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Stomatitis

Stomatitides

Stomatitis is an inflammation of the oral mucosa. It is associated with pain, redness, swelling and halitosis.


Presentation

Stomatitis is characterized by the open sore in or around the mouth. It usually presents with pain and discomfort. Other associated signs and symptoms are [7]:

Aphthous Stomatitis
  • Aphthous stomatitis usually lasts for a few days and causes rarely complications.[symptoma.com]
  • Aphthous Stomatitis and Healthy Subjects. 198 days ago Read Risk factors for periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome: a case-control study. 184 days ago Read Risk factors for periodic fever, aphthous stomatitis[terkko.helsinki.fi]
  • What causes aphthous stomatitis? The exact cause of this disease is not known.[stanfordchildrens.org]
Xerostomia
  • Xerostomia was significantly more common and severe in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ.[ncbi.nlm.nih.gov]
  • Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis.[ncbi.nlm.nih.gov]
  • Dry mouth (Xerostomia). Your saliva provides natural protection against infection and lubricates your mouth to stop dentures from traumatizing your gums. Without it you are more prone to getting problems.[jamiethedentist.com]
  • Most commonly, it is due to: Dry mouth / xerostomia Viral infection Candida albicans infection Trauma including surgery Smoking tobacco Toxicity of chemotherapy drugs – including methotrexate used for psoriasis and other skin disorders Therapeutic radiation[dermnetnz.org]
Drooling
  • The child will typically run a fair amount of fever, drool quite a bit, and will be very uncomfortable. You may see some sores on the tongue as your first clue, or perhaps sores around the mouth.[drhull.com]
  • When symptoms do present, they include fever, malaise, drooling, dysphagia (also known as difficulty swallowing), and mouth sores and ulcers, according to the National Institutes of Health .[colgate.com]
  • Other associated signs and symptoms are: Bad breath Burning or tingling in the mouth Dysphagia Drooling Fever, sometimes as high as 38.3 to 40 C (101 to 104 F) Pain in and around the affected area Restlessness or irritability Swollen gums Due to the characteristics[symptoma.com]
  • . • Drooling. • Dysphagia. • Foul-smelling breath. 9.[slideshare.net]
  • Blisters can make it difficult to swallow and cause drooling. Your child may have a high fever, sore throat, and feel tired. Is stomatitis contagious? Yes. It is contagious. It can be spread by close contact with cold sores.[virtualpediatrichospital.org]
Tongue Ulcer
  • Signs and symptoms may include: Ulcers in the mouth, usually inside the lips, on the cheeks, or on the tongue Ulcers that are covered with a yellow layer and have a red base No fever present (in most cases) Lesions usually heal in seven to 14 days Lesions[stanfordchildrens.org]
  • Symptoms may include: Ulcers in the mouth, usually inside the lips, on the cheeks, or on the tongue Ulcers that are covered with a yellow layer and have a red base For the full article: Hope this helps. More discussions about stomatitides[medical-dictionary.thefreedictionary.com]
  • Candidiasis of the tongue. Ulcer on the tongue. Candida fungus. Coloring page.[shutterstock.com]
Sore Mouth
  • Denture Sore Mouth (Denture-Related Stomatitis) Denture sore mouth is also known as sore mouth under plates, chronic denture palatitis , stomatitis prosthetica , denture-related candidiasis , denture- induced stomatitis and denture stomatitis .[exodontia.info]
  • Stomatitis , a general term for an inflamed and sore mouth , can disrupt a person's ability to eat, talk, and sleep . Stomatitis can occur anywhere in the mouth , including the inside of the cheeks, gums, tongue , lips, and palate.[webmd.com]
  • Call your provider if your child develops a fever followed by a sore mouth, and your child stops eating and drinking. Your child can quickly become dehydrated. If the herpes infection spreads to the eye, it is an emergency and can lead to blindness.[medlineplus.gov]
  • Called also chronic atrophic candidiasis and denture sore mouth . gangrenous stomatitis see noma . herpetic stomatitis herpes simplex involving the oral mucosa and lips, characterized by the formation of yellowish vesicles that rupture and produce ragged[medical-dictionary.thefreedictionary.com]

Workup

Due to the characteristics of the open sores associated with stomatitis, the disorder can usually be diagnosed clinically [8]. Laboratory tests are usually not needed to confirm a diagnosis, but during a workup cultures or blood tests may be done in order to rule out any other condition and to find the etiologic factors behind the disorder. 

Treatment

Each treatment plan is fully dependent on the type of stomatitis the person is suffering from [9]. Generally, the condition will resolve on it own, but lifestyle recommendations for the patient may be useful. For example improved oral hygiene including a professional cleaning. The patient should also be told to stay away from sharp-edged or acidic foods while the sores are present. Switching to a softer tooth brush may also be recommended.

If the stomatitis has been caused by irritation from braces, jagged teeth, ill-fitting orthodontia or from chronic mouth breathing, those specific factors might need to be addressed by the appropriate medical professional. Alcohol and tobacco use should be avoided.For pain relieve, acetaminophen is usually recommended. Depending on the cause, several other medications may be used to treat stomatitis. 

Prognosis

Most stomatitis ulcerations are considered to be benign and will resolve themselves without any medical treatment, but the prognosis for stomatitis can vary depending on the type [6].

