Definition

What is stomatitis?

Stomatitis is a sore or inflammation inside of the mouth. The sore can be in the cheeks, gums, inside of the lips, or on the tongue.

The two main forms of stomatitis are herpes stomatitis, also known as a cold sore, and aphthous stomatitis, also known as a canker sore.

How common is stomatitis?

Stomatitis is quite common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of stomatitis?

The common symptoms of stomatitis are:

  • Mouth ulcers with a white or yellow layer and red base, usually inside the lips, cheek, or on the tongue
  • Red patches
  • Blisters
  • Swelling
  • Oral dysaesthesia – a burning feeling in the mouth
  • Lesions that heal in 4-14 days and often recur

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes stomatitis?

An infection of the herpes simplex 1 (HSV-1) virus cases herpes stomatitis. It is more common in young children between the ages of 6 months and 5 years. People exposed to HSV-1 may develop cold sores later in life as a result of the virus. HSV-1 is related to HSV-2, the virus that causes genital herpes, but it isn’t the same virus.

Aphthous stomatitis can be one or a cluster of small pits or ulcers in the cheeks, gums, the inside of the lips, or on the tongue. It’s more common in young people, most often between 10 and 19 years of age.

Aphthous stomatitis is not caused by a virus and is not contagious. Instead, it’s caused by problems with oral hygiene or damage to mucous membranes. Some causes include:

  • Dry tissues from breathing through the mouth due to clogged nasal passages
  • Small injuries due to dental work, accidental cheek bite, or other injuries
  • Sharp tooth surfaces, dental braces, dentures, or retainers
  • Celiac disease
  • Food sensitivities to strawberries, citrus fruits, coffee, chocolate, eggs, cheese, or nuts
  • Allergic response to certain bacteria in the mouth
  • Inflammatory bowel diseases
  • Autoimmune diseases that attack cells in the mouth
  • HIV/AIDS
  • Weakened immune system
  • Deficiency in vitamin b-12, folic acid, iron, or zinc
  • Certain medications
  • Stress
  • Candida albicans infection

Risk factors

What increases my risk for stomatitis?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is stomatitis diagnosed?

Diagnosis will depend entirely on what is causing the stomatitis. Relevant investigations include a physical examination, as doctors can learn a lot by looking at the appearance and distribution of ulcers.

Other tests might include:

  • Swabs, both bacterial and viral
  • Tissue scrapings or swabs for fungal infections
  • Biopsy, or the removal of cells or tissue for further study
  • Blood tests
  • Patch tests to identify allergy

A doctor will also look at a person’s medical history to see if a current or previous medication has caused the stomatitis. The doctor will also ask a person about their sexual history and whether they have ever smoked.

Other conditions can cause stomatitis, so investigation and diagnosis are vital to ensure the doctor gives the correct treatment.

How is stomatitis treated?

Mouth sores generally don’t last longer than two weeks, even without treatment. If a cause can be identified, your doctor may be able to treat it. If a cause cannot be identified, the focus of treatment shifts to symptom relief.

The following strategies might help to ease the pain and inflammation of mouth sores:

  • Avoid hot beverages and foods as well as salty, spicy, and citrus-based foods.
  • Use pain relievers like Tylenol or ibuprofen.
  • Gargle with cool water or suck on ice pops if you have a mouth burn.

For canker sores, the aim of treatment is to relieve discomfort and guard against infection. Try the following:

  • Drink more water.
  • Rinse with salt water.
  • Practice proper dental care.
  • Apply a topical anesthetic such as lidocaine or xylocaine to the ulcer (not recommended for children under 6).
  • Use a topical corticosteroid preparation such as triamcinolone dental paste (Kenalog in Orabase 0.1%), which protects a sore inside the lip and on the gums. Blistex and Campho-Phenique may offer some relief of canker sores and cold sores, especially if applied when the sore first appears.

For more severe sores, treatments may include:

  • Lidex gel
  • Aphthasol, an anti-inflammatory paste
  • Peridex mouthwash

If you seem to get canker sores often, you may have a folate or vitamin B12 deficiency. Talk with your doctor about being tested for these deficiencies.

Anti-inflammatory drugs such as corticosteroids (including prednisone) are the most effective treatment for canker sores, as they will reduce swelling and pain. They are also effective for cold sores after the sore has been present for three to four days, because at that point the virus has disappeared and only the inflammation remains.

Not all people can take certain types of anti-inflammatory drugs. For example, if prednisone is given to people with diabetes, their blood sugars will go up. Talk to your doctor about any health conditions you have before starting a new medication.

There is no cure for cold sores. Treatment includes:

  • Taking a dose of valacyclovir (Valtrex) at the first sign of an attack
  • Coating the lesions with a protective ointment such as an antiviral agent (for example, 5% acyclovir ointment)
  • Applying ice to the lesion
  • Taking L-lysine tablets may also help, as might antiviral mediations that a doctor prescribes. Some experts believe that these drugs shorten the time that the blisters are present.

Not all sores are harmless. Schedule an appointment with your doctor if your mouth sores haven’t healed within two weeks.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage stomatitis?

The following lifestyles and home remedies might help you cope with stomatitis:

  • Using an antiseptic and non-alcoholic mouthwash
  • Treating chronic dry mouth
  • Using a soft toothbrush
  • Maintaining proper nutrition and hydration
  • Receiving routine dental care

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 3, 2018 | Last Modified: January 3, 2018

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