Treatment of stomatitis in adults: types, drugs

What is stomatitis?

Stomatitis is an inflammation of the oral mucosa. According to statistics, about 20% of the population of our planet faces it. In adults and children, it can take the form of an independent disease or act as a symptom indicating pathologies of the body. In both cases, treatment is carried out comprehensively and under the supervision of a doctor.

What does the disease look like?

Stomatitis is not difficult to recognize. The initial stage of the disease is characterized by the appearance of mild swelling of the oral mucosa. It becomes redder, drier and shiny. A plaque may appear on its surface, and at the site of future lesions the patient feels an unpleasant itching or burning sensation.

As the disease develops, small ulcers and wounds appear on the mucous membrane - painful oval or round lesions. Their location may be the inside of the lips, cheeks, palate, tonsils, or mucous membrane under the tongue. Their appearance can be seen in the photo at the end of our article.

Causes of acute stomatitis

The causes of acute stomatitis are varied. The acute course of the disease is always associated with the internal characteristics of the immune system. So there are three main categories of pathogens:

1. Infections. These include pathogens of viral origin, bacteria, and yeasts. During treatment, a drug is selected that affects a specific type of pathogen.
2. Traumatic causes. Acute stomatitis can develop due to mechanical damage to the mucous membrane, abrasion or burn.
3. Allergic reactions.

Most often, acute allergic reactions are provoked by medications. The form of the reaction can be catarrhal, hyperemic or erosive-ulcerative.

Causes of stomatitis

The mechanism of stomatitis is not yet fully understood. But scientists are inclined to believe that the root cause of its development is the reaction of the human immune system to various irritants. At some point, the immune system ceases to recognize the potential threat of internal and external factors, which causes its atypical reaction, as a result of which “aggressive behavior” of lymphocytes is observed. The attack of lymphocytes against irritant molecules leads to lesions of the oral mucosa.

A variety of factors can provoke an atypical reaction of the immune system. The most likely of them are the following irritants:

• Pathogenic microorganisms that live in the mouth.
• Improper oral hygiene.
• Various damage to the mucous membrane, for example, burns from eating too hot food or mechanical injuries from seeds, nuts, crackers and other hard foods.
• General dehydration due to high fever, blood loss, vomiting, diarrhea, or thirst.
• Poor quality treatment of teeth and gums.
• An allergic reaction to dental structures in the mouth - braces, implants, crowns, bridges, etc.
• Long-term use of medications.
• A diet depleted of beneficial vitamins and elements.
• Smoking.
• Malignant formations of the oral cavity, respiratory organs or undergoing a course of chemotherapy.
• Hormonal imbalances in the body, for example in pregnant women or children during puberty.
• The presence of chronic diseases or allergies.
• Severe stress.

Interesting to know! Frequent stomatitis in adults can be caused by the use of toothpaste containing sodium lauryl sulfate, a substance added to oral care products to form a thick foam. According to recent studies, it dehydrates the oral mucosa and makes it vulnerable to various types of irritants. Patient observation data confirms the fact that avoiding the use of sodium lauryl sulfate paste can reduce the risk of developing stomatitis in adults by 81%.

Types and forms of stomatitis

What types of stomatitis are there? Depending on what is taken as the basis for the classification, various forms and varieties of this disease can be distinguished. For example, according to the degree of damage to the mucous membrane, a distinction is made between catarrhal (superficial) stomatitis and ulcerative stomatitis.

According to the causes of occurrence, traumatic stomatitis, bacterial, candida, viral, prosthetic, drug, allergic and radiation are distinguished. The nature of the course of the disease and the presence of relapses make it possible to determine such forms of stomatitis as acute and chronic stomatitis.

To accurately determine the type of stomatitis in a particular case, it is necessary not only to carefully examine the oral cavity, but also to conduct tests for the presence of certain pathogens, and also take into account the presence of allergic reactions in the patient, chronic diseases (such as diabetes or gastritis) , pathologies of the immune system.

Chronic

Chronic stomatitis usually occurs as a continuation of advanced acute stomatitis and is characterized by a long course with periodic remissions and exacerbations. By origin, this is most often viral (herpetic) stomatitis. After treatment, the virus remains in the body and when the immune system is weakened again (due to stress, illness or other reason), it is activated and leads to relapse of stomatitis.

Chronic recurrent stomatitis can be not only viral in nature, but also bacterial, allergic, and candidiasis. The causative agents of many diseases are constantly present in the body, or easily enter it from the external environment. And if stomatitis was caused by an allergy to some substance or exposure, then it is very likely that with each contact with this allergen the stomatitis will return again.

