appetite.

Allergic stomatitis

They arise as a reaction of the mucous membrane to an allergen. An allergic agent can be toothpastes, mouthwashes, food, medicines, materials for crowns, fillings, etc. Allergies often occur to removable dentures. The mucous membrane is affected precisely at the point of contact with the damaging agent, for example, the hard palate under a removable denture. With allergic stomatitis, the mucous membrane is swollen, red, bubbles appear, which burst with the appearance of painful erosions.

Allergic stomatitis also includes chronic recurrent aphthous stomatitis , it begins with swelling and burning, then a painful aphtha appears, and then a healing period begins. This disease is characterized by constant relapses with a certain frequency.

Folk remedies

Traditional healers do not offer anything for the treatment of stomatitis in Samara : there are onions with garlic, and aloe, and a decoction of onion peels, and peroxide with water, and honey, and propolis and ... hundreds of other variations on the theme of anti-inflammatory substances. All this is very good, but does not exclude standard treatment, since all these substances act primarily on the consequences - on inflammation, but do not act on the pathogen. Rosehip and sea buckthorn oils are successfully used to heal erosions (the pharmacy equivalent is a solution of vitamins A and E), chamomile, aloe and other plants are used as antiseptics and anti-inflammatory, but their effect is rather weak.

The only thing that deserves attention:

• Rinse with raw egg white. 1 protein is dissolved in 100 ml. water and rinse with this solution (or lubricate the mucous membrane in infants). The protein contains a lot of lysozyme, which helps increase local immunity and helps fight infection. But the other side of the coin in this method is the danger of salmonella infection, so it is difficult to say whether it is worth the risk.

Prevention of stomatitis

Consists of the following items:

• strengthening the immune system, giving up bad habits, hardening, playing sports, eating with a sufficient amount of macros and vitamins (especially vitamin C)
• regular visits to the dentist
• adequate brushing of teeth at home, as well as removal of dental plaque in the dentist’s office once every 6 months
• identifying the allergen and avoiding contact with it
• undergoing medical examination for timely detection of diseases
• treatment of systemic diseases
• taking antibiotics only as prescribed by a doctor, together with a course of probiotics, to avoid dysbiosis
• vaccination (against measles, chickenpox)

Tantum® Propolis

It is worth paying attention to Tantum Propolis, since propolis has an immunostimulating effect, promotes healing, and vitamin C, which is part of it, is responsible for regeneration, participating in the synthesis of collagen.
Propolis also has antiviral and antifungal effects. Therefore, vitamin therapy Tantum Propolis is an effective means of preventing stomatitis.12 Find out more

Caring for a child with stomatitis

Parental involvement in treatment and proper care of children is not only important, but also necessary. With stomatitis, it is necessary to strictly follow the treatment plan, which is often very labor-intensive, so the result depends on parental care and control. The oral cavity is a kind of epicenter of pain, so it is not surprising that the child is very temperamental. Therefore, it is important for parents to be patient and persistent.

Most mothers and fathers are concerned about what to feed their child with stomatitis. Firstly, you need to eat only soft, warm and pasty foods, such as purees. The main thing is that the food is high in calories and not heavy, because the child’s immunity is already weakened. After eating, be sure to rinse your mouth so as not to provoke the development of stomatitis and not to add an additional infection. Spicy, sour, sweet and citrus foods should be excluded from the child's diet.

For stomatitis in children, it is necessary to relieve pain. This is done with the help of various medications to avoid food refusal and poor sleep. Also, for stomatitis in children, adequate oral treatment is very important. Your doctor should recommend how to handle your child and rinse his mouth.

Treatment of stomatitis

Treatment of stomatitis depends on the severity and cause of the disease and includes the following measures:

1. For bacterial stomatitis, antibacterial drugs are prescribed. For fungal stomatitis - antifungal drugs, for viral ones - antiviral drugs

Important! Antibiotics, antiviral and antifungal drugs are prescribed only by the attending physician!

2. For high fever and pain, antipyretic and painkillers are prescribed

3. Vitamin therapy. It is especially important to take vitamins A, C, E

4. Immunomodulatory drugs

5. Antiseptic treatment of the oral cavity. Antiseptics are used in the form of solutions, sprays, tablets, ointments

6. Epithelializing agents are used after acute phenomena have subsided

7. Sanitation of the oral cavity, removal of dental plaque

8. A gentle diet

9. Eliminating allergens and taking antihistamines

Important! Stomatitis is treated by a dentist, in some cases together with a therapist, infectious disease specialist, allergist and dermatologist. If you have symptoms, consult a specialist.

