Summary about Disease
Stomatitis is a general term for inflammation and sores inside the mouth. It can affect the cheeks, gums, tongue, lips, and palate. There are various types of stomatitis, including canker sores (aphthous stomatitis), cold sores (herpes simplex stomatitis), and denture stomatitis. The severity can range from mild discomfort to significant pain that interferes with eating, talking, and sleeping.
Symptoms
Painful sores or ulcers inside the mouth
Redness or swelling in the mouth
Difficulty eating, drinking, or speaking
Irritability in infants and young children (drooling, refusing to eat)
Bleeding gums
White or yellow plaques in the mouth (in some types of stomatitis)
Fever (less common, but possible)
Causes
The causes of stomatitis vary depending on the type:
Canker sores (Aphthous Stomatitis): The exact cause is unknown, but factors may include stress, hormonal changes, immune system problems, food sensitivities, nutritional deficiencies (iron, vitamin B12, folate), minor mouth injuries, and genetics.
Cold sores (Herpes Simplex Stomatitis): Caused by the herpes simplex virus type 1 (HSV-1).
Denture Stomatitis: Often caused by a fungal infection (Candida) due to poorly fitting dentures or poor denture hygiene.
Other causes: Bacterial infections, viral infections (other than HSV), fungal infections, allergic reactions, burns from food or drinks, chemotherapy, radiation therapy, medications, autoimmune diseases (like lupus or Crohn's disease), and certain medical conditions.
Medicine Used
Treatment depends on the type and severity of stomatitis:
Pain Relief:
Over-the-counter pain relievers (acetaminophen, ibuprofen)
Topical anesthetics (lidocaine mouthwash, benzocaine gels)
Antiviral Medications:
Acyclovir, valacyclovir, or famciclovir (for herpes simplex stomatitis)
Antifungal Medications:
Nystatin mouthwash or clotrimazole troches (for fungal infections like denture stomatitis)
Corticosteroids:
Topical corticosteroids (triamcinolone acetonide) or oral corticosteroids (prednisone) for severe canker sores or other inflammatory conditions.
Mouth Rinses:
Salt water rinses
Chlorhexidine mouthwash (antimicrobial)
Magic mouthwash (a compound rinse containing various ingredients like an anesthetic, antihistamine, and corticosteroid).
Other:
Amlexanox oral paste (for canker sores)
Is Communicable
Cold sores (Herpes Simplex Stomatitis): Highly contagious. Spread through direct contact (kissing, sharing utensils, etc.).
Denture Stomatitis: Not generally contagious, as it is usually caused by an overgrowth of Candida that is already present in the mouth.
Canker sores (Aphthous Stomatitis): Not contagious.
Precautions
Good Oral Hygiene: Brush teeth gently after meals, floss daily.
Avoid Irritants: Avoid spicy, acidic, or salty foods. Avoid hard or crunchy foods that can irritate sores.
Soft Toothbrush: Use a soft-bristled toothbrush.
Proper Denture Care: Clean dentures daily and remove them at night. Ensure dentures fit properly.
Manage Stress: Stress can trigger canker sores.
Avoid Sharing: Avoid sharing utensils, drinks, or personal items (e.g., lip balm, towels) with others, especially if you have cold sores.
Handwashing: Wash hands frequently, especially after touching sores.
Dietary Considerations: Identify and avoid foods that trigger outbreaks. Ensure adequate intake of iron, vitamin B12, and folate.
Sun Protection: Use sunscreen on lips to prevent cold sore outbreaks triggered by sun exposure.
How long does an outbreak last?
Canker Sores (Aphthous Stomatitis): Typically last 1-2 weeks.
Cold Sores (Herpes Simplex Stomatitis): Usually last 7-14 days.
Denture Stomatitis: Can persist for weeks or months if not treated properly. Duration depends on the underlying cause and treatment effectiveness.
How is it diagnosed?
Visual Examination: A doctor or dentist can often diagnose stomatitis based on a visual examination of the mouth.
Medical History: The doctor will ask about your medical history, medications, and any possible triggers (stress, foods, etc.).
Culture: A swab of the sore can be taken to test for viral (herpes simplex virus), bacterial, or fungal infections.
Biopsy: In rare cases, a biopsy of the sore may be necessary to rule out other conditions.
Blood Tests: Blood tests may be done to check for underlying medical conditions (e.g., nutritional deficiencies, autoimmune diseases).
Timeline of Symptoms
This is a general timeline and can vary from person to person:
Canker Sores:
Prodrome (1-2 days): A tingling or burning sensation may precede the appearance of a sore.
Sore Formation (1-2 days): A small, red bump appears, which quickly develops into an open ulcer.
Painful Stage (4-10 days): The sore is most painful during this time.
Healing (1-3 weeks): The sore gradually heals without scarring.
Cold Sores:
Prodrome (1-2 days): Tingling, itching, or burning sensation at the site where the sore will appear.
Blister Formation (1-2 days): Small, fluid-filled blisters appear.
Ulceration (2-3 days): The blisters rupture and form open sores.
Crusting (4-5 days): The sores begin to crust over.
Healing (7-14 days): The crusts fall off, and the skin heals.
Important Considerations
Recurrent Stomatitis: If you experience frequent outbreaks of stomatitis, it's important to identify and avoid potential triggers.
Underlying Medical Conditions: Stomatitis can sometimes be a symptom of an underlying medical condition. If you have recurrent or severe stomatitis, especially if accompanied by other symptoms, see a doctor to rule out other problems.
Infants and Children: Stomatitis can be particularly uncomfortable for infants and young children. Consult a pediatrician for appropriate treatment and management.
Medication Side Effects: Some medications can cause stomatitis as a side effect. Discuss any new medications with your doctor or pharmacist.
Cancer Screening: Chronic non-healing ulcers must be checked for cancer.