What causes stomatitis and treatment. How to treat stomatitis in the mouth? Stomatitis in adults and children: treatment, medications. Antiviral, antifungal and antihistamine drugs

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Stomatitis is an inflammatory process in the oral mucosa (stoma in Greek means “mouth”, itis is an inflammatory process). Since the etiology and causes of inflammation can be different, the clinical picture and symptoms of stomatitis are also variable and depend on the form, the location of the disease, the degree of prevalence and many other factors. Factors that provoke stomatitis can be local or general - injury, allergy, virus, fungal or bacterial infection, oral irritation from food, chemicals, vitamin deficiency and lack of microelements (most often iron). Stomatitis develops in people of any age and gender, but more often it affects children and elderly patients.

IN international classification diseases, ICD-10 disease is described in block K12 - Oral diseases, salivary glands and jaws.

Stomatitis and its symptoms are classified as follows:

By prevalence:

Superficial inflammatory processes, superficial stomatitis.
Aphthous (fibrinous).
Catarrhal.
Deep stomatitis.
Ulcerative.
Necrotic.

For reasons, etiology:

Traumatic factors – physical, chemical.
Infectious stomatitis – viruses, bacteria, fungi.
Symptomatic stomatitis as a consequence of the underlying disease internal organs and systems.

According to the course of the inflammatory process:

Spicy.
Subacute.
Recurrent, chronic.

By localization of inflammation:

Inflammation of the gums - gingivitis.
Inflammation of the tongue - glossitis.
Inflammation of the lips - cheilitis.
Inflammation of the palate (upper and lower) - palatinitis.

Is stomatitis contagious?

Depending on the form, etiology and type, stomatitis can indeed be contagious, that is, infectious. There is still no consensus on how contagious stomatitis is, however, it is quite logical to assume that it is viral, bacterial or fungal disease Oral diseases can be passed from one person to another just like other diseases. Whether stomatitis is contagious is determined by a dentist who identifies the real reason inflammation.

How different types of stomatitis can be transmitted:

Herpetic stomatitis. This type of disease can be infected through household items - dishes, toys, towels, toothbrush, lipstick, and so on. The herpes virus is transmitted from a sick person to a healthy person and can affect the oral cavity.
Candidal stomatitis. It is most often diagnosed in children under one year of age, but adults can also suffer from it. The fungus can be transmitted through untreated cutlery, an infected infant on breastfeeding, can infect the mother's breasts (nipples), just as an infected mother can contribute to the infection of the child during childbirth - passage through the birth canal.
Enteroviral vesicular stomatitis. This species is characterized by a high degree of contagiousness among young children and it is no coincidence that the disease is called “hand-foot-mouth”. The virus is isolated from the feces, vesicles of an infected person and is transmitted through multiple routes - oral (food or water), contact, airborne droplets.

It is believed that the contagiousness of stomatitis has not been confirmed by scientifically based facts, however, the question of whether stomatitis is contagious can be answered by practicing doctors, and definitely. As a rule, with stomatitis, they recommend that all objects used by the patient be treated as thoroughly as possible and that close contact (kissing) be limited to avoid infection. In a word, like any other infection - bacterial, viral, mycotic, certain types of stomatitis are still contagious.

Signs of stomatitis

The most typical signs of stomatitis are hyperemia of the oral mucosa, swelling, burning sensation, itching, often ulceration and bleeding. Stomatitis can be localized to certain areas, but can affect the entire oral cavity. The generalized form is accompanied by a serious condition - high fever, weakness, difficulty eating.

Symptoms of stomatitis usually develop in three stages:

The first stage of the inflammatory process manifests itself in slight redness of areas of the oral cavity, and a feeling of dryness may appear.
A few days later, this area swells and a characteristic white coating, under which the developing erosion is hidden.
Ulcers under plaque can be multiple or single, superficial or deep, merging with each other.

If the inflammation is not stopped, the process spreads throughout the mouth, often affecting the corners (jams). Ulcers covered with a white coating are visible on the cheeks, tongue, palate and even on the tonsils.

The specific clinical picture and symptoms of stomatitis are directly related to the type of disease, its form and causes and can be as follows:

The formation of erosions of different sizes - from a millimeter to 10 mm.
Feeling of dry mouth, frequent swallowing.
Pain when swallowing food.
Pain when talking.
Redness and swelling of the tongue.
Tongue irritation.
Loss of taste.
Intense salivation.
Characteristic odor from the mouth.
In the acute form – hyperthermia.
Lack of appetite.
Ulcers in the corners of the mouth.
Plaque on the tongue, cheeks, palate.
Bleeding.

Bad breath with stomatitis

As with many other diseases of the oral cavity, when bacteria and harmful microorganisms multiply there, bad breath with stomatitis is a common uncomfortable consequence. Hypersalivation, that is, increased salivation, in itself is a source of an unpleasant odor, but this symptom is especially typical in the ulcerative-necrotic form of the disease, when stomatitis does not occur in isolation, locally, but affects all the mucous membranes of the cavity up to the tonsils, spreading to the internal organs and on the skin. In addition to headache, hyperthermia, weakness and inability to eat, and pain when talking, a characteristic smell of rotting or, as it is commonly called, halitosis emanates from the mouth of a sick person.

A similar symptom in the form of halitosis and an unpleasant odor is typical of almost all types of stomatitis, which occurs in a chronic, recurrent form. The acute form of the disease rarely lasts more than 2 weeks and the bacteria simply do not have time to die and cause an unpleasant odor. Thus, bad breath with stomatitis can be a completely logical consequence of the course of catarrhal (chronic), aphthous, vesicular, ulcerative-necrotic, purulent type of disease. As soon as the bacterial plaque and the actual cause of stomatitis are eliminated, the unpleasant odor disappears. In addition, measures aimed at treating gastrointestinal diseases, which are often the root cause of protracted stomatitis, help get rid of halitosis.

Blood with stomatitis

The mucous membrane is always populated by a certain number of microorganisms, this directly concerns the oral cavity, where the bacterial balance is most vulnerable. The balance between the bacterial microflora and local immunity in the form of salivation is the most important protective function, and if it is disturbed, the mucous membrane becomes thinner, becomes dry and ulcerated, opening the way for the uncontrolled proliferation of bacteria. Blood during stomatitis can be released due to the appearance of ulcers, necrotic areas, and also because the mucous membrane is characterized by its intense blood supply. Thus, local protection in the form of an integral mucous membrane is disrupted, the composition of saliva changes, where increased level lysozyme.

Blood and bleeding in stomatitis are characteristic of herpetic, ulcerative-necrotic (Vincent's stomatitis), aphthous (severe recurrent form), and other types of disease associated with infection and penetration of bacteria and viruses into the oral cavity. Blood is atypical for stomatitis caused by candida, allergies, for catarrhal, medicinal and symptomatic types of the disease, although their severe, advanced forms can also be accompanied by bleeding gums.

Pain with stomatitis

Pain symptom when swallowing, chewing food, talking, smiling, and so on - this is a typical clinical manifestation of many types of stomatitis in an advanced stage.

Even something as simple as catarrhal inflammation of the oral mucosa can be accompanied by a painful symptom. Pain with stomatitis is caused by ulceration of large areas of the oral cavity, drying out of the mucous membrane and necrotization of tissues. In addition, pain can be caused by total swelling of the gums, palate, swelling and erosion of the tongue. The acute form of many types of stomatitis lasts quite a long time - up to two weeks, and all this time the patient feels pain and burning during such ordinary actions as eating and talking. Severe, recurrent forms of stomatitis are also characterized by pain; in addition, a person’s body temperature rises and pain is felt not only in the oral cavity, but also in the submandibular lymph nodes, joints, and muscles (aches). Pain is also characteristic of the herpetic type of stomatitis, while discomfort is constantly felt, the entire oral cavity itches, herpetic rashes can spread to the lips, which also hurt, their corners crack and become inflamed. The painful symptom subsides when the main inflammatory process is removed and the identified pathogen - virus, bacteria - is neutralized.

Temperature with stomatitis

Hyperthermia with stomatitis is a phenomenon characteristic of severe forms diseases when it is not diagnosed in a timely manner and is not treated initial stage.

As a rule, the symptoms of acute forms of stomatitis with proper therapy subside within 2-3 days. If the inflammatory process is not stopped, it develops and becomes widespread, generalized, not only the oral mucosa suffers, pathogens - viruses, bacteria, fungi - penetrate into the regional lymph nodes, often into the gastrointestinal tract (enteroviral stomatitis), provoking a reaction from the immune system.