Diagnostics

Patients with suspected stomatitis are examined by a dentist. In some cases, he may prescribe laboratory tests (bacterial culture, PCR smear, etc.) to detect candidiasis or herpes virus. In case of severe stomatitis (severe forms of the disease), it is necessary to conduct a blood test and seek advice from a physician. Almost all types of disease are treated according to the general principle. But during diagnosis, it is important to distinguish between herpetic and aphthous forms of stomatitis, since special therapy is selected for them.

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Answers to popular questions

Which doctor treats stomatitis?

The dentist, if necessary, can refer the patient to other doctors.

Do I need to take antibiotics for stomatitis?

Some forms of stomatitis require the use of antibacterial agents, but in most cases this is not only useless, but even dangerous, since it can lead to dysbacteriosis. Antibiotics should be taken only as prescribed by a doctor in the prescribed dosage.

How long does it take to treat stomatitis?

Depends on the severity and form of the disease. On average 7-10 days.

Is stomatitis contagious?

Not all forms of stomatitis are contagious. Traumatic stomatitis is absolutely not contagious. If stomatitis is caused by viruses, such as herpes or measles, the risk of infection is very high.

How to rinse your mouth

Rinsing the mouth is both a hygienic and therapeutic procedure. For rinsing, pharmaceutical products, self-prepared decoctions, tinctures, and solutions are used. Ready-made solutions - rotokan, hydrogen peroxide, chlorhexidine, furatsilin, miramistin - have proven antiseptic properties.

Homemade herbal remedies additionally soothe and relieve pain in inflamed tissues.

Below we will talk in detail about drugs that help get rid of stomatitis at home.

Chlorhexidine

The most commonly prescribed antiseptic is chlorhexidine. It is used for rinsing and helps to completely destroy pathogenic bacteria in the oral cavity. You should rinse your mouth with a solution of chlorhexidine after eating for 7-10 days. On the second or third day of therapy, pain will decrease significantly, and after a week it will disappear completely.

Hydrogen peroxide

Gargling with hydrogen peroxide is prescribed for aphthous, candidal, and herpetic stomatitis. The drug has antibacterial properties, relieves itching, pain, and swelling. It is necessary to dilute 1 tablespoon of peroxide in 100 milliliters of water, rinse the mouth with the resulting solution 2 times a day for 10-14 days.

Soda

Rinsing your mouth with soda is the most common remedy for stomatitis. Soda relieves pain, inflammation, irritation, promotes the healing of aphthae, and disinfects the surface of the oral cavity. One teaspoon of baking soda should be diluted in 100 milliliters of warm water. Rinse your mouth with the resulting solution three times a day. You can also wipe the inflamed mucous membrane with a gauze swab dipped in a soda solution.

Furacilin

Doctors often recommend furatsilin, which has antibacterial properties. To prepare a solution for rinsing, you need to dilute 2-3 tablets of furatsilin in a glass of warm water, rinse your mouth 2-3 times a day. It is advisable to prepare a new portion of the medicine daily.

You cannot rinse your mouth with cold or hot solutions; they must be slightly warmed up.

Forest balm

The use of medicinal balms helps to quickly cope with the symptoms of the disease. When treating the disease, oral hygiene is important; its absence causes the active proliferation of pathogenic bacteria, which provoke an increase in the inflammatory process. “Forest balm” is used to rinse the mouth after meals to remove food debris from the interdental spaces.

It is impossible to get rid of stomatitis only with the help of balms!

Rotokan

A modern herbal anti-inflammatory, antiseptic, hemostatic drug. Rotokan consists of extracts of calendula, chamomile and yarrow, and is effective in treating aphthous stomatitis at home. One teaspoon of rotokan is diluted in a glass of warm water and used for rinsing and mouth baths. The course of treatment is 5-7 days.

Malavit

The naturopathic remedy Malavit has an analgesic, decongestant, and antipruritic effect. It is used externally for various diseases of the skin and mucous membranes. Dissolve 10 drops of the medicine in a glass of water, rinse your mouth several times a day until complete recovery.

Miramistin

For candidal stomatitis, the most effective remedy is Miramistin. It has antibacterial, antiseptic properties, destroys all types of microorganisms, and restores the protective functions of the mucous membrane. It is necessary to rinse the mouth with Miramistin solution 3-4 times a day until complete recovery.

Borax in glycerin

In acute and chronic forms of stomatitis, borax in glycerin is often used for rinsing, douching, and rubbing. This medicine successfully fights the symptoms of the disease, has an anti-inflammatory and disinfectant effect. You should rinse your mouth with a borax solution for three to seven days. You can also wipe the inflamed mucous membrane with a gauze swab dipped in the medicine.

Burnt alum

To treat aphthae, you can use burnt alum, which has antimicrobial, itching and hemostatic properties. Dissolved alum envelops the ulcers with a colloidal film, which promotes rapid healing. A piece of alum must be diluted in boiled water, rinse your mouth with the resulting mixture 3-5 times a day.