what is stomatitis

Our mouth is made from complex tissues and organs that help in various functions such as speaking, chewing, and swallowing. Several diseases can affect the health and functions of the mouth. One of them is stomatitis. Stomatitis is characterized by inflammation inside the mouth. Usually, stomatitis affects the cheeks, gums, mucosal part of the lips, and the tongue. Soreness of the mouth is one of the common symptoms of stomatitis. Additionally, it causes pain and discomfort while chewing and swallowing.

A wide range of factors can cause stomatitis. However, an oral infection such as herpes and aphthous ulcerations are two prime causes of stomatitis. Treatment typically depends on the type of cause. Herpes infections are treated with antiviral therapy, and topical pain relief techniques manage aphthous stomatitis. Today’s article will highlight some of the characteristics of stomatitis. Furthermore, we will discuss the causes and treatment of stomatitis.

What is stomatitis?

Stomatitis is a type of mucositis which causes inflammation of the mouth. Typically, the mucosal membrane of the mouth is affected on a large scale. The mucosal membrane is a thin layer of skin that lines the surface of the oral tissues. (1)

Often the common parts of the mouth affected by stomatitis include the cheeks, gums, tongue, and the mucosal part of the lips inside the mouth. There are two primary forms of stomatitis –

  • Herpes stomatitis
  • Aphthous stomatitis

What causes stomatitis?

Typically, one of the leading causes of stomatitis is herpes simplex 1 (HSV-1) infection. It usually occurs in young children between six months and five years. Often, people infected by HSV-1 develop cold sores later in life. (2)

Another cause of stomatitis is aphthous ulcerations. Any viral exposure does not cause these ulcers. However, they are caused by inadequate oral hygiene and damage to the mucosal membrane. Aphthous ulcers are non-contagious. Aphthous ulcers grow in a cluster of small pits in the cheeks, gums, and tongue. Aphthous stomatitis typically occurs in young children between ten and 19 years. (3)

Some other causes of stomatitis may include –

  • Injury to the mucosal membrane during dental work, accidental cheek bite, sharp tooth, dentures or dental braces
  • Celiac disease
  • Allergic response to bacteria in the mouth
  • An autoimmune disorder that affects the cells in the mouth
  • HIV/AIDS
  • Weak immune system
  • Nutritional deficiency such as vitamin – B12, folic acid, iron, and zinc
  • Certain medications
  • Excessive stress
  • Candida albicans infection

What are the symptoms of stomatitis?

Typically, herpetic stomatitis is characterized by the formation of multiple blisters in the gums, cheeks, roof of the mouth, tongue, and borders of the lip.

  • Often, the patient may feel pain and discomfort while eating, drinking, or swallowing.
  • Cold sores may form at a later stage and irritate the mucosal layer
  • Dehydration
  • Swollen and tender gums (4)
  • High fever
  • The blisters may pop and develop ulcers in the mouth
  • Risk of secondary infection

Usually, herpetic stomatitis and its symptoms last for seven to ten days. The following symptoms characterize aphthous stomatitis –

  • Round and oval ulcers with red, inflamed border and white or yellowish center
  • The sores usually heal within one to two weeks without scarring
  • Large ulcers may take six or more weeks to heal. Moreover, they may leave a scar in the mouth

What is the treatment for stomatitis?

Treatment of stomatitis usually depends on the underlying cause –

Herpetic stomatitis

  • Typically, herpetic stomatitis is treated with antiviral medications such as acyclovir.
  • Additionally, the patient is advised to drink plenty of water and reduce the risk of dehydration.
  • A liquid diet of non-acidic foods and beverages is recommended.
  • Acetaminophen is prescribed for pain relief and fever.
  • Severe oral pain can be treated with lidocaine. (5)

Aphthous stomatitis

Aphthous stomatitis is usually less severe than herpetic stomatitis. It is treated as follows –

  • Topical application of benzocaine helps to heal the ulcer and manage the pain
  • Large ulcers are treated with cimetidine or oral steroids (6)
  • Silver nitrate solutions are used to treat recurrent canker sores in the mouth
  • Often aphthous ulcers heal on their own

How to prevent stomatitis?

Prevention of stomatitis can be done by following ways –

  • Maintain proper oral hygiene
  • Have a nutritious diet which may include green leafy vegetables, lentils, and beets
  • Refrain from contacting any person affected by HSV-1 infection
  • Avoid spicy and acidic food
  • Prevent accidental oral injuries – do not talk while chewing and use dental wax to cover sharp braces or dentures
  • Follow routine relaxation exercises to reduce stress

Take away message

Stomatitis is one of the common oral health problems suffered by young children. It is characterized by soreness and inflammation of the mucosal membrane in the mouth. The typical locations of stomatitis include the cheeks, lips, gums, and tongue. Stomatitis typically occurs in two forms depending on the type of cause – herpetic stomatitis caused by herpes simplex one infection. The second form is aphthous stomatitis caused by aphthous ulcerations in the mouth.

Both types of stomatitis cause swelling, pain, and discomfort. Moreover, they interfere with the functions of the mouth, such as speaking, chewing, and swallowing. Some other causes of stomatitis include poor oral hygiene and damage to the mucosal membrane.

Treatment of stomatitis usually includes antiviral therapy for herpetic stomatitis and topical pain management for aphthous ulcers. Prevention of stomatitis is always crucial. It is essential to maintain proper oral hygiene and protect the mouth from accidental injuries. Moreover, follow a nutritious diet.