The temperature during stomatitis can be quite high - up to 39-40 degrees, this is especially dangerous for newborn babies, who are most often diagnosed with candidiasis and herpetic types of stomatitis. Body temperature directly depends on the severity of the process, its prevalence, if stomatitis occurs in mild form, hyperthermia does not occur. Moderate forms are accompanied by low-grade fever, sometimes reaching 38 degrees. Children under 3 years of age suffer the most from stomatitis; older children cope with the symptoms more easily, since they are able to rinse their mouths on their own, and unlike newborns, they understand the importance and take a direct part in the treatment.

The absence of elevated temperature during stomatitis indicates its mild or acute, transient form, when no additional infection is added to the process - ARVI, adenovirus, and so on.

Cough with stomatitis

Cough with stomatitis is not a typical clinical manifestation of the disease and cannot be considered a specific symptom.

In the dental pediatric practice There have been cases where severe forms of generalized stomatitis can be accompanied by a runny nose, cough, and hyperthermia. However, this is more likely a manifestation of side symptoms of a concomitant or primary disease, rather than a sign of stomatitis as an independent nosological unit. Even catarrhal stomatitis, despite the origin of the name from the Greek katarreo - inflammation, drainage, is not characterized by a cough; rather, it is characterized by inflammation of the entire mucous membrane, its hyperemia.

A cough with stomatitis is a signal of an additional infection, often of viral etiology, since bacterial infections are more characterized by purulent discharge. A cough may be accompanied by a severe form of herpetic stomatitis, but not as a specific symptom, but due to the fact that herpes weakens the immune system and makes the body vulnerable to various viral and bacterial diseases - influenza, ARVI, acute respiratory infections. Adenovirus, parainfluenza often coexists with stomatitis, especially in young children, manifesting itself with fever, cough and nasopharyngeal discharge.

In addition, cough is a typical symptom characteristic of stomatitis, which develops as a consequence of tuberculosis infection; this disease is more often diagnosed in adult patients.

Stomatitis on the gum

Stomatitis on the gums is gingivitis, which is the name given to inflammatory processes localized on the gums. The cause of gum stomatitis can be various etiological factors, however, most often inflammation is provoked by mechanical irritation from dentures, tartar, an unsuccessfully placed filling or an incorrectly selected Toothbrush. In addition, simple malocclusion can be the main cause of gingivitis. Rarely, stomatitis on the gums can be caused by vitamin deficiency or periodontal disease - a systemic disease of the gum tissue.

Symptoms of gum inflammation:

Swelling and hyperemia of the gums, lower or upper.
Bleeding gums when eating or brushing teeth.
A burning sensation, itching in the gum area with catarrhal gingivitis.
Formation of ulcers along the edge of the gums in severe forms of stomatitis.
Smell from the mouth.

It should be noted that the rarest type of gum stomatitis is scurvy gingivitis, which develops as a result of persistent persistent deficiency of vitamin C.

There is also a hypertrophic form of gingivitis, which is a consequence of chronic periodontal disease, when the gums atrophy, become necrotic, and teeth become loose without pain.

Stomatitis under the tongue

Symptoms that manifest themselves as stomatitis under the tongue indicate that a herpetitised form of inflammation of the oral cavity is developing. It is this type of stomatitis that is characterized by ulceration of the area under the tongue, the fundus area. All other signs of stomatitis that affect the tongue are classified as glossitis. Glossitis is characterized by inflammation of the surface layer of the mucous membrane; less often, deep ulcers affecting the thickness of the tissue can develop. The rarest symptom is a deep perforated ulcer of the tongue, accompanied by purulent discharge in the form of an abscess. Stomatitis sublingualis can develop as a result of a protracted, infectious process, which is characterized as generalized, involving the entire oral cavity. Most often, the sublingual area suffers from purulent-inflammatory stomatitis. A person has difficulty swallowing, speaking, and develops hypersalivation (increased salivation). If timely treatment is not started, the spread of bacterial infection involves the mandibular space, maxillary lingual groove, jaw bone tissue, up to the development of osteomyelitis.

Stomatitis in the mouth

Stomatitis is a general name that unites many types of inflammation of the oral cavity.

A collective description of the inflammatory process, which many call stomatitis in the mouth, is actually divided into certain isolated localized (local) inflammations:

The inflammatory process in the gums is gingivitis.
Inflammation of the palate - palatinitis.
Inflammation of the mucous membrane of the tongue - glossitis.
Inflammation of the border and tissues of the lips - cheilitis, including angular (seizures).

Also, stomatitis in the mouth can be generalized, that is, one that affects literally the entire oral cavity, including the tonsils.

The causes of stomatitis are also multiple; the symptoms are directly related to the type of inflammation and its etiology. Nevertheless, common features stomatitis are:

Redness of the mouth.
Swelling of the gums.
Plaques on the cheeks and tongue.
The appearance of rashes in the form of papules, ulcers, aphthae, pustules (depending on the type of stomatitis).
Smell from the mouth.
Bleeding.
Pain when eating.

Diagnosis and treatment of stomatitis in the mouth is carried out differentially according to symptoms and etiological reasons. The prognosis is generally favorable, but relapses and transformation of inflammation into chronic form.

Stomatitis on the lip

Stomatitis on the lip, in the corners of the lips, is cheilitis, most often caused by the herpes virus, as well as angular cheilitis or catarrhal cheilitis.

Causes of cheilitis:

Candidal stomatitis.
Rarely - catarrhal stomatitis, which transforms into a chronic form.
Herpetic stomatitis.
Vitamin deficiency (B vitamins).
Gonococcal stomatitis.
Bacterial forms of stomatitis caused by staphylococcus, streptococcus.

Stomatitis on the lip most often manifests itself as angular inflammation, that is, seizures.

The corners of the lips first become inflamed, then become covered with pustules containing pus. The pustules burst, forming cracks, which, as a result of moving the lips when eating food or talking, do not heal for a long time. The skin of the corners of the lips is hyperemic, ulcers may form, which periodically recur and secrete pus. The epithelium of the lips desquamates (flakes), the lips itch and itch. Stomatitis on the lip is a contagious inflammation, so the patient first of all needs to observe the rules of personal hygiene and use only personal cutlery, a toothbrush, a towel, and so on.

Stomatitis on the tonsils

Stomatitis can spread to the tonsils only in the case of a severe form of the disease; these types of inflammation belong to a serious category - fusotrepanematosis of the oral cavity. The causative agents of such diseases are bacteria of the Treponema or Fusobacterium family. As a rule, the herpes virus, streptococci, and staphylococci do not spread to the larynx due to stomatitis, although they may be present in it for another separate reason (an independent disease).

Fusotrepanematoses include the following diseases:

Gingivostomatitis, Vincent's disease.
Angina Plaut - Vincent.
Ludwig's phlegmon, phlegmon of the oral cavity.

Most often, stomatitis on the tonsils is Plaut-Vincent angina or Botkin-Simanovsky stomatitis. Its causative agents are two microorganisms - spirochetes and spindle-shaped bacilli, or rather saprophytes, which are present in the mouth of a healthy person without causing inflammation. The pathogenicity of microorganisms is associated with the following factors:

Gradual decrease in immune defense (often HIV).
Violation of basic rules of personal hygiene.
Alcoholism, drug addiction.
General exhaustion of the body as a result of prolonged chronic inflammation.
Fasting, poor nutrition.
Hypothermia, frostbite.
Intoxication.

Localized on the tonsils, such a sore throat quickly spreads throughout the entire oral cavity, affecting the gums, tongue, cheeks, and palate. Most often, stomatitis on the tonsils is unilateral, accompanied by ulcers, infiltrates, and necrotic areas of the mucosa. The disease can recur if complex and adequate treatment is not applied. In addition, adenophlegmons and severe intoxication of the body can be a complication.

Symptoms of aphthous stomatitis

Aphthous stomatitis It is divided according to the nature of the course into acute and recurrent, and the symptoms of the disease are accordingly different.

The acute form of aphthous stomatitis has very specific causes:

Colitis, enteritis, other diseases of the gastrointestinal tract.
Allergy.
Viral infection.
Trophoneurotic disorders.

The symptoms of aphthous stomatitis in acute form are specific:

A sharp increase in temperature to 39-40 degrees.
Weakness, adynamia.
On the second day, when aphthae appear, the condition becomes severe, there are all signs of intoxication and inflammation.
Enlarged regional lymph nodes.
There is constant pain when eating and swallowing.
Salivation increases.
A sharp, specific odor from the mouth.

Aphthous acute stomatitis is characterized by its specific rashes on the mucous membrane - aphthae. These are single, painful, round-shaped formations that are formed from small blisters that, when bursting, turn into ulcers. The ulcers also look characteristic - they are covered with a thin fibrinous film and have a red rim along the edges. Aphthae are the main symptoms of aphthous stomatitis; they are localized on the lateral surfaces of the tongue, its tip, on the lips (inner part of the mucous membrane), on the floor of the mouth, inside the cheeks and on the palate. Aphthae may go away on their own within a week, but this does not mean their complete disappearance; aphthae can recur for many months without proper treatment. Frequent relapses are noted in the autumn and spring seasons, when aphthous stomatitis is diagnosed 2 times more often.

