Stomatitis is an inflammation of the mucous membrane of the mouth and lips. it can be present with or without oral ulcers.
There are many causes of it. There may be acute or chronic mouth ulcers. Appearance and clinical features can be different in different types of stomatitis. Let’s discuss it today.
Recurrent aphthous stomatitis (RAS):
- In this case, positive family history may be present in 1 out of 3 cases.
- Other causes can be a food allergy, local trauma, stress, Behcet’s syndrome, Sweet’s Syndrome.
- It can also be associated with menstrual cycles, HIV infection, and cyclic neutropenia.
- Tiny shallow ulcers on an erythematous base which can be covered with greyish-white exudate.
- You can apply topical anesthetics such as 2% lidocaine gel before meal. It relieves pain.
- Mouthwash with alkaline or chlorhexidine gargle.
- A thin coating of 0.1% Triamcinolone oral paste can be applied.
- Steroids by mouth whenever necessary.
- It is caused by excessive use of tobacco, alcohol, spice, antibiotics, certain drugs, infectious and debilitating diseases.
- Red mucous membrane with increased exudation is present.
- It is aimed to eliminate the cause.
- Oral Vitamin B complex is given.
- Hexidine or povidone-iodine mouth wash also helpful.
Various infections like bacteria, viruses, fungus can also cause stomatitis and ulcer.
- It may have some predisposing factors like pre-existing gingivitis, trauma, or excessive use of tobacco, which again leads to more bacterial infection.
- Ulcer may be present which is covered by grayish pseudo-membranous slough demarcated from surrounding mucosa by linear erythema.
- Fever with lymphadenopathy, increased salivation, putrid smell, spontaneous gingival bleeding also present.
- Metronidazole orally and locally is useful. Other antibiotics when required.
- Proper oral hygiene and surgical correction of deformed gingivae after acute illness is controlled.
- Herpes simplex and other viruses.
- Ulcer formation after formation of discrete spherical grey vesicle ruptures. It may remain for 2-3 weeks. It is common in children with severe ulceration of mouth mucous membrane, fever, lymphadenopathy, and malaise.
- In severe cases, antiviral like acyclovir can be given.
- General care with mouse wash and complete bed rest should be done.
Other viral infections also cause stomatitis such as…
- Herpes varicella zoster which is presented with painful oral ulcer and teardrop rash of chickenpox.
- Infectious mononucleosis causes ulcers particularly on fauces which is the back part of the mouth.
- Symptomatic treatment is given in all other viral stomatitis.
- Trush or pseudo-membranous candidosis.
- It usually affects infants, debilitated adults such as heroin addicts, elders with low immunity, and after antibiotic and steroid therapy. Also affects immuno-compromised person such as in diabetes, AIDS, etc.
- Presence of a white raised patch that looks like milk curd on the tongue and mucous membrane of the mouth.
- It leaves raw bleeding surface when removed.
- Good oral hygiene should be taken.
- Mouth cleaning with nystatin suspension. Gentian violet can also be applied.
- Oral antifungal should be administered when required.
- Caused by secondary syphilis infection which is a sexually transmitted disease.
- It is presented with circular, mucous patches, usually greyish white with red areola.
- Treatment of syphilis should be started in this case.
- It is caused by hypersensitivity of some medicines and cytotoxic drugs like methotrexate.
- Inflammation and ulceration of buccal, labial, and palatal mucosa is present.
- Symptomatic treatment is done.
Vitamin deficiency-related stomatitis:
- Various vitamin B complex especially nicotinic acid deficiency causing pellagra.
- Raw red ‘Angry looking’ tongue in pellagra.
- Vitamin B supplements in therapeutic doses.
It is also caused by other disorders in the body such as…
GI disorders: like Crohn’s disease, Coeliac diseases.
Dermatological disorder: erythema multiforme, lichen planus, pemphigoid.
Neoplasia: like Kaposi’s sarcoma and other carcinomas.
Systemic diseases: like Systemic lupus erythematosus (SLE), Bechet’s syndrome.
This is all about the article. This article is meant only for information and educational purpose. Please consult your doctor before taking any action. Any medicine or action should not be taken without the advice of healthcare experts. Thank you.