Aphthous stomatitis usually lasts for a few days and causes rarely complications. Herpes stomatitis, usually takes around 10 days to clear up without any medical treatment, but an oral acyclovir can speed up the recovery time and help with some of the discomfort. In general, neither form of stomatitis poses a significant health risk to the patient, if the underlying etiology if necessary is treated.

Etiology

There are various factors responsible for the appearance of stomatitis including irritation from braces, jagged teeth harming the soft tissue, cheek biting, and other similar causes [2]. Herpes stomatitis is a direct result of the herpes simplex virus type 1. Aphthous stomatitis has unclear etiologic factors but theories include a predisposition which is associated to a person’s immune system of triggers such as stress or certain deficiencies like a lack of iron, B12, or folic acid. Other viral infections, notrition, smoking, chemotherapy, radiation therapy, menstruation in women, and food allergies are also thought to be linked to stomatitis [3].

Epidemiology

Stomatitis, in general, is reported across the world and has a prevalence rate ranging from around 2 percent to 66 percent. It can occur at any age but there are certain variations of the ailment that appear at different stages of a person’s life [4].

Aphthous stomatitis usually affects children and adults and is seen most often in people between the ages of 10 and 19 years of age. Herpes stomatitis is seen more so in children between the ages of one and two and is considered possible anywhere between the ages of six-months-old and five-years-old.

According to research, children from a higher socioeconomic level are more commonly affected by stomatitis than children living in lower socioeconomic groups.

Sex distribution
Age distribution

Pathophysiology

The pathophysiology of the disorder depends on the underlying etiology. Stomatitis initially usually causes erythema of the mucous membrane of the mouth, further developing into open ulcers and fissures [5]. The condition can occur as a single sore or they can appear in clusters. The lesions on examination usually have a yellow or white color at the center coupled with a fibrous texture. The border of the sores is erythematous.

Prevention

Stomatitis can be prevented if it occurs due to an outside irritant. Improved oral hygiene, better eating habits, and regular dental check-ups can help prevent stomatitis [10].

In order to prevent aphthous stomatitis, it is recommended to avoid any mouth trauma like biting the cheeks or burning the mouth with hot food or drinks. Herpes stomatitis isn’t considered to be preventable since it is due to the herpes simplex virus which can be transmitted from an infected person even when they show no signs of the disorder.

Summary

Stomatitis occurs when the soft tissue lining in the mouth becomes inflamed causing redness, swelling, and often times pain [1]. The may have various etioligies, two common forms are aphthous stomatitis and herpes stomatitis due to the herpes simplex virus

Stomatitis can occur at any point in a person’s life but is seen more often in children and adolescents. It is associated with poor oral hygiene, side effects of certain medications, infections, allergic reactions, or it may occur as the result of burns from hot food or liquids.

Patient Information

Stomatitis refers to the open sores that can occur on the soft tissue inside the mouth. They are not considered to be contagious and can usually resolve themselves without medical treatment. There are several forms of the ailment, herpes stomatitis and aphthous stomatitis being common ones. Each form has its own causes and prognoses. Note, stomatitis is different than cold sores.

The sores can be painful or cause discomfort during eating and swallowing, but there are no dangers posed from the ailment. The disorder can affect anyone at any stage in life but is most commonly seen in children and adolescents.

If a patient notices that their sores haven’t resolved themselves after two weeks, medical treatment should be sought.

References

Article

  1. Solomon LW. Chronic ulcerative stomatitis. Oral diseases 2008 14 (5): 383–9.
  2. Yamada T, Alpers DH, et al. Textbook of gastroenterology (5th ed.). Chichester, West Sussex: Blackwell Pub. 2009 ISBN 978-1-4051-6911-0.
  3. Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, Walsh T, Riley P, Yates JM. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). In Brocklehurst, Paul. The Cochrane database of systematic reviews 9: CD005411. 2012
  4. Kanerva L, Alanko K, Estlander T. Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates". Allergy 1999 54 (12): 1316–1321.
  5. Neville BW, Damm DD, Allen CA, Bouquot JE. Oral & maxillofacial pathology (2nd ed.). Philadelphia: W.B. Saunders. pp. 141, 142. 2002 ISBN 0721690033.
  6. Crivelli MR, Aguas S, Adler I, Quarracino C, Bazerque P. Influence of socioeconomic status on oral mucosa lesion prevalence in schoolchildren. Community Dent Oral Epidemiol. Feb 1988;16(1):58-60.
  7. Axéll T, Henricsson V. The occurrence of recurrent aphthous ulcers in an adult Swedish population. Acta Odontol Scand. May 1985;43(2):121-5.
  8. Gallo Cde B, Mimura MA, Sugaya NN. Psychological stress and recurrent aphthous stomatitis. Clinics (Sao Paulo). 2009;64(7):645-8.
  9. Huling LB, Baccaglini L, Choquette L, Feinn RS, Lalla RV. Effect of stressful life events on the onset and duration of recurrent aphthous stomatitis. J Oral Pathol Med. Feb 2012;41(2):149-52. 
  10. MacPhail LA, Greenspan D, Feigal DW, Lennette ET, Greenspan JS. Recurrent aphthous ulcers in association with HIV infection. Description of ulcer types and analysis of T-lymphocyte subsets. Oral Surg Oral Med Oral Pathol. Jun 1991;71(6):678-83.

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Last updated: 2017-08-09 17:55