Recurrent chronic forms of aphthous stomatitis have the following symptoms and are classified as follows:

The typical course of the disease, a typical form in which superficial aphthae ulcers periodically form in the oral cavity. Symptoms of aphthous stomatitis in chronic typical form can be subdivided according to another differentiation:
- A generalized form of aphthosis, in which aphthae spread to the oral mucosa, skin, genitals, conjunctiva of the eyes, provoking extensive pyoderma, streptoderma.
- Isolated recurrent aphthous stomatitis is the most commonly diagnosed type, in which ulcers affect the mucous membrane of the cheeks, lips, and sides of the tongue. Aphthae are not multiple, they are grouped in the form of 2-3 ulcers nearby.
An atypical form in which deep aphthae are formed, leaving scars (Sutton's aphthae, cicatricial aphthae).

There is a more dangerous type of aphthous stomatitis - Behçet's disease, when the entire mucous membrane of the mouth, including the tonsils, is covered with aphthae; moreover, aphthae spreads to the conjunctiva of the eyes and even to the mucous tissue of the woman's genital organs. This serious disease was described in the 30s of the last century by Dr. Behçet as a symptom complex that included ulcerative stomatitis, genital ulcers, and uveitis (damage to the conjunctiva of the eyes). Later, this triad was joined by symptoms of thrombophlebitis, arthritis, erythema, cutaneous vasculitis, aneurysms of large aortas, and intestinal ulcers. Etiology of this systemic disease is still not clear, but the symptoms of aphthous stomatitis, which quickly spread throughout the body, are one of characteristic features Behçet's disease.

Symptoms of candidal stomatitis

Symptoms of oral thrush and candidal stomatitis are quite specific and manifest. Oral candidiasis is a common disease diagnosed in young children with reduced immune defense, under the age of 1-2 years.

Symptoms of candidal stomatitis in children depend on the location and form of the process:

Signs of stomatitis of the entire oral cavity.
Gingivitis.
Glossitis.
Seizures, cheilitis.

Forms - a mild form of thrush with unmanifested symptoms, a moderate-severe form, when the following phenomena may be signs of candidiasis:

White, cheesy consistency, coating on the tongue and the inner cavity of the cheeks.
The eroded surface of the mucous membrane is hidden under areas of plaque.
Pain when eating, swallowing.
Decreased appetite, refusal to eat due to pain.
Weight loss.
Irritability, insomnia.

In severe, advanced forms, the symptoms of candidal stomatitis can spread into the gastrointestinal tract. If the fungus enters the digestive organs, dyspepsia, stool upset, and dysbacteriosis develop.

Symptoms of oral thrush in adults:

Burning sensation, dry mouth.
The characteristic white, cheesy coating is primarily on the tongue.
Swelling and redness of the mouth.
Bleeding when eating or brushing teeth.
Loss of taste.
Difficulty eating, pain in chewing and swallowing.
A characteristic metallic taste in the mouth.

Symptoms of herpetic stomatitis

Herpetic stomatitis is one of the most common types infectious inflammation oral cavity, which is diagnosed in 75% of children. In adults, the herpes virus provokes the formation of vesicular rashes on the lips, less often in the oral cavity. The disease is usually mild. Children suffer from herpetic stomatitis more severely, with increased body temperature and a febrile state.

The symptoms of herpetic stomatitis are as follows:

Swelling of the oral mucosa.
A sharp increase in body temperature to 38, sometimes up to 39 degrees.
The lymph nodes become enlarged and are painful on palpation.
2-3 days after the temperature rises and the gums become red, many small vesicular rashes form in the oral cavity, often so small that they are not noticeable against the background of the reddened membrane.
The vesicles quickly merge with each other, forming larger erosions.
The erosive areas are covered with a white-gray coating.
A person often has a headache and develops nausea.
With herpetic stomatitis, symptoms of catarrhal gingivitis (inflammation of the gums) often appear; the gums are swollen and bleeding.

Symptoms of viral stomatitis caused by herpes may appear depending on the form of the process:

Mild form - vesicles are located only in the mouth.
Moderate severity - the rash spreads to the lips.
A severe form of herpetic stomatitis - vesicles quickly spread to the lips, to areas of the body located far from the oral cavity - the nasolabial triangle, face. This form is most dangerous for newborns, who may experience nosebleeds, blood appear in saliva, and symptoms are noted. general intoxication body, blood pressure and pulse drop. Patients with severe herpetic stomatitis are hospitalized.

Herpetic stomatitis, which acquires an advanced severe form, can transform into an ulcerative-necrotic, intoxicating form.

Symptoms of allergic stomatitis

Stomatitis of allergic etiology according to the clinical picture is divided into the following types:

Catarrhal allergic stomatitis.
Hemorrhagic stomatitis.
Blistering-erosive appearance.
Ulcerative-necrotizing allergic stomatitis.
Combined view.

Symptoms of allergic stomatitis can be localized, that is, appear only in a separate area of the oral cavity - palate, gum, tongue, but the process can also be diffuse and widespread. In addition, the clinical picture depends on the type of immunological response, on morphological changes, which may be as follows:

Serous allergic stomatitis.
Hyperemic, exudative stomatitis.
Erosive-ulcerative drug-induced inflammation of the oral cavity.

Clinical manifestations of allergic stomatitis, depending on the provoking factor, are as follows:

Allergy to medications in the form of stomatitis is catarrhal, catarrhal-hemorrhagic stomatitis. The patient feels itching, burning in the gums, the oral cavity is dry and painful, especially when eating. The mucous membrane swells, swells, and turns red. The papillae of the tongue atrophy and it looks “varnished”.
Allergy to fillings, dentures. Patients complain of dry mouth, increased salivation (saliva is atypically viscous), burning sensation in the gums and tongue. Prosthetic bed - the mucous membrane is inflamed exactly within the boundaries of the prosthesis, the gum tissue is loosened and hyperemic. Against the background of reddened gums, hypertrophied growths like papillomas are often observed. Characteristic symptoms Allergic stomatitis of this type is characterized by clear teeth marks on the inner area of the cheeks, swelling of the tongue, palate, pharynx, difficulty swallowing food, and possible erosive damage to the mucous membrane.

A specific difference in the clinic of allergic stomatitis is the withdrawal syndrome of the provoking factor, as soon as the trigger cause is eliminated, the symptoms subside.

Symptoms of viral stomatitis

Stomatitis is often provoked by viruses, among which the herpes virus has held the leading position for many years; less often, such inflammation is caused by a virus chickenpox, parainfluenza and influenza, adenovirus, enterovirus.

According to WHO statistics, herpetic lesions of the oral cavity occupy second place after influenza diseases; the symptoms of viral stomatitis caused by herpes are as follows:

Acute onset, a sharp rise in body temperature from 37 to 40 degrees in a few hours.
After two days, swelling forms on the reddened oral mucosa, hiding the smallest rashes (vesicles). The bubbles can be multiple and merge with each other; they contain exudate. If the vesicles burst, then in their place erosive areas are immediately formed, hidden by plaque and crust.
Hypersalivation is noted, while the saliva is very viscous, thick, and foaming.
Vesicles spread to the edges of the lips, the corners of the lips, even to the mucous membrane of the nose and other organs if the disease is severe.
The period of viral stomatitis rarely exceeds 3 weeks; after a week, the symptoms subside and recovery occurs, of course, with adequate treatment.

Symptoms of viral stomatitis can be a manifestation of vesicular stomatitis, which is clinically very similar to the symptoms of influenza. The vesicular species is a zoonotic infection that is rarely found in humans. Most often, signs of vesicular inflammation can be seen in zoo workers, farm workers, and those who frequently and constantly come into contact with animals.

A person has a severe headache, a fever develops, and after 2-3 days vesicles form, usually in the oral cavity. The blisters are filled with light liquid; when opened, they itch, transforming into ulcers.

Symptoms of stomatitis on the tongue

The inflammatory process in the mucous membrane and tissues of the tongue, glossitis, can be caused by an independent, separate disease, but most often this is how the symptoms of stomatitis appear on the tongue. The cause of inflammation is pathogenic microorganisms, both bacteria and viruses. The most common among them are herpes virus, staphylococcus, streptococcus, and candida.

Symptoms of stomatitis in the tongue are as follows:

Burning, itching in the upper part of the tongue, rarely in the sublingual area.
Feeling foreign body in the mouth.
Edema, swelling of the tongue.
Increased salivation.
Dulling of the sense of taste, often loss of taste.
Feeling of an unusual taste in the mouth.
Painful sensations at the root of the tongue when swallowing.
Swelling of the tongue causes difficulty speaking (slurred, slow speech).

