Stomatitis

Inflammation usually appears on the roof of the mouth, tongue, inside of the cheeks and at the base of the gums.

This inflammation of the oral cavity can be painful and cause intense burning or pain in the area of appearance, and usually heals in one or two weeks.

What is stomatitis?

Stomatitis can be acute or chronic and affect individuals of any age.

The inflammation may be localized in a precise point of the oral mucosa or involve the oral mucosa in a diffuse and generalized manner.

Stomatitis can cause different symptoms, all of which are localized in the oral cavity: swelling, redness, sometimes oral ulcers (aphthae) and bleeding. The signs of stomatitis are often intensified by eating, talking or brushing the teeth.

There are several types of stomatitis:

• Aphthous stomatitis: this is the most common form of stomatitis. It presents with multiple aphthous lesions that may appear in any area of the oral mucosa.
• Subprosthetic stomatitis: lesions that appear in the prosthesis support area, usually hard palate or mandibular bone ridge. It is associated with inadequate prosthetic hygiene and lack of rest from the use of these.
• Herpetic stomatitis: leads to the appearance of canker sores, usually in the form of a cluster that after a few days may become a large canker sore.
• Angular stomatitis: reddish lesions that appear in the labial commissure, unilaterally or bilaterally, frequently occurring in children and older adults.

If stomatitis recurs with some regularity, it is worth reflecting on possible triggering factors, which are usually food intolerances or allergies, nutritional deficiencies (e.g. lack of iron, folic acid or vitamin B3) or conditions of high stress.

What areas are involved?

Stomatitis is an inflammation of the tissue lining the oral cavity and can be located on the inside of the cheeks and on the roof of the mouth, tongue, gums and/or lips.

Possible disorders associated with stomatitis

Stomatitis is sometimes associated with small painful mouth ulcers. In addition, depending on the area of occurrence, it may be associated with secondary disorders such as: gingivitis (gums), glossitis (tongue) or cheilitis (lips). If extremely painful, the lesions that characterize stomatitis can make food intake problematic, leading to dehydration and malnutrition.

Causes

Infections and decreased immune defenses.

At the level of the oral mucosa, there are numerous microorganisms which, for various reasons, can predispose to the appearance of stomatitis. However, the normal flow of saliva is generally effective in protecting the mucosa against mechanical, physical and chemical aggressions.

Sometimes, with the appearance of stomatitis, a decrease in the defenses naturally present in the oral cavity can be highlighted; this deficit favors the establishment and proliferation of bacteria, viruses or fungi, which can exert their pathogenic action. This condition would be favored by nutritional deficiencies or endocrine system disorders.

Irritants and allergens

Stomatitis can be caused not only by local infections, but also by contact with irritating substances (chemical or physical) or by an allergic reaction.

Other possible causes

Other factors that predispose to the onset of stomatitis can be of various kinds and include:

• Poor oral hygiene.
• Alteration of saliva composition.
• Infectious diseases.
• Metabolic alterations.
• In some cases, stomatitis can be defined as an idiopathic disease, i.e. without known external causes.

Symptoms

Stomatitis is a generally very painful inflammation, which may present with burning, swelling, redness and oral ulceration (aphthae); these sensations usually increase during the ingestion of beverages or food.

In addition to these manifestations, other secondary signs may appear:

• Bleeding gums.
• Increased salivary secretion.
• In some cases, general symptoms such as fever and enlarged lymph nodes also appear.

Treatment

Before starting treatment, it is important to remember that it is essential to identify the specific cause of the stomatitis. The treatment of stomatitis depends, in fact, on the type, symptomatology and the set of factors that are at the origin of the disorder.

Medications for stomatitis

Stomatitis is usually treated with medications to alleviate the symptoms associated with the disease:

• Antiseptics, useful for the disinfection of the oral cavity avoiding the risk of complications.
• Antibiotics, antifungal or antiviral drugs, in case of infection, under medical advice.
• Anesthetics and analgesics, to relieve the sensation of pain related to the presence of the injury.

