Stomatitis( inflammation of the mouth) with photos - Causes, symptoms and treatment. MF.
Probably, none of the dental diseases has such a diverse manifestation and such a vast number of causes as stomatitis.
Stomatitis ( oral inflammation ) is a disease caused by a variety of factors, manifested by the appearance of various inflammatory elements on the mucosa of the mouth and lips.
Causes of stomatitis
The causes of stomatitis are very diverse, but can be combined into the following groups:
1. Stomatitis of traumatic origin( trauma can be mechanical, chemical or physical, acute or affecting for a long time).
2. Infectious stomatitis( viral, bacterial, fungal infections).
3. Allergic stomatitis.
4. Stomatitis in certain systemic diseases( hypo- and avitaminosis, endocrine diseases, diseases of the blood system, diseases of the gastrointestinal tract, etc.).
Diagnosis of stomatitis
To make the correct diagnosis, the doctor, first of all, will collect anamnesis( hold a survey), then conduct an examination of the oral cavity. Sometimes this is enough, but in some cases it is necessary to conduct special studies - the coloration of the elements of the lesion with special dyes, luminescence, general and biochemical blood tests, microscopic examination of scrapings from the lesion element, and the conduct of allergic tests.
Symptoms of stomatitis with photos and treatment of stomatitis
It is obvious that the manifestations and principles of treatment of all these stomatitis will be different.
Traumatic stomatitis symptoms and treatment.
The oral mucosa has a certain "safety margin" to the effect of various traumatic factors. In the case of an intensive influence of one or another factor exceeding this physiological reserve, a traumatic lesion of the mucous membrane of the oral cavity occurs. Consider the most common types of traumatic factors - mechanical, chemical and physical.
Mechanical injuries of the oral cavity can be acute and chronic. Acute injuries of the mouth occur when striking, injuring an object or accidentally biting. First, pain appears on the injury site, and then a small hematoma( hemorrhage), erosion, or sore can form. After 1-3 days, all symptoms, as a