Symptoms of advanced inflammatory process in the tongue area:

Persistent swelling of the tongue.
Changes in the structure of the surface of the tongue, the pattern of the papillae changes.
Plaques are possible, the nature of which depends on the type of stomatitis (white, curdled, white, purulent, and so on).
Redness and ulceration of the tongue.
Advanced erosions can develop into an abscess of the tongue, which is manifested by pulsation, a strong increase in the abscess area, swelling of the entire tongue, hypersalivation, and increased temperature.

Symptoms of stomatitis in the throat

Some types of stomatitis can indeed clinically manifest themselves in atypical places - the skin of the face, larynx, nasopharynx.

Symptoms of stomatitis in the throat are most likely manifestations of aphthous recurrent inflammation of the oral cavity. It is with this course of the disease that aphthae can spread beyond the cheeks, palate, and gums. The generalized form of aphthous, ulcerative-necrotic inflammation of the oral mucosa is often accompanied by the appearance of characteristic ulcers not only in the oral cavity, but also on the mucous membrane of the palate, pharynx, larynx, but almost never on the tonsils. It should be noted that symptoms and signs of stomatitis in the throat may be clinical manifestations throat diseases themselves - tonsillitis, sore throat, and so on. In this case, stomatitis is a consequence of the primary pathology, and not the root cause.

In addition to aphthous, symptoms localized in the throat can be caused by almost any type of infectious stomatitis in a chronic, advanced form. Streptococci, staphylococci, diplococci, fungi and other pathogenic microorganisms easily penetrate deep into the oral cavity if the disease is not diagnosed and treated in a timely manner.

Types of stomatitis

Types of stomatitis are divided into three main classification areas:

Forms - acute and chronic, where the acute form of stomatitis is the primary symptoms of the disease, and the chronic form is untreated early stage stomatitis, characterized by a long course and relapses. Primary stomatitis includes catarrhal, fibrinous proliferative type of disease. Secondary, chronic stomatitis is erosive, aphthous, ulcerative stomatitis.

Morphology:

A simple form is catarrhal stomatitis.
Aphthous stomatitis.
Ulcerative stomatitis.
Etiology:
Traumatic stomatitis.
Allergic stomatitis.
Infectious stomatitis.
Symptomatic stomatitis as a consequence of the underlying disease.
Specific stomatitis as a consequence of a specific pathology, such as syphilis, tuberculosis.

In addition, types of stomatitis can differ in the nature and intensity of the inflammatory process, these are such varieties as:

Catarrhal, simple stomatitis.
Catarrhal-ulcerative.
Catarrhal-desquamative stomatitis.
Gangrenous.
Vesicular stomatitis.
Aphthous.
Hyper and parakeratotic stomatitis.

Here is a description of the most common types of inflammatory process in the oral cavity:

Catarrhal, simple stomatitis, which is characterized by inflammation of the mucous membrane without ulceration and the formation of aphthae.
Ulcerative stomatitis, which often develops as a consequence of untreated primary catarrhal disease. Actually, the ulcerative type of stomatitis is the second stage of the undiagnosed catarrhal type. The ulcerative variety is distinguished by a rather severe course of inflammation and is diagnosed mainly against the background of chronic gastrointestinal diseases, iron deficiency, and anemia. Ulcers penetrate the entire depth of the mucous membrane, accompanied by severe pain when eating or talking, body temperature may rise, lymph nodes may enlarge, and symptoms of general intoxication may occur.
The aphthous type of stomatitis is distinguished by special formations in the oral cavity - aphthae. These are specific blisters that quickly rupture and transform into small ulcers. The ulcers have a characteristic appearance - they are covered on top with a thin fibrous film, and have a bright red rim along the edges. Aphthae are usually localized on the tongue, its tip, cheeks and hard palate. The tongue looks burned, swollen, and salivation increases. Aphthous stomatitis often recurs in the autumn or spring season; aphthae heal difficultly, slowly, often merging into one large ulcer.
The ulcerative-necrotic type of stomatitis almost always covers the entire oral cavity and even internal organs and skin. This stomatitis is characterized by a general severe condition, fever, intoxication, headaches, high fever, hypersalivation and a characteristic putrid odor from the oral cavity.
Herpetic stomatitis, which, as a rule, is acute and is typical for young children and reduced immunity. Herpetic rashes are very similar to aphthae, but contain a characteristic serous fluid inside, develop faster, accompanied by intense symptoms - increased body temperature, increased submandibular lymph nodes. The herpetic form often transforms into an ulcerative one without proper treatment and oral care.
Candidal stomatitis (oral candidiasis, thrush). This is an inflammation caused by yeast-like microorganisms - fungi. Most often, oral thrush affects newborn infants with low immune status, elderly patients with persistent, chronic diseases.
The traumatic type of stomatitis is characteristic of adults, especially those who use dentures. Stomatitis caused by trauma to the oral cavity, as a rule, develops as catarrhal inflammation and, with timely diagnosis, is treated quickly. More severe cases are associated with the addition of a microbial infection, when ulcers and infiltrates can develop in the oral cavity.
The vesicular type of stomatitis is very similar to the symptoms of influenza disease. A person begins to have a headache, bones ache, muscles ache, and a fever develops. Such signs accompany the formation of vesicles, which are visible 2-3 days after the onset of the first symptoms. Untreated vesicles transform into erosive ulcers.
Intoxication stomatitis, which is a consequence of poisoning with salts of heavy metals. Ulcers of this type are persistent, difficult to treat, a person cannot eat because of pain, and feels a characteristic taste of metal. In case of intoxication, the clinical picture of poisoning manifests itself very quickly - dyspepsia, weakness, falling blood pressure, and stomatitis is just one of the signals about the accumulation of toxins in the body.

Simple stomatitis

Simple stomatitis is considered to be a superficial type of catarrhal inflammatory process in the oral cavity or simple gingivitis - gingivitis simplex.

Simple stomatitis most often occurs acutely with the following symptoms:

Redness of the oral mucosa.
Swelling of the mouth and tongue.
Erosive formations along the edge of the gum, in areas where there is tartar or caries.
Rounding, smoothing of gum papillae.
There may be a feeling of loosening of the teeth in the alveoli.
A whitish coating appears on the tongue in the first days, then it darkens.
The mucous membrane becomes thinner, and tooth marks are visible on it.
Hypersalivation is noted - increased secretion of saliva.
There is a smell from the mouth.
Eating can be painful.

The acute form, which is characterized by simple stomatitis, lasts no more than 2 weeks. Further development of the disease can occur in three variants:

With timely diagnosis and treatment, the symptoms of stomatitis subside, the disease ends and does not recur.
If catarrhal stomatitis is not treated, it turns into a persistent chronic form, and the disease can periodically recur.
If the chronic form of simple stomatitis is accompanied by an additional infection of the oral cavity and nasopharynx, the disease transforms into a deep form.
Recurrent catarrhal stomatitis is one of the typical signs of pathology of the digestive tract, as well as helminthic infestation.

Vesicular stomatitis

In terms of symptoms, vesicular stomatitis is very similar to acute respiratory viral infections, acute respiratory infections and influenza. Stomatitis, which is not accidentally called Indiana fever or stomatitis vesiculosa contagiosa, since it is diagnosed mainly in the southern American states, as well as in Africa, less often in Europe and Asia. Vesicular stomatitis is an extremely contagious, contagious disease of cattle, horses, and pigs. People get this type of stomatitis extremely rarely and only in case of constant, close contact with sick animals. The disease has a viral etiology, the causative agent is a specific RNA virus from the Rhabdoviridae family. This virus strives to reproduce in the bodies of almost all vertebrates and easily replicates in animal cells.

In humans, vesicular inflammation of the oral cavity is observed very rarely; if such cases are diagnosed, then treatment is carried out according to the treatment of the influenza virus. The prognosis is 100% favorable, recovery occurs in 5-7 days.

Catarrhal stomatitis

Catarrhal stomatitis is the simplest, safest and non-contagious form of inflammation of the oral cavity. The disease rarely lasts more than 2 weeks and has no consequences in the form of mucosal defects - ulcers, infiltrates, aphthae. The etiology of the catarrhal type of stomatitis lies in non-compliance with the rules of personal hygiene, poor care of the oral cavity and teeth; in fact, such stomatitis is a disease of dirty hands and uncleaned teeth. Most often, catarrhal stomatitis is diagnosed in young children who put everything in their mouths, but adults can also suffer from a similar disease due to persistent untreated caries and the presence of tartar. In addition, catarrhal stomatitis may be a consequence of intolerance to the filling material during dental treatment, dentures, or allergies to certain types of medications.