Treatment of chronic stomatitis always includes the use of specific therapy aimed at suppressing the pathogen: antibacterial, antiviral, antifungal. It is also necessary to eliminate foci of infection (for example, carious cavities) and complete sanitation of the oral cavity with professional hygiene.

Bacterial

Bacterial stomatitis is caused by pathogenic microorganisms (for example, streptococci or staphylococci) that enter the oral cavity or are already in it (for example, in carious cavities, in the thickness of tartar) and infect the mucous membrane. This is facilitated by injury to the mucous membrane with sharp edges of teeth, rubbing dentures, or other objects.

Treatment of bacterial stomatitis involves the use of antiseptic and antibacterial agents. If the cause of stomatitis is a denture, then it should be cleaned with special means (for example, in an ultrasonic bath), or replaced with a more comfortable one.

Angular

Angular stomatitis is associated with the appearance of cracks in the corners of the mouth (“jams”). The main causes of this disease are lack of vitamins and bacterial (or fungal) infection. This type of stomatitis is characterized by damage to the outer surface of the lips.

Treatment for angular stomatitis depends on the type of infection. For fungal infections, fungicidal ointments and preparations are used. The streptococcal variety requires the use of antibacterial agents. Treatment is complemented by taking vitamins, eliminating their deficiency and raising the level of immune defense.

Viral

Viral stomatitis is caused by infection of the body with a virus. Most often (in about 80% of cases) this is the herpes virus. But besides it, stomatitis can be caused by almost any virus - chickenpox, measles, influenza, adenoviruses or rotaviruses. Typically, the onset of the disease is typical for a viral infection of this type - it may be fever, chills, runny nose, cough, or swollen lymph nodes. But after 1-3 days, characteristic symptoms of viral stomatitis appear: blisters form in the mouth, which later turn into ulcers, swelling of the gums, bleeding, and putrid breath may occur.

Viral stomatitis can be considered a complication of the underlying viral infection. Its causes (in addition to the virus itself) are reduced immunity and poor oral hygiene - the presence of untreated caries, periodontal disease, gingivitis.

Treatment of viral stomatitis involves first of all treating the underlying disease. In addition, the affected areas of the mucosa can be treated with local antiseptic drugs, anti-inflammatory and wound healing agents. Often in such cases, antiviral ointments or gels are prescribed, and vitamins, immunomodulators, and adaptogens are prescribed to maintain and strengthen the immune system.

Allergic

Allergic stomatitis is caused by exposure to allergens. In addition to the typical allergens that are well known to us, such as animal fur, pollen, foods such as honey, citrus fruits, etc., allergies can be caused by some medications, dental products and orthodontic structures (for example, acrylic dentures).

It often happens that an incorrectly manufactured prosthesis (for example, with a violation of the proportions of the material components) causes an allergic reaction and, as a result, stomatitis. When replacing the prosthesis with a correctly made one (without excess monomer in the composition), the allergy disappears. Symptoms of allergic stomatitis are redness of the mucous membrane (and with prosthetic stomatitis, this can be not only the areas under the prosthesis, but all parts of the tongue, cheeks, etc., in contact with the prosthesis), swelling, itching, and subsequently small blisters appear, often turning into sores.

When treating allergic stomatitis, it is important first of all to determine the cause of the allergy and remove contact with the allergen (eliminate foods that cause allergies, or replace the denture if this is the cause), and take antihistamines. The rest of the treatment involves the use of local antiseptic, anti-inflammatory and analgesic agents.

Herpetic

Herpetic stomatitis is one of the contagious forms of stomatitis. Moreover, contagiousness persists even for 2 weeks after recovery. In most cases, the herpes virus never completely leaves the infected body. It is in a dormant, inactive form, but can be activated when immunity decreases - due to stress, lack of vitamins, due to a severe respiratory disease. Therefore, herpetic (cold sore) stomatitis is often chronic.

An adult very often does not have a strong reaction to the effects of herpes and damage to the mucous membrane. In children, acute herpetic stomatitis can be accompanied by an increase in temperature, general intoxication; when the bubbles merge, burst and form erosion, the child may feel severe pain, which interferes with eating, drinking, and talking. Most often, rashes appear on the palate, tongue, and inner surface of the cheeks. But often they also affect the lips and gums. The danger of this type of stomatitis is that it can turn into gingivitis, so it must be treated.

Treatment of herpetic stomatitis always involves suppressing the herpes virus. Antiseptics (chlorhexidine) and even many antiviral drugs do not affect the herpes virus. Moreover, antibiotics have no effect on him. Special medications have been developed against herpes - acyclovir, valacyclovir, famciclovir. They should be taken only as prescribed by a doctor, in case of severe herpetic stomatitis.

Among the local antiseptics, you can use Miramistin (effective against both types of herpes viruses) and Hexoral (active only against HSV-1). Anti-inflammatory drugs (cholisal) and wound-healing agents (solcoseryl, actovegin, sea buckthorn and rosehip oil, vitamins A and E) perform well.

Candida

Candidal stomatitis often occurs in children under 3 years of age and is therefore often called childhood thrush. This disease is caused by the fungus Candida. It is distinguished by a characteristic white cheesy coating, which is practically impossible to remove mechanically. When trying to remove it, the patient experiences pain, and under the plaque a bleeding, swollen surface of the mucous membrane is found. At the onset of the disease, a person may feel dry mouth, a burning sensation, and white dots appear that merge to form a continuous plaque.

The decision on how to treat candidal stomatitis should be made by a doctor, especially when it comes to a child. For adults, antifungals and topical medications (such as candida) are almost always prescribed. Treatment of candidal stomatitis in children is often limited to the use of vitamins and immune-strengthening agents. To eliminate symptoms, use alkaline rinses and lubricate the mouth with iodine. Antifungal drugs are used only in cases of severe candidomycosis stomatitis.

Ulcerative

Ulcerative stomatitis is a more severe form of the disease than catarrhal stomatitis. Its peculiarity is that the lesion covers the entire thickness of the mucosa, in contrast to the catarrhal form, where it affects only the superficial layers. Deep damage to the oral mucosa causes great suffering to the patient, and after the ulcers heal, scars often remain. Treatment for ulcerative stomatitis depends on the cause of the disease. If an infection is present, antibacterial, antiviral or antifungal therapy is carried out, as well as a course of restoratives and vitamins. Treatment is carried out with means for topical use - antiseptic drugs (furacilin, chlorhexidine, miramistin), herbal decoctions, healing agents. If the cause is traumatic damage to the mucosa, dental procedures are indicated: removal of decayed teeth, treatment of caries, professional oral hygiene.

Vesicular

Vesicular stomatitis is most often enteroviral. It is usually transmitted from animals (or from people who are carriers of the virus) - by airborne droplets, contact and fecal-oral routes. Children most often suffer from it. One of the characteristic symptoms of this disease is a rash on the palms and soles (sometimes also on the face around the mouth, on the buttocks and genitals) - this is vesicular stomatitis with exanthema.

Watery rashes are quite painful and cause itching, which causes severe discomfort to the child, often leads to refusal to eat, and disrupts sleep. With proper timely treatment, the disease goes away without a trace, leaving lasting lifelong immunity. Unfortunately, there are several types of Coxsackie virus, so a person who has had vesicular stomatitis can become infected again with a different type of virus.

Treatment is mainly symptomatic and includes isolating the patient (to avoid infecting other people), taking painkillers, treating rashes with local antiseptics, using applications and rinses, taking vitamin complexes, and in some cases, antiviral and antihistamine drugs.

Aphthous

Aphthous stomatitis is characterized by the formation of aphthous stomatitis on the oral mucosa - one (less often two or three) round ulcers up to 1 cm in size, surrounded by a bright red border and covered with a gray-yellow coating. Touching them is very painful. Itching or burning is often felt before ulcerations appear. Other symptoms rarely appear - slight fever, weakness.

The cause of aphthous stomatitis is reduced immunity, the presence of foci of infection (chronic tonsillitis, pharyngitis, etc.), gastrointestinal diseases, allergic reactions (including to sodium lauryl sulfate contained in some toothpastes), trauma to the mucous membrane (biting), increased concentration of nitrates in food or drink.

If the situation of decreased immunity, exposure to infections or allergens is repeated, the disease may recur, taking on the character of recurrent aphthous stomatitis. With a mild course of the disease, there are no more than 2-3 relapses per year. More frequent attacks indicate a severe form of the disease.

Treatment of aphthous stomatitis involves eliminating contact with allergens, incl. Avoid toothpaste with sodium lauryl sulfate and avoid allergenic and acidic foods. Antihistamines are also often prescribed.

When deciding how to treat aphthous stomatitis, the doctor must conduct a thorough diagnosis and establish the cause of the disease. In accordance with this, a selection of antiseptic drugs (for example, miramistin or chlorhexidine), anti-inflammatory gels (for example, cholisal) and wound healing agents (solcoseryl) is made.

The severe course of chronic aphthous stomatitis often involves the use of more serious medications and methods: laser treatment, immunomodulators, glucocorticoids, but such drugs should be prescribed exclusively by the attending physician.

Symptoms of the disease

Stomatitis can occur at any age. In the early stages, its course is accompanied by swelling, redness and dryness of the oral mucosa. The main sign of the disease is the presence of one or multiple ulcers and their appearance.