Your KIN must-haves:

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TOOTHPASTE

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MOUTHWASH

Mouth rinses for stomatitis

Some types of mouthwashes are especially indicated for the treatment of stomatitis, thanks to the presence of active ingredients and specific components effective in treating the signs of inflammation.

These components are:

• Chlorhexidine: the most widely used antiseptic in dentistry due to its high efficacy on microorganisms present in the oral cavity.
• Cetylpyridinium chloride: another antiseptic commonly used in daily oral hygiene products, thanks to its ability to act on the bacteria that cause gingivitis and caries.
• Aloe vera: active ingredient frequently used in cosmetic products for its benefits on skin and mucous membranes. It improves wound healing because it increases the content of collagen fibers in the connective tissue.

In addition, it has anti-inflammatory, antiseptic and moisturizing properties.

The use of mouthwashes is intended to improve symptoms and prevent complications.

Other treatment options

Depending on the cause, other treatments for stomatitis include the local use of:

• Anesthetics: sucralfate, lidocaine.
• Protective or barrier medications.
• Anti-inflammatory drugs: dexamethasone, triamcinolone.
• Physical or chemical cauterization.

In the case of stomatitis, it is useful to take certain precautions from the beginning:

• If detected, all substances that cause stomatitis should be avoided, including drugs and/or specific foods to which the person has developed allergies or intolerances.
• Meticulous oral hygiene can help prevent secondary infection.
• Suspend or eliminate the consumption of alcohol, coffee and tobacco.

Prevention of stomatitis

The best way to prevent the formation of vesicles in the mucosa is undoubtedly to achieve perfect oral health, especially when wearing dentures or braces, and thus also avoid the formation of cavities and bad breath.

Therefore, it is important to choose a toothpaste suitable for the mouth and teeth and to choose a toothbrush with soft or semi-soft bristles . Brush your teeth every day after every meal.

To prevent the formation of ulcers, it would be advisable to eliminate, or at least reduce, the consumption of alcohol and tobacco in general, but also to limit the consumption of acidic or spicy foods.

It is advisable to incorporate into the diet plenty of fruits, vegetables and whole grains rich in sodium and mineral salts that can help improve our immune system and, therefore, the well-being of the whole organism.

Last but not least, it is advisable toalways try to reduce stress, one of the main causes of mouth ulcers, perhaps by doing some physical activity to keep the body and mind healthy.

Infantile stomatitis

Even children, usually after the age of 10, can be affected by stomatitis, in particular recurrent aphthous stomatitis and herpetic stomatitis, due to Herpes Simplex, which manifest as annoying blisters inside the mouth that can cause pain when they break. The causes are the same as in adults:

• Weakening of the immune system.
• Stress.
• Use of NSAIDs (non-steroidal anti-inflammatory drugs).
• Vitamin deficiencies.

The difference between aphthous and herpetic stomatitis is that the former is not contagious, while the latter is very contagious, and a contact as simple as a kiss is enough. The former can be recognized by the characteristic appearance of ulcers, even on the tongue, while herpetic stomatitis (also called gingivostomatitis) gives fever and pain in the mouth. Most cases resolve on their own, but it is good to know that these are recurrent manifestations, even several times in a year.

As for treatment, if the diagnosis is recurrent aphthous stomatitis, neither antibiotics nor antivirals are recommended, even in children, as the cause is not directly attributable to a specific pathogen. Therefore, the physician will suggest maintaining optimal oral hygiene and treating the symptoms, for example:

• Keep the child hydrated.
• If necessary, prescribe local anti-inflammatory drugs or cortisone, depending on the extent of the manifestation.

Herpetic stomatitis, on the other hand, will require the use of antivirals, usually in the form of an ointment to be applied or, alternatively, in tablet form, to accelerate healing.