The main symptoms are manifested in the form of hyperemia of the oral mucosa, tongue, swelling, plaque on the tongue, and a burning sensation. An unpleasant odor, bleeding gums, and loosening of teeth are possible. The acute stage can become chronic without proper treatment, in such cases the catarrhal form develops into aphthous and other types of stomatitis with more serious symptoms and consequences.

As a rule, treatment consists of following a diet that excludes irritating foods (spicy, sour, hot foods, foods that have a hard consistency). Intensive sanitation of the oral cavity is also carried out, rinses, B vitamins, vitamin C and A are prescribed. Treatment of caries teeth and removal of tartar is mandatory, and personal hygiene and oral care rules are considered the main preventive measures.

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Acute stomatitis

The acute form of stomatitis is diagnosed when such manifestations appear for the first time in the patient’s medical history. In the future, if after treatment stomatitis again manifests itself with one or another symptomatology, it is considered chronic, recurrent, which may be a sign of either inadequate therapy or a missed systemic pathological process in the internal organs.

Acute stomatitis, despite such a formidable name, is considered a fairly safe form in which the disease progresses quickly and is treatable. Moreover, the acute form of stomatitis is the very initial stage of the development of inflammation, when it can be stopped and the formation of persistent recurrent types can be prevented. Acute stomatitis rarely lasts more than 14 days, accompanied by a burning sensation in the mouth, hyperemia of the mucous membrane, tongue, usually without the formation of aphthous ulcerations.

The hardest thing acute form Newborn children suffer from it, they refuse to eat, lose weight, and their general condition worsens every day. Therefore, attentive parents should be alarmed when a white coating appears on the tongue, the inside of the baby’s cheeks, and pay attention to any atypical behavior - capriciousness, bad dream, continuous crying.

The most dangerous is acute herpetic stomatitis, an extremely contagious disease that occurs with painful symptoms. The herpetic type of inflammation of the oral cavity has incubation period from 2 to 4 days. Symptoms manifest quickly and acutely:

A sharp increase in body temperature to 39-40 degrees is possible.
Pain appears in the mouth when eating or talking.
The mucous membrane of the entire mouth is hyperemic, small vesicles form on it, which are often not visible.
The stage of vesicular vesicles lasts no more than a day; they quickly transform into ulcers.
If treatment is not started, erosive ulcers spread to the palate, tongue and lips.
A more severe form, which acute stomatitis of herpetic etiology can acquire, is accompanied by an increase in regional lymph nodes. This form of stomatitis in children is treated in a hospital setting.
Despite the acute onset, this type of stomatitis resolves after 2-3 weeks with adequate therapy.

Any acute stomatitis in clinical practice It is customary to divide it into three forms - mild, moderate and severe; the disease also occurs in five stages:

Incubation.
Prodromal period.
Development.
Reduction of symptoms, fading of the process.
Recovery.

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Chronic stomatitis

The chronic form of stomatitis is a typical consequence of either self-medication, or the absence of therapeutic measures at all in the manifestation of an acute form of inflammation of the oral cavity. Chronic stomatitis can bother a person for many months, and sometimes years, interspersed with short periods of remission. In addition to self-medication, uncontrolled use of medications or lack of therapy as such, the following factors may be the causes of chronic recurrent stomatitis:

Sluggish, latent pathological processes in the digestive tract - gastritis, colitis, dysbacteriosis.
Decreased immune activity, immunodeficiency caused by either a sluggish disease of internal organs or systems, or serious illness, such as tuberculosis, sexually transmitted diseases, HIV. In addition, premature newborn babies can also have extremely low immune activity and suffer from chronic stomatitis for many months.
Constant mechanical irritation of the oral cavity due to uncomfortable dentures and braces.
Diseased teeth, such as chipped, protruding roots, which constantly injure the mucous membrane of the mouth and open access to infection.
Tartar, caries.
Vitamin deficiency, anemia.
Streptococcal, staphylococcal infection, systemic candidiasis.
Bad habits such as smoking, the habit of biting nails, neurotic habits of holding pens, matches, and other objects in the mouth that can introduce a bacterial or fungal infection into the mouth.
Persistent non-compliance with the rules of personal hygiene, including the oral cavity, the habit of using other people's toothbrushes, utensils, and cosmetics.

Chronic stomatitis, depending on the type, can manifest itself as periodic redness of the oral mucosa or ulceration. Often there is a low-grade fever, which is not associated with other specific diseases - colds, inflammation, and so on. The constant formation of ulcers, aphthous erosions that cannot be treated, enlarged lymph nodes, paroxysmal swelling of the tongue - this is not a complete list of symptoms chronic course stomatitis.

Despite the variety of symptoms, they have one thing in common - systematic repetition and relapses.

Treatment of chronic stomatitis has a specific goal - eliminating the root cause; therapy is carried out using both local procedures and by prescribing drugs per os (orally).

Ulcerative stomatitis

Ulcerative stomatitis is, as a rule, a consequence of untreated catarrhal form, but it can also be an independent disease associated with chronic pathologies gastrointestinal tract, infections or intoxication.

Ulcerative stomatitis is very different from a simple catarrhal type of inflammation, since with catarrh only the upper layer of the mucous membrane is damaged, and with the ulcerative form, the entire tissue of the membrane is eroded. The ulcers penetrate so deeply that the surface epithelium becomes necrotic, merges and forms rather large erosions. Ulcers can spread even to bone tissue jaws and provoke osteomyelitis.

Symptoms of ulcerative stomatitis:

The onset is similar to the catarrhal form - hyperemia of the mucous membrane, swelling of the tongue, burning sensation.
A characteristic putrid odor appears from the mouth.
Ulcers develop quickly and cause symptoms typical of general intoxication - weakness, increased body temperature (low-grade fever), headache.
After 2-3 days, white-gray plaques form on the cheeks and under the tongue, covering the eroded mucous membrane.
Lymph nodes enlarge from the first days of the disease.
Eating, talking, smiling cause acute pain.

The earlier treatment for ulcerative stomatitis is started, the lower the risk of the erosive process penetrating deep into the tissue. Local treatment usually combined with etiotropic drugs prescribed orally. The pain is relieved with the help of powders, anesthetic ointments, and rinses are also prescribed. antiseptic solutions, applications, baths.

Timely started therapeutic measures make it possible to reduce the period of epithelization of erosions to one week. After the painful symptoms subside, systemic sanitation of the oral cavity is prescribed.

There is ulcerative stomatitis in a more serious form, this is ulcerative necrotic inflammation. Vincent's stomatitis, named after the French doctor who, at the beginning of the last century, first described the syndrome of acute oral ulcerative process in soldiers fighting at the front. The disease has many synonyms - “trench mouth”, Vincent’s angina, Vincent’s gingivitis, Botkin-Simanovsky stomatitis and so on. The disease is caused by a combination of a spirochete and a spindle-shaped rod, which is also present in healthy people. Under the influence of various factors, microbial symbiosis causes an acute erosive generalized process. The causes of the development of Vincent's disease may be the following factors:

Hypothermia.
Starvation.
Hypovitaminosis.
Alcoholism.
Intoxication with salts of heavy metals.
Calculus (tartar).
Systematic irritation of the oral cavity with dentures, fragments of molars.
Unsanitary conditions.
Severe viral infection.
Mononucleosis.
Exudative erythema.
Oncology.
The consequence of treatment of oncological processes is chemotherapy.

Vincent's stomatitis affects mainly young men; it begins as an inflammation of the tonsils, then the tongue becomes inflamed and the process spreads to the entire oral cavity, reaching the deep layers of the mucous membrane, right down to the bone tissue of the jaw.

The symptoms of the disease are specific:

Bleeding gums even without traumatic irritation - eating, brushing teeth.
Pain in the gums, inability to chew food.
Halitosis (bad breath).
Ulceration of the gum edges, tissue necrosis.
Bleeding ulcers in the mouth.
Uncontrolled salivation.
Seal lymph nodes.
General intoxication, nausea, weakness, dizziness.

Ulcerative stomatitis of this type is treated comprehensively, first of all, anesthesia and pain relief are carried out, then detoxification appointments and sanitation of the oral cavity are indicated. With timely intensive treatment, the prognosis is favorable, the ulcers heal within a week. A chronic, advanced process requires longer-term therapy; in addition, it is often accompanied by periodontitis, which requires systematic monitoring of the condition of the oral cavity throughout the year.

Angular stomatitis

Angular stomatitis is what is commonly referred to in everyday life as seizures. The name comes from the Latin word angulus or angle, that is, inflammation at the corners of the mouth.

Also the disease in dental practice may be called infectious cheilitis.