• Oval or round ulcer shape.
• Small sizes.
• Smooth edges.
• The presence of a thin grayish or white film in the central part of the ulcer.
• The ulcer is surrounded by a slightly reddish halo.
• The mucosal tissue around the lesion has a normal, healthy appearance.

The slight itching or burning sensation that the patient experienced at the beginning of the disease is replaced by pain. The ulcers hurt when eating, talking and smiling broadly. Any touch to them causes pain, which complicates hygiene measures and leads to bad breath.

On average, the disease lasts from 4 to 14 days. Its clinical picture depends on the individual characteristics of the organism, the form and type of the disease. During this period, in addition to the main signs of pathology, other symptoms of the disease may be observed.

• Increase in temperature - during the first days, until characteristic ulcers appear (in severe forms of stomatitis, the elevated temperature persists throughout the entire illness).
• General malaise and fatigue.
• Chills.
• Headache.
• Lack of appetite (especially in children).
• Enlarged lymph nodes (in rare cases).

Important to remember! Severe inflammation, toothache or high temperature for a long time indicate a severe form of stomatitis or the development of its complications. In this case, immediate medical attention is required, and if necessary, hospitalization of the patient is possible.

Clinical manifestations

The symptoms of stomatitis depend on the type of inflammatory processes.

Can stomatitis go away on its own?

As a rule, mild forms of the disease caused by trauma to the mucous membrane, poor oral hygiene or an allergic reaction of the body can go away on their own. Severe stomatitis caused by infection requires qualified treatment. In both cases, it is better not to wait and not to self-medicate. Because the disease not only causes pain and discomfort, but can also lead to generalization of infection and serious complications.

Consequences and complications of the disease

Possible complications arise when the patient ignores treatment for stomatitis. As a result, mild and severe forms of the disease become chronic. The neglected process turns into an ulcerative-necrotic and then gangrenous form of the disease, as a result of which not only the mucous membrane is damaged, but also the soft tissues of the mouth and jaw bones.

Other serious consequences of untreated stomatitis include the following complications.

• Bleeding gums.
• Scarring of the oral mucosa, disruption of its elasticity and mobility.
• Attachment of a secondary infection.
• Tooth loss.
• Voice changes – hoarseness, hoarseness.

Important to remember! A small ulcer on the oral mucosa is a potential threat to the entire body. Infection from it can spread to other organs and systems, which will disrupt the functions of the heart, liver, kidneys, gastrointestinal tract and respiratory organs.

Signs and symptoms of stomatitis

The symptoms of acute stomatitis are very similar for different types of this disease, although there are differences that make it possible to more accurately diagnose the disease. The location of the rash does not always indicate the form or causes of the pathology. The symptoms of stomatitis on the tongue or in the throat are generally the same; much more important is the nature of the manifestations, the presence of rashes - small blisters or one large ulcer. The severity of the inflammatory process allows us to judge whether the disease is milder, catarrhal, or more severe. For example, the symptoms of catarrhal stomatitis include only:

• redness and swelling of the mucous membrane,
• soreness, sometimes bleeding gums,
• bad breath,
• increased (or, on the contrary, decreased salivation),
• Sometimes a white sticky coating appears.

But at the same time, there are no rashes or ulcers, the temperature rises very rarely and slightly, the lymph nodes are not enlarged. It would seem that this indicates the stability of the immune defense and an easy and quick cure, however, even this form of stomatitis needs treatment, otherwise, once neglected, it can become more severe, ulcers will appear, a bacterial infection will join, which will spread to neighboring organs, causing serious complications.

So, let us highlight the symptoms of the disease characteristic of stomatitis:

• redness and swelling of certain areas of the mucous membrane,
• blisters, blisters or sores (not always),
• pain, burning, itching in the affected areas, which intensifies when touched, eating, talking,
• bad breath,
• plaque (white or grayish-yellow) on the affected areas,
• fever, chills (not always, more often in children than in adults),
• signs of intoxication - weakness, headache, nausea (not always).

Symptoms of stomatitis in newborns are slightly different. Most often this is:

• temperature increase,
• baby's refusal to breastfeed,
• restlessness and moodiness of the baby,
• small blisters or sores on the oral mucosa.

The most common causes of stomatitis in newborns are the herpes simplex virus (65%) or the Candida fungus (30%). In the case of herpes, blisters with transparent contents appear on the mucous membrane, which soon burst, forming ulcers. With candidal stomatitis, white dots appear that merge to form a solid white coating. Since damage to the mucous membrane causes pain and burning, the baby refuses to eat, which is very dangerous, as it leads to weight loss and dehydration.

