DAGESTAN MEDICAL DENTAL INSTITUTE

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« Stomatitis »

Made by students of 1 course

Pirdamova Zulfiya

Makhachkala, 2019
 Rarely, no ulcers develop, and only a burning sensation inside the mouth
occurs. Stomatitis can involve any part of the mouth, including the cheeks, gums,
tongue, throat, lips and roof or floor.
Aphthous ulcers are the most common cause of stomatitis. These ulcers are
acute, painful ulcers on the tongue, or the inside of the lips or cheeks. They are also
called canker sores, and have a reddish base, with a yellowish covering.
Aphthous ulcers are not associated with other symptoms and heal in one to two
weeks. They usually appear first after the age of 10 years and may reappear on and
off over the next few years.
 Types of recurrent aphthous stomatitis
Minor recurrent aphthous stomatitis
This is the most common type, appearing on the lips, cheeks and
tongue. Typically, they leave no scar once healed.
Major recurrent aphthous stomatitis
This type is characterized by large ulcers that last from two to six weeks. They
can appear anywhere in the mouth, including the gums, the roof of the mouth, and the
throat.
Herpetiform recurrent aphthous stomatitis
These ulcers are tiny, and very painful. A high number, around twenty to thirty,
can appear at once and may join to form larger areas of ulceration.

What causes stomatitis?

Stomatitis has several possible causes,
which may overlap or interact with each other.
Local causes of stomatitis include
factors such as:
 Trauma: Trauma can possibly stem
from ill-fitting dentures or other dental
appliances like braces or retainers.
 Infections: Stomatitis can be caused
by bacterial infections, such as syphilis, or viral infections, such as herpes simplex
and herpes zoster. Ulcers can also be caused by hand, foot, and mouth disease
(Coxsackie virus), or yeast infections.
 Other local causes include a weakened or deficient immune system,
chemical irritation, and medications such as sulfonamide drugs, which treat
conditions from eye infections to rheumatoid arthritis and include antibiotics, can
also cause stomatitis, along with anti-epileptic drugs.
 Systemic causes include:
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 Stress
 Behçet’s disease (inflammation of the blood vessels and tissues)
 Celiac disease (inflammation of the small intestine)
 Lupus
 Other illnesses affecting the blood vessels
 Nutritional deficiencies, such as riboflavin deficiency
 Chemotherapy for cancer
 Allergic reactions
 Any condition which is associated with xerostomia (dry mouth)
 Sexually transmitted diseases such as syphilis, gonorrhea
 Other infections such as acute necrotizing ulcerative gingivitis.
Conditions associated with
stomatitis
Herpes simplex and Behçet’s
disease can all cause recurrent oral
ulcers. Yeast infection as a cause of
stomatitis should be suspected in the
presence of diabetes, HIV infection,
or any other condition which causes
weakened immunity.
Some diseases have symptoms associated with stomatitis, including:
 Gastrointestinal symptoms with celiac disease, or inflammatory bowel
disease
 Skin bullae with pemphigus
 Fever, conjunctival redness and skin rashes with Steven-Johnson syndrome
 Erythema and palmar skin scaling with Kawasaki disease.
 Conditions that present with both skin and oral ulceration include:
 Steven-Johnson syndrome (flu-like symptoms followed by a rash and
blisters)
 Erythema multiforme (quick-spreading skin reaction)
 Pemphigus (rare and serious condition characterized by blisters on the skin,
lining of the mouth, nose, throat and genitals)
 Bullous pemphigoid (blisters between the epidermis and dermis)
 Kawasaki disease (inflamed blood vessels)
 Hand, foot, and, mouth disease
 Varicella or herpes zoster (chickenpox and shingles)
 Secondary syphilis
Conditions that manifest with oral ulcers alone include:
 Herpes simplex
 Behçet’s disease
 Yeast infections
 Acute necrotizing ulcerative gingivitis
 STDs such as primary syphilis and gonorrhea
 Most viral causes
How is stomatitis diagnosed?
Diagnosis depends on a careful
history and examination. A lot of
information can be obtained by
carefully noting the type and
distribution of the ulcers, their
appearance, a history of sexual contact
with multiple partners, the
medications the patient is on or has taken in the past, a history of tobacco use, and
information on other symptoms that may indicate the presence of systemic disease.
 In the absence of systemic symptoms, a diagnosis of primary ulceration is easy,
and no testing is required. If such symptoms are present, or ulcers persist without
obvious cause, testing and sometimes, but not often, a biopsy should be carried out.
Treating stomatitis
Treatment includes eliminating or treating any obvious local or systemic
causes, good oral hygiene, salt-water rinses, use of a soft toothbrush, and the use of
mouthwashes that, preferably, do not contain alcohol.
Topical treatments include the use of anesthetics, substances that coat the ulcer,
steroids, or cauterization. Painkillers can be prescribed to reduce the amount of
discomfort stomatitis can cause, which can help with brushing teeth.
If stomatitis is left untreated, it will continue to worsen. To prevent spreading
mouth sores that are contagious, avoiding kissing, sharing cups or cutlery with other
people is recommended.
Is stomatitis preventable?
Some vitamins can help prevent the development of stomatitis. B vitamins can
be beneficial. Foods containing high levels of vitamin B include:
 Broccoli
 Bell peppers
 Spinach
 Beetroot
 Calf Liver
 Lentils
 Asparagus
Sources
 www.msdmanuals.com/.../stomatitis
 www.guysandstthomas.nhs.uk/.../recurrent-aphthous-stomatitis.pdf
 www.urmc.rochester.edu/.../content.aspx