Angular stomatitis is a typical process in young children in whose bodies a staphylococcal, streptococcal infection or candidiasis is detected.

In addition, the cause of angular stomatitis may be vitamin deficiency, Iron-deficiency anemia, chronic diseases of the throat, nasopharynx (sore throat, sinusitis).

Stages of the angular process:

Hyperemic corners of the lips.
Maceration skin, mucous membrane (softening).
Formation of pustules (purulent blisters) in the corners of the lips.
Pustules burst and form erosions.
Movement of the lips and mouth when eating, talking, smiling provokes cracking of the corners.
The cracks regularly bleed and become crusty.
Failure to comply with treatment rules can lead to the spread of pustules throughout the face (impetigo).

Angular stomatitis is considered a contagious type of inflammation of the oral mucosa, when streptococci and staphylococci can be transmitted through household items, dishes, toothbrushes from a sick person to a healthy one.

The angular type of stomatitis can also be caused by candidiasis, then the lack of treatment can provoke the spread of the process throughout the entire mucous membrane of the mouth inside. The disease can last for many months, periodically subside and recur again. It is with etiological variability that the important role of accurate diagnosis is associated, which should include laboratory methods microscopy to identify a specific pathogen. In addition, angular cheilitis should be differentiated from cheilitis caused by syphilis or tuberculosis.

Purulent stomatitis

Purulent stomatitis or pyostomatitis is a type of inflammation of the oral cavity caused by microbial, bacterial infection. Most often, the cause of purulent stomatitis is microtrauma of the oral mucosa. Injuries, in turn, can be caused by gross mechanical damage (scratches, cuts), as well as thermal burn from eating excessively hot food, incorrect location molars, fragments of untreated teeth, and so on. The thing is that every year the oral mucosa becomes more vulnerable; the saliva of an adult contains many times less antibacterial protection - lysozyme - than in childhood. When sores form in the mouth, this means that the risk of infection and development increases. bacterial stomatitis. In addition, purulent stomatitis can be a consequence of chronic inflammation of the nasopharynx - sore throat, otitis, sinusitis.

Symptoms of a purulent type of inflammation are nonspecific; purulent pustules can form on the lips, that is, on the outside, but purulent ulcers can also be located inside - on the gums, on the cheeks and even on the tongue.

In addition, in dentistry and dermatology, a separate definition of purulent stomatitis has been identified - vegetative pyostomatitis. This disease is described under the heading of skin and venereal diseases as pyostomatitis vegetans - a purulent inflammatory process of the oral cavity. Symptoms – small vegetations with purulent contents, according to external signs similar to an abscess. Pyostomatitis is characterized by multiple ulcers, which quickly transform into deep ulcers and eroded areas. Pustules open within 24 hours, ulcers also quickly epithelialize, leaving scars on the mucous membrane, subsequently papillomatosis.

Gonococcal stomatitis

Gonococcal or gonorrheal stomatitis is now very rare, since it mainly develops in utero and when a child passes through infected birth canal mother. When registering for pregnancy, each woman undergoes comprehensive examination, so gonorrhea is detected and treated before the baby can become infected with it.

Rare cases of infection with gonococcal stomatitis occur when a sick person comes into contact with a healthy person, usually through oral contact. Nevertheless, gonococcal stomatitis occurs in dermatological practice and is worthy of a brief description.

In most diagnosed diseases, gonococcus affects not only the oral cavity, but also the entire nasopharynx. Diagnosis of gonococcal stomatitis can be difficult, since the initial stage of the disease is asymptomatic; moreover, gonorrhea is, in principle, prone to episodes of false self-cure and remission. When the patient comes to the attention of the doctor, the process has already spread throughout the pharynx, tonsils, and oral cavity.

This type of stomatitis is most often diagnosed in the following categories of the population:

Newborns whose mothers do not register with obstetrics and gynecology and lead an asocial lifestyle.
Persons entering into orogenital contacts (often of non-traditional homosexual orientation).

The symptoms of gonococcal stomatitis are characterized by lethargy, weariness, and can manifest themselves with the following nonspecific signs:

Low-grade body temperature.
Transient sore throat.
Hyperemic oral mucosa.
Small erosive areas in the mouth.
Discharge of a viscous, purulent secretion along with saliva.
The appearance of ulcers on the inside of the cheeks, gums, and tongue is a symptom of a severe form of the process.

Helps differentiate the type of stomatitis histological examination contents of eroded, ulcerated areas. Extragenital gonorrhea in the form of stomatitis is treated in the same way as the genital form - with the help of antibiotics, in addition, aseptic lotions and applications are prescribed locally.

Herpetiform stomatitis

Stomatitis herpetiformis is a very rare form of aphthous recurrent stomatitis, which is similar in appearance to the viral version of oral inflammation, herpes. With herpetiform stomatitis, just like with herpes, multiple rashes form in the form of tiny ulcers that cover the entire mucous membrane. Aphthae are very small and this differs from the typical rather large aphthae (rashes) with classic form aphthous stomatitis. The ulcers are not clearly defined, have a grayish tint, and the mucous membrane around them is not hyperemic. One of the specific signs of this rare species may be the localization of aphthae - under the tongue, at the bottom of the mouth. Herpetiform stomatitis is prone to recurrence and periodic remissions. The ulcers heal quite quickly - within a week.

This form of the disease is more common in young women under the age of 28-30 years. The etiological reasons are not fully understood.

Consequences and complications of stomatitis

The consequences and complications of stomatitis depend on the age of the sick person, the period of detection of inflammation, and the degree of neglect of stomatitis.

Stomatitis is in vain considered to be a safe disease; its complications can quite seriously affect the state of health.

As a rule, catarrhal stomatitis occurs most simply and quickly, but even without proper treatment it can transform into an ulcerative-necrotic process, affecting not only soft fabrics gums, but also the bone tissue of the jaw (osteomyelitis). More severe complications may look like gangrenous inflammation; such pathologies are diagnosed with gonococcal stomatitis, stomatitis caused by tuberculosis, and syphilis.

In addition, the consequences and complications of stomatitis in advanced form are potential threat loss of teeth, as inflammation quickly becomes chronic, causing periodontal disease.

The main danger of any stomatitis is its transformation into a recurrent form, which is long, difficult and quite expensive to treat due to the use of many medications aimed at systemic effects on the body.

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There are no specialized tests or samples for stomatitis; diagnosis usually takes place in several stages: 1.

Collection of anamnesis and medical history.
Visual examination of the oral cavity:
- Appearance of the mucosa.
- Appearance of aphthae, ulcers, their shape, quantity, structure.
- Determination of halo, erosion boundaries, edge characteristics.
- Presence of plaque on ulcers.
- The presence of plaque on the mucous membrane.
- Characteristics, color, structure of plaque.
- Localization of ulcers, plaque.
Identification of accompanying symptoms - body temperature, pain, nausea and so on.

The main parameter that helps in diagnosing stomatitis is external, visual signs, that is, external examination is the most important in a diagnostic sense. Additional smears for culture, blood tests, and so on only confirm the doctors’ initial assumption. In addition, stomatitis must be differentiated by types associated with different etiological factors, the success and timing of treatment depends on the definition of a specific type - infectious, traumatic, allergic, symptomatic.

UAC – general analysis blood.
Blood chemistry.
Blood sugar level.
Blood for antibodies to treponema, gonococci if a venereal etiology of stomatitis is suspected.
Immunoenzyme test to clarify the activity of the immune system.
Bacteriological culture of saliva to determine bacterial infection and specific pathogen.
Cytology, histology of smears from the inflamed mucous membrane.
Virological study of nasopharyngeal swabs and fluid contained in vesicles and vesicles.

The final conclusions depend on the combination and big picture examination, medical history, analytical research data.

Stomatitis is a disease of the oral cavity, inflammation of the mucous membrane on the inner surface of the cheeks, gums, and tongue. The disease is accompanied by the formation of wounds and ulcers. The disease is infectious, so the symptoms of inflammation do not go away on their own. Treatment is needed.

It may be an advanced form of catarrhal disease or an independent disease. That is, the symptoms of the disease can immediately appear in the form of ulcers, without a solid white coating. If in the catarrhal form only the upper layer of the mucosa is affected, then in the ulcerative form the mucous membrane becomes inflamed to its entire depth. The temperature often rises and the lymph nodes become enlarged. The cause of ulcerative stomatitis can be gastric ulcer, various poisonings (food, household).

It is a manifestation of a viral infection or an allergic reaction. This is the most complex manifestation of the disease. Aphthous stomatitis in adults is provoked by internal diseases of the body and often becomes chronic. Symptoms of aphthous inflammation of the mucous membrane: large ulcers up to 5 mm in size, covered with a gray or white coating. Photos of aphthous and ulcerative diseases of the oral cavity allow you to visually distinguish the two types of infection.