Temperature with stomatitis

The question of whether there can be a fever with stomatitis usually worries the parents of a sick child, who are trying to understand whether it is worth seeing a doctor. Yes, with stomatitis in children, the temperature very often rises. In general, the signs of stomatitis in children are usually more pronounced than in adults, due to the fact that the child’s immune system still reacts to infections and inflammation quite violently.

But even in adults with stomatitis, the temperature may rise, especially with a more severe course of the disease.

You need to know how long the temperature lasts for stomatitis. Usually this is several days, but depending on the cause of the disease and the severity of its course, this time may be shorter or longer. In any case, you should definitely consult a doctor - correct diagnosis and proper treatment can shorten this period and prevent the disease from developing into a complicated form.

Which doctor should I contact if I have signs of stomatitis?

Which doctor treats stomatitis? At the first signs of stomatitis, you should go to a doctor who treats diseases of the oral cavity - a dentist. He will determine the type of disease and its causes, prescribe treatment, and, if necessary, refer you for tests or to a specialized doctor to clarify the diagnosis.

If manifestations of stomatitis are noticeable in a child, then you should contact your local pediatrician.

Diagnosis of stomatitis

Successful healing requires correct diagnosis of stomatitis. Only a doctor with the necessary knowledge and professional experience can accurately determine the type of disease, establish the causes and propose treatment tactics taking into account the individual characteristics of a particular patient.

On the one hand, this disease has very characteristic symptoms and stomatitis is relatively easy to diagnose. On the other hand, stomatitis may be concomitant with another, more serious disease. The effectiveness of the medications and treatment methods used directly depends on the correct identification of the causes that caused stomatitis.

Treatment of stomatitis in adults

Adults usually tolerate stomatitis more easily than children, however, stomatitis in adults also requires treatment, since if it is neglected, it can become more severe, cause serious complications, and become chronic.

Treatment of stomatitis in adults should always be based on identifying the causes of the disease. If the cause is an allergy, then it is necessary to identify the allergen and eliminate contact with it. If the cause is a bacterial or viral infection, then a course of antibacterial or antiviral therapy should be administered. Depending on the specific diagnosis, the most effective painkillers, antiseptic, anti-inflammatory and healing agents in a particular case are selected. To the question - how to treat stomatitis in adults? — the dentist must answer. In no case should you self-medicate, as this can have the opposite effect and lead to a worsening of the situation.

Treatment of stomatitis includes:

• Elimination of the cause of the disease (allergy or viral infection, bacterial contamination).
• Local treatment - rinsing with antiseptics and herbal decoctions, using anti-inflammatory and healing gels.
• Suppression of acute conditions - reduction of high temperature, pain relief.

In addition to systemic treatment aimed at suppressing infection, antihistamines are often used, and local treatment - rinses, applications, ointments and gels, the purpose of which is to clean the surface of the mucous membrane from plaque with microorganisms, prevent the proliferation of pathogenic microflora, reduce inflammation, eliminate pain, and stimulate regeneration of damaged tissue.

How to rinse

Mouth rinsing for stomatitis is aimed at mechanical removal of dead epithelial cells, mucus containing pathogenic microflora, as well as the death of harmful microorganisms and suppression of their reproduction.

One of the best antiseptics is Miramistin - it has not only antimicrobial activity, but also antiviral activity (including against both herpes simplex viruses). It also restores local immunity of the mucous membrane.

The second rinse option is chlorhexidine. It has less antiviral protection, but more actively suppresses bacteria, and most importantly, it leaves an indelible layer of the drug on the mucous membrane, which prolongs the rinsing effect.

Furacilin and other antiseptics give good results. Hexoral contains not only an antiseptic, but also anti-inflammatory and analgesic components.

Rinsing with herbal decoctions helps with stomatitis: chamomile, sage, calendula, eucalyptus, etc. But you need to understand that these remedies are auxiliary, not primary - you should not rely on them alone in the treatment of such a serious disease as stomatitis.

Soda for stomatitis

Rinsing with soda for stomatitis has two advantages: first of all, soda softens and helps remove mucus and bacterial plaque. In addition, it creates an alkaline environment, which is destructive for many harmful bacteria, fungi and viruses.

Soda solution for stomatitis does not cause burning or pain, has no contraindications, and is suitable even for children. To prepare it, you need to dissolve 1 teaspoon in 200 ml of warm water. The solution will help reduce swelling and pain, soothe the mucous membranes, and slow down the development of harmful microorganisms.

Stomatitis during pregnancy

Stomatitis occurs very often in pregnant women. The reason for this is weakened immunity, lack of vitamins, and hormonal changes in the body. It is necessary to treat this disease only under the supervision of a doctor, since only a doctor can prescribe medications that will not harm the health of the mother and her unborn baby.

To avoid stomatitis during pregnancy, it is necessary to visit the dentist in advance and perform a complete sanitation of the oral cavity - cure caries, remove tartar, and solve all other problems. And also regularly and carefully care for your oral cavity throughout the entire period of pregnancy, take care of your health and follow all doctor’s recommendations.

Antibiotics for stomatitis

In all cases, antibiotics are prescribed only by a doctor. They are effective only against bacterial infections and the forms of stomatitis caused by them (for example, with Vincent's ulcerative necrotizing stomatitis). Viral types of stomatitis cannot be cured with antibiotics. The success of treating stomatitis with antibiotics directly depends on correct diagnosis and accurate selection of the most effective drugs and dosages in a particular case.

Folk remedies

For treatment, you can use traditional medicine. The following juices, decoctions, oils and infusions have proven themselves well.

You can gently lubricate the affected areas of the mucous membrane with juices and oils. Solutions and decoctions of herbs are used for regular rinsing of the mouth.

Important! Before using traditional medicine, you should consult a doctor. Only a specialist can determine the advisability of their use without harm to health. The use of folk remedies does not cancel the main therapy, but only complements its effect.

How many days does treatment last?

Correct, competent treatment of stomatitis significantly speeds up the healing process. Depending on the type of disease, it lasts for 3 to 7 days. If after 1 week of treatment the signs of the disease have not disappeared or worsening is observed, then the patient most likely has complications. The following factors may be the probable reasons for its development.

• The patient self-medicated or did not follow the doctor's instructions.
• Decreased immunity.
• The presence of chronic diseases of the body.
• Regular injury or infection of the oral mucosa.
• Undiagnosed allergy.
• Having bad habits - smoking, chewing, etc.
• Depression or frequent stress.
• Improper oral hygiene.
• Uncontrolled use of medications.
• The use of oral hygiene products containing sodium lauryl sulfate.

Returning to the question - can stomatitis go away on its own - it should be noted that a seemingly harmless disease can turn into serious problems for the patient. Therefore, you should remember three “don’ts” - don’t

engage in self-medication,
do not
put off visiting a specialist and
do not
ignore the recommendations of your doctor.

How to understand that stomatitis has passed?

Very simple! A complete cure is indicated by the absence of lesions in the oral mucosa. There are no small ulcers, wounds or plaque on the cheek, palate, lip, tongue or tonsil area. The mucous membrane looks healthy, is well moisturized, does not cause pain and does not create discomfort during eating, talking, smiling and performing hygiene procedures.

Types of stomatitis in adults

The clinical picture of the disease indicates that stomatitis can be mild or severe, have an acute or chronic course. To facilitate the diagnosis and treatment process, experts have developed the following classification of the disease.

• Allergy is usually a chronic disease that occurs as a result of an allergic reaction of the body to an irritant. In addition to the characteristic ulcers, it may be accompanied by the appearance of white spots, blisters and small hemorrhages on the mucous membrane.
• Herpetic or herpes - the disease occurs due to the entry of the causative agent of the herpes virus into the human body. Stomatitis of this type is characterized by an acute course. Bubbles appear on the surface of the mucous membrane, which open to form erosions and crusts.
• Traumatic (bacterial) – a consequence of mechanical trauma to the oral mucosa and infection entering the wound. As a rule, the disease is mild, with symptoms characteristic of stomatitis.
• Catarrhal and catarrhal-hemorrhagic stomatitis is a mild form of stomatitis, the causes of which are poor oral hygiene, the development of candidiasis, decreased immunity or gastrointestinal pathologies. The disease is accompanied by a typical clinical picture for the disease.
• Candidal (fungal) stomatitis is an acute form of the disease, the so-called thrush, caused by the activity of bacteria of the genus Candida. It is most common in young children, the elderly, and patients who overuse antibiotics. Accompanied by the appearance of a white coating on the mucous membrane, a burning sensation and an unpleasant taste in the mouth.
• Ulcerative is a severe form of the disease that occurs independently or as a result of a complication of the catarrhal course of stomatitis. It occurs acutely, with increased body temperature and enlarged lymph nodes. The resulting ulcers are very painful and can unite and form extensive lesions of the mucous membrane.
• Aphthous stomatitis is a severe form of the disease, occurring acutely or chronically. Accompanied by the appearance of single or multiple gray-white ulcers. The ulcers are surrounded by a red halo and are very painful.

It is important to know! By analyzing the condition of the oral mucosa, the nature of the ulcers and the patient’s complaints, specialists accurately determine the type of stomatitis and make an accurate diagnosis. Thanks to this, treatment of the disease occurs quickly and without complications.

Chronic recurrent herpetic stomatitis

This form of stomatitis is directly related to infection, namely the herpes virus. This virus usually enters the body of an adult in early childhood (in this case, the disease can be practically asymptomatic and not be noticed), after which it settles in the body and remains with us for life. When immunity decreases and other factors favorable for the development of the disease coincide, herpes becomes more active, causing a characteristic picture of the disease.

Among the common causes contributing to the disease, it is worth noting:

• acute respiratory infections, acute respiratory viral infections, hypothermia (leading to a general decrease in immunity);
• seasonal vitamin deficiencies;
• stressful situations;
• allergies of various origins;
• exacerbation of chronic infections of ENT organs (tonsillitis, sinusitis);
• taking drugs that reduce immunity (corticosteroids, for example).

Local factors influencing the development of diseases include:

• injuries to the mucous membrane of the oral cavity and lips;
• soft plaque and tartar;
• infection living in carious cavities and periodontal pockets during gingivitis and periodontitis;
• mouth breathing (as a result of which the mucous membrane dries out and cracks).

Symptoms

• The total duration of the disease usually ranges from 10-14 days.
• General symptoms (headache, weakness, fever), if expressed, are not to a significant extent. There may be enlargement of the submandibular lymph nodes and their soreness.

In the mouth, herpetic stomatitis manifests itself as follows:

• Small (millet-sized) blisters appear on the bright red and swollen mucous membrane, which are usually located in groups.
• Favorite localization sites are lips, cheeks, tongue, palate and palatine arches.
• At the beginning, the contents of the bubbles are transparent, over time they become cloudy, and on the 2-3rd day the bubbles burst, forming erosions, which can be located separately, or can merge into a common erosion with uneven edges.
• Very quickly, a whitish or yellowish fibrinous coating forms on the surface.
• In addition to rashes, the clinical picture of gingivitis is often noted (redness, soreness and bleeding of the gum edge adjacent to the teeth and interdental papillae).
• Often, rashes in the mouth are duplicated by the same bubbles in the area where the edge of the lip meets the skin of the face and at the transition of the nasal mucosa to the skin.
• Outside, after opening the vesicles, a dense crust forms on their surface, which is not removed until the skin underneath has healed and does not leave scars after removal.

It is important to distinguish aphthous stomatitis from herpetic stomatitis, since their treatment is different!

If with aphthous stomatitis the mucous membrane surrounding the rash is unchanged, then with herpetic stomatitis it is bright red and swollen, with aphthous stomatitis there is one or two aphthae of the correct shape, and with herpetic stomatitis there are many small ones or they merge, forming erosion with uneven edges; with aphthous stomatitis there is no primary the appearance of bubbles, no rashes on the lips.

Treatment

• In the first days, antiviral drugs are prescribed in the form of gels and tablets orally. If no treatment was carried out in the first 3-4 days and the blisters have already burst, then antiviral drugs will be of little use in the future. Acyclovir (tablets or ointment), Viferon and other drugs can be taken at the pharmacy and used according to the instructions.
• Antiseptic rinses must also have antiviral activity (herbal decoctions, chlorhexedine and other traditional antiseptics are not used here). It is better to rinse your mouth with miramistin - it is active against the virus.
• Skin rashes are treated with antiviral ointments. Acyclovir, herpevir, Zovirax and other drugs for external use (use according to instructions).
• General treatment comes down to symptomatic correction of well-being (lowering the temperature, if any, drinking plenty of fluids), as well as immunostimulants.
• To heal erosions, from the 3-4th day, the same means are used as for aphthous stomatitis (vitamins A and E, sea buckthorn oil, solcoseryl).
• If erosions are significantly painful, use local anesthetics.

Which doctor should I contact for stomatitis?

If you notice the first signs of damage to the oral mucosa, you should immediately consult a dentist. After differential diagnosis of the disease and an accurate diagnosis, it is possible to observe it with a general practitioner or other specialized specialist, for example, an allergist.

Do not ignore preventive visits to the dentist.

It is enough to visit a specialist 1 – 2 times a year, which will allow you to promptly identify any dental problem at an early stage of development. This means that its elimination will be quick, easy and without complications.

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Where to contact?

Dentists at the Good Hands clinic treat acute stomatitis. They diagnose the form of the disease and, in accordance with it, select a treatment method that gives good results, eliminates pain symptoms and minimizes other unpleasant manifestations of this disease. For this purpose, modern techniques and effective medications are used, which makes the treatment as comfortable and painless as possible. You can schedule a free consultation with us and find out all the necessary information right now by filling out an application on our website or calling us by phone.

How to distinguish stomatitis from other diseases?

The main sign of stomatitis is the presence of characteristic ulcers, the tissue around which looks healthy. The disease is rarely accompanied by systemic symptoms and, as a rule, recurs from time to time. For a competent specialist, it is not difficult to distinguish stomatitis from other ailments.

For a sore throat

When you have a sore throat, your body temperature always rises. In this case, it is not the ulcers themselves that hurt, but the throat area. Upon visual examination, the tonsils appear swollen, inflamed and red.

For herpes

The problem is that herpetic stomatitis is one of the manifestations of herpes. A viral disease is accompanied by the formation of characteristic blisters that burst and dry out. In the presence of other types of stomatitis, the nature of the ulcers is completely different.

For cancer

Ulcers due to cancer of the oral mucosa do not go away on their own even after treatment. Over time, they increase in size and may bleed and become painful.

From thrush

Candidal stomatitis is thrush caused by the activity of bacteria of the genus Candida. In all other cases, the nature of the disease will be different and can be easily distinguished from thrush by the presence of characteristic ulcers.

For syphilis

When infected with syphilis, a red spot appears on the surface of the mucous membrane. Gradually it thickens, takes the form of a dense nodule and ulcerates - a typical hard chancre is formed, which is completely different from ulcers with stomatitis.

Stomatitis: how to overcome the “language barrier”?

Stomatitis on the tongue is just one of the manifestations of this “popular” disease. There are a huge number of reasons for its appearance, as well as ways to treat it.

There are several types of stomatitis, when it manifests itself specifically on the tongue: glossitis, viral stomatitis, vesicular stomatitis, enteroviral vesicular stomatitis, catarrhal stomatitis, fungal stomatitis, etc.

In general, stomatitis on the tongue is most common. Its notable feature is small ulcers, from which the patient suffers greatly. If inflammation is observed only on the tongue, and, for example, there are no signs of stomatitis on the palate, cheek or gum, then this disease is called glossitis.

Recommendations during treatment

Treatment of stomatitis should be carried out comprehensively - local therapy, taking medications appropriate to the type of disease, and strengthening the immune system. During the treatment period, you must adhere to the following recommendations.

• Compliance with the diet - you need to exclude from the diet spicy, salty, sour, too sweet, smoked, hot, cold and any dishes that are traumatic to the mucous membranes.
• Maintaining oral hygiene . To maintain it, it is necessary to use antiseptic agents that you regularly rinse your mouth with.
• Taking vitamin-mineral complexes that strengthen the body's protective functions.

If the doctor has diagnosed the presence of candidal stomatitis, then you should not drink milk or consume fermented milk products, which activate the activity of pathogenic fungi.

Any medications should be used only as prescribed by a doctor. Especially antibiotics.

It is important to know! It is not recommended to cauterize emerging ulcers with pure alcohol solutions. The only thing that is allowed is treating the lesions with a weak solution of iodine or potassium permanganate.

Prevention

To avoid the occurrence of stomatitis and its relapses, you should adhere to the following recommendations.

• Maintain oral hygiene.
• Avoid using products containing sodium lauryl sulfate.
• Protect the oral mucosa from injury.
• To treat teeth and gums, contact experienced, qualified specialists.
• Balance your diet with healthy foods.
• Strengthen immunity.
• Be attentive to your physical health and psycho-emotional state - if necessary, seek help from specialized specialists.

And do not forget that herpes stomatitis can be transmitted from person to person - follow the rules of hygiene.

Photo of stomatitis

Our doctors

18 years of experience

Baghdasaryan

Armen Evgenievich

Chief physician, dentist-orthopedist-therapist

Graduated from VSMA named after. N.N. Burdenko. Internship on the basis of MGMSU named after. A.E. Evdokimov in “General Dentistry”.

Clinical residency at the Moscow State Medical University named after. A.E. Evdokimov in “Orthopedics”.

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5 years experience

Sadina

Ekaterina Vladislavovna

Dental therapist, surgeon

Penza State University Medical Institute, specialty “Dentistry”.

In 2021, she underwent professional retraining in the specialty “Therapeutic Dentistry” at the Moscow State Medical and Dental University named after A.I. Evdokimov.

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8 years of experience

Arzumanov

Andranik Arkadievich

Dentist-orthodontist

Graduated from Moscow State Medical University. Internship - Moscow State Medical University at the Department of Orthodontics and Children's Prosthetics.

Residency at Moscow State Medical University at the Department of Orthodontics and Children's Prosthetics. Member of the Professional Society of Orthodontists of Russia since 2010.

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The development of candidal stomatitis is caused by a fungus of the genus Candida. Frequent stress, hypothermia and fatigue can cause the herpes virus, “dormant” in the body, to transition into the active phase. As for traumatic stomatitis, the reasons for its development can be trauma to the oral mucosa: biting, sharp injury, chemical burn. Drug stomatitis develops due to taking medications that inhibit saliva production.