These two photos are aphthous types of the disease.

One of the forms of aphthous is herpes stomatitis. The ulcers take on the appearance of bubbles (as seen in the photo). The appearance of bubbles on the palate and tongue occurs in a group, later they merge and form a painful erosive area.

And this is herpes stomatitis.

How to treat stomatitis in adults?

To treat stomatitis, the following drugs are needed:

for disinfection of the oral cavity (to eliminate pathogens);
for healing existing wounds;
to restore normal acidity and microflora of the mucous membrane.

Rinsing is a common type of treatment for catarrhal disease of the oral cavity. Catarrhal stomatitis in adults is easily treated by increasing the level of hygiene and irrigation with disinfecting solutions. To do this, use potassium permanganate, herbal infusions of antiseptic action (calendula, chamomile, sage), as well as antiseptic sprays with an anesthetic (pain-relieving) effect.

Soda is used as a rinse (a solution of 1 tablespoon of soda in 100 ml) or as a lubricant (a more concentrated solution, 1 spoon per 50 ml). Pharmaceutical preparations for rinsing include hydrogen peroxide (a solution of 1 tablespoon of peroxide per 100 ml of water), as well as chlorhexidine, furatsilin, miramistin, iodinol.

To boost immunity, drink rosehip infusion, which provides the body with essential vitamins.

For ulcerative stomatitis, wound treatment is supplemented with local lubrication. For this purpose, ready-made pharmaceutical drugs(ordinary green, blue or blue iodine, Lugol, stomatidine, kamistad, cholisal). They are applied to the surface of the ulcers with a finger or swab up to 5 times a day. Folk remedies for treating oral infections use a solution of alcoholic propolis for rinsing (1:10 water) and for lubricating (1 part propolis: 5 parts water).

To accelerate the healing of the epithelium, wound healing agents are used (sea buckthorn oil, oil solution vitamin A – carotoline).

The most difficult to treat with folk remedies is candidiasis and herpes stomatitis. To eliminate viral (herpes virus) and bacterial infections (candida fungus), antiviral and antifungal ointments (interferon, oxolinic or nystatin ointment) are used.

Allergic stomatitis is treated with the use of antihistamines (laratadine, suprastin) and removal of the source of the allergy.

Also, when treating stomatitis, drinking plenty of fluids is recommended (to remove toxins and reduce intoxication of the oral mucosa). Drinking plenty of fluids creates conditions for normal saliva production. The disinfecting properties of salivary secretion will additionally counteract the spread of infection.

Prevention of stomatitis

Stomatitis in adults is considered a recurrent disease, that is, it is prone to return and relapse. In order to prevent a recurrence of the disease, it is necessary to adhere to the rules of prevention:

wash your hands before eating;
remove tartar and plaque in a timely manner;
treat caries promptly;
treat the gastrointestinal tract in a timely manner;
provide for yourself and your loved ones healthy eating, with a balanced combination of proteins, fats, carbohydrates, vitamins, microelements;
choose correctly toothpaste and mouth rinse.

Stomatitis is not a terrible, but very unpleasant disease of the oral cavity. Its occurrence can be effectively prevented. And timely treatment helps to quickly relieve yourself of painful symptoms.

There are quite a large number of causes of frequent stomatitis in adults. This inflammatory process appears in the oral mucosa and brings a lot of inconvenience.

Recurrent stomatitis usually occurs as a result of improper oral hygiene. Sometimes it happens due to other diseases that occur secretly in the human body.

As a rule, stomatitis appears due to poor oral hygiene, but there are many other more serious pathologies. During diagnosis, various factors may turn out to be the causes of the disease.

Action of viruses and bacteria. In the case of normal functioning of the body, opportunistic microorganisms are constantly present in the mouth, which under normal conditions do not cause irritation. But when any provoking factors appear, inflammatory processes occur, which is why ulcers form in the oral cavity.

Mechanical injuries, chemical and thermal effects on the oral mucosa can lead to illness. Sometimes a person with stomatitis cannot understand why he was injured and why the disease developed. But the more often its symptoms appear, the more seriously it is worth thinking about the reasons for such frequent manifestations.

Because of poor nutrition the risk of contracting stomatitis increases, which is observed with a lack of various vitamins and microelements.

Development and exacerbation do not always occur. Minor damage in the mouth often goes away on its own, but it happens that for other reasons the disease still begins to develop.

Anna Losyakova
Dentist-orthodontist
Often, the disease can appear if normal hygiene rules are not followed, for example, unwashed hands or eating dirty fruit.
Sometimes it happens that with constant stomatitis a person has some kind of pathology. This may indicate a violation of one of the systems in the body. Eg:
People with HIV infection are more susceptible to the disease;
during frequent stomatitis, cancerous tumors of the neck and nasopharynx may develop;
the disease quite often appears after undergoing chemotherapy and radiotherapy for cancer treatment;
Gastrointestinal diseases can cause illness;
anemia;
hormonal disorders during menopause or pregnancy.

It may appear due to severe loss of fluid in the body after blood loss, prolonged vomiting or diarrhea.
Anna Losyakova
Dentist-orthodontist
With frequent stomatitis, the immune system may be weakened, which indicates the presence of various diseases.
This is observed in cases of gastrointestinal dysfunction, autoimmune pathologies and blood diseases. In this case, it is recommended to be examined in a clinic to determine the exact cause.
Symptoms of the disease

Signs of stomatitis are, as a rule, the same for everyone and do not depend on the type of lesion. In adults, fever and intoxication of the body during the development of the disease are usually not observed.
The course of the disease can occur in several stages, which are accompanied by different symptoms.
Aphotic Traumatic Allergic Candidiasis
With stomatitis at the initial stage, a slight redness can be seen at the site of the lesion, the mucous membrane around the source of inflammation begins to gradually swell and swell, causing a burning sensation and painful sensations.
On the second day of the disease, a round or oval ulcer appears at the site of the lesion, surrounded by an inflamed bright red halo. In addition to pain from the ulcer, the patient's salivation increases, the gums bleed, and an unpleasant odor appears from the mouth. Very often, a patient with stomatitis may feel severe pain, which makes it difficult to chew food. In this case, the person tries to limit himself only to movements of the lips and tongue.
Anna Losyakova
Dentist-orthodontist
In case of acute stomatitis, the patient may develop heat and enlarged lymph nodes. With stomatitis, ulcers usually form in the area of the soft palate, on the inside of the lips, on and under the tongue, on the tonsils and on the inside of the cheek.
Treatment of frequent stomatitis

To cure this disease as quickly as possible, you should determine an accurate diagnosis, that is, identify the type of stomatitis, and also try not to use folk remedies with a serious form of the disease. Need to apply effective drugs, which are intended to treat a specific type of disease.
Catarrhal stomatitis, which has a mild form and is caused by non-compliance with the rules of oral hygiene, can be cured even without consulting a doctor. To do this, you just need to adhere to a strict diet, do not eat hot, hard, sweet and sour, spicy and salty foods, and at this time use various antiseptics to rinse your mouth.
But in the case of ulcerative, herpetic and aphthous stomatitis, you must definitely seek advice from a dentist and therapist. In the treatment of these forms of stomatitis, they use complex treatment, which includes taking painkillers, antifungals, antihistamines and antivirals.
These drugs are prescribed based on the form of the disease. So, antifungal agents are used for fungal diseases. In the case of allergic stomatitis, as well as damage to the oral mucosa, drugs that have an antihistamine effect are very helpful. To reduce pain, various painkillers are used.
The use of folk remedies

There are many different medicines that allow you to get rid of stomatitis, but people who stick to the remedies traditional medicine, use infusions and decoctions for treatment, which can be prepared from the following ingredients:
Salvia officinalis;
horseradish;
bergenia thick-leaved;
pharmaceutical camomile;
Oak bark;
anise;
verbena officinalis;
carrot;
Potentilla erecta;
White cabbage;
pomegranate flowers;
aloe;
Kalanchoe.

Pain during stomatitis can be reduced by using hydrogen peroxide dissolved in water. To do this, take a glass of water and 2 tbsp. l. peroxide. You should rinse your mouth with the resulting mixture 2 times a day.
To relieve inflammation, you can use leaves of Kalanchoe or aloe. To obtain the product, squeeze out the juice and dilute it with water. You can simply pick a leaf from the plant and chew it thoroughly.
For ulcerative and catarrhal stomatitis, the following remedy will help well. To prepare it, take a tablespoon of anise and pour a glass of boiling water, then let it brew for half an hour. You should rinse your mouth with this infusion 3 times a day.
All juices, decoctions and infusions must be used warm. Even if there are no obvious signs of stomatitis, procedures using the above-described means must be continued for several more days.

Stomatitis, which means “mouth” in ancient Greek, is the most common name for a group of diseases of the oral mucosa. The disease should not be confused with glossitis (damage to the tongue), cheilitis (damage to the lips) and palatinitis (damage to the palate). Stomatitis is not contagious, but almost every person has directly or indirectly encountered one or another type of the disease. Once you have been ill, the chance of recurrence of the disease is very high.

Correctly diagnosing stomatitis is difficult. The doctor often assesses the situation only visually - in medicine there are no special tests for this disease. The difficulty of diagnosing stomatitis also lies in the fact that it can be a symptom of more serious diseases.

Causes of stomatitis

The mechanism of stomatitis, unfortunately, has not yet been fully identified, so there are many causes of the disease:

microorganisms that cause infection, acting directly on the oral mucosa;

diseases of the gastrointestinal tract;

diseases of cardio-vascular system;

general weakening of the immune system;

avitaminosis;

metabolic disorders;

nervous disorders;

malignant tumors;

hormonal fluctuations;

various injuries in the form of abrasions of the oral mucosa;

heredity.

Among the causes of stomatitis there are also local factors. Elementary lack of oral hygiene, caries, dysbacteriosis, poorly made or poorly installed dentures, the consequences of using medications, nicotine and alcohol consumption, as well as allergic reactions to products. Of particular note is the use of toothpastes containing sodium lauryl sulfate. Various studies have proven that they provoke the occurrence of stomatitis and its exacerbation.

Symptoms of stomatitis

Light redness of the oral mucosa is the first symptom of stomatitis. Over time, they swell and a burning sensation appears. If treatment is not started at this stage, the redness is replaced by small oval or round ulcers, grayish or white, with a red halo and a film on top. Moreover, the tissue around them looks absolutely healthy. Mouth ulcers are very painful and make eating difficult. They appear on the inner surface of the cheeks and lips, under the tongue. In most cases, mild stomatitis manifests itself as one ulcer.

The appearance of several ulcers of larger size and depth, which sometimes merge into one, are signs of more severe forms of stomatitis. The appearance of ulcers is accompanied by fever, inflammation of the lymph nodes, general deterioration of health, headache, loss of appetite and constipation. Acute stomatitis is accompanied by severe pain in the mouth, which interferes with eating and speaking. In addition, there may be excessive salivation, a coating on the tongue, a bright red mouth, irritability, and vomiting after eating.

Types of stomatitis

There are many types of oral stomatitis.

Catarrhal stomatitis

The most common type of stomatitis. With this unpleasant disease, the oral mucosa becomes swollen, painful, hyperemic, and may be covered with a white or yellow coating. There is an increased secretion of saliva. All this may be accompanied by bleeding gums and bad breath. The causes are local factors: poor hygiene, caries, tartar, oral candidiasis. Catarrhal stomatitis also occurs as a result of diseases of the gastrointestinal tract and worms.

A more severe disease than catarrhal disease. It can develop independently or be an advanced form of catarrhal stomatitis. Most often develops in people suffering from peptic ulcer stomach or chronic enteritis, diseases of the cardiovascular system and blood, infections and poisoning. With ulcerative stomatitis, the entire thickness of the mucous membrane is affected, there is an increase in temperature to 37.5 0C, weakness, headache, enlargement and tenderness of the lymph nodes. Eating is accompanied by severe pain.

Causes of the disease: gastrointestinal tract, allergic reactions, viral infections, rheumatism, as well as heredity.
Aphthous stomatitis has symptoms:

the appearance on the oral mucosa of single or multiple aphthae - small ulcers (3 - 5 millimeters) of gray-white color with a narrow red rim;
bad feeling;
increased temperature and pain of ulcerative lesions.

The disease can have an acute form or occur chronically with periods of exacerbation and remission, the so-called chronic recurrent aphthous stomatitis.

Candidal stomatitis

It is a fungal disease that most often appears in young children (stomatitis in children) and the elderly. This type of stomatitis is caused by a fungus (usually the genus Candida) and develops mainly with a decrease in the body’s immune forces, as a result of long-term treatment with strong antibacterial drugs, as well as against the background of another chronic disease. Candidal stomatitis has the following symptoms:

burning sensation in the mouth and larynx,
white coating on the tongue and mouth,
hyperemia and bleeding of the mucous membrane,
bad taste in the mouth or loss of taste.

This type of stomatitis is considered contagious and can be transmitted both through household and sexual contact.

Herpetic or herpes stomatitis

Occurs in both adults and children. It is caused by the herpes simplex virus and can be acute or chronic. Symptoms of herpetic stomatitis:

in mild cases, small blisters appear that resemble aphthae;

the severe form is characterized by multiple rashes on the mucous membrane;

swelling and inflammation of the lining of the oral cavity;

increased salivation;

general malaise;

toxicosis;

elevated temperature;

enlarged lymph nodes;

burning sensation and pain when eating.

The peculiarity of herpetic stomatitis is that the herpes virus remains in the body forever.

Allergic stomatitis also occurs; read more about the disease in the article.

Allergic stomatitis

Represents allergic disease, which can occur in both adults and children. Its etiology is different: if in childhood most often act as an allergen food products, introduced into a child’s diet for the first time, then in adult patients, the triggering mechanism for a pathological reaction may be a weakening of the immune system due to the use of certain medications, rejection of dentures, or advanced inflammatory processes in the oral cavity.

The characteristic signs of allergic stomatitis are:

itching in the mouth, increasing after eating;

severe swelling of the oral mucosa;

allocation large quantity thick saliva;

hyperthermia;

unbearable pain;

bad breath.

For the treatment of allergic stomatitis, in addition to visiting a dentist, consultation with an immunologist and an infectious disease specialist is recommended.

How to treat stomatitis?

Possible complications

If stomatitis in the mouth is left untreated, it will certainly lead to negative consequences, from gum inflammation to tooth loss. That is why it is extremely important when treating stomatitis to strictly adhere to the recommendations given by your dentist. The list of major potential complications includes the following diseases.

Chronic stomatitis. Statistically, this is the most common complication. An untreated inflammatory process becomes chronic and recurrent, which means that an infectious focus will always be present in the body.

Appearance of scars. A symptom such as bleeding gums can be a manifestation of many diseases, but with stomatitis, due to constant non-healing cracks in the oral cavity, scar tissue forms, which in the future may not allow the patient to open his mouth wide.

Laryngitis. If the infection spreads up respiratory tract, the patient’s voice becomes hoarse, and a cough appears.

Vision problems. With advanced herpetic stomatitis, the target of damage becomes not only the gums, but also the mucous membranes of other organs. Most often, these are the eyes and genitals.

Loss of teeth. Most dangerous complication stomatitis. The main threat is the fact that the destructive process can last for many years and may not be noticeable to the patient at first. First, periodontal disease will develop - serious damage to periodontal tissue. And only then, as a consequence, the teeth will gradually become looser until they fall out.

Stomatitis and treatment at home

Treatment of stomatitis at home primarily involves the use of various herbal decoctions and infusions with antiseptic, anti-inflammatory and immunostimulating effects. For example, even doctors recommend rinsing with calendula - it has a strong antimicrobial and anti-inflammatory effect and promotes healing. Chamomile is an excellent antiseptic - it is one of the most popular remedies found wide application in folk and official medicine.

Stomatitis is treated using folk remedies not only for rinsing, but also for oral administration. For example, rosehip decoction is a real storehouse of vitamins and other necessary for the body human substances. It improves immunity, prevents the development of inflammatory processes, and also helps destroy harmful bacteria. Despite the miraculous power of herbs, it should be remembered that candidiasis and herpetic stomatitis are similar traditional treatment will not eliminate, since fungi and viruses are not affected by antiseptic, anti-inflammatory and immune-modifying agents.

Prevention of stomatitis

The basis for the prevention of stomatitis is compliance with the rules of oral hygiene. Brushing your teeth twice a day with an ultrasonic brush and visiting a hygienist every six months are mandatory. It is important to monitor the general condition of your teeth. Special attention will require wearing braces or dentures, as they can injure the oral mucosa.

To prevent stomatitis, it is very important to be careful about your diet. Using special tests, it is recommended to identify and exclude foods that cause allergies from the diet. You should not eat foods that have a traumatic or irritating effect on the oral mucosa: crispy, salty, hot and spicy foods. Tomato and orange juices and alcohol are not recommended. The diet must be sufficiently balanced, since a lack of vitamins and microelements can cause an attack of the disease. Remember that stomatitis is always recurrent, that is, it occurs periodically during periods of general weakening of the body.

If you have had stomatitis at least once in your life, there will always be a risk of it occurring again. Therefore, prevention comes to the fore. Avoid bad habits, stick to your diet, try not to get nervous and, of course, maintain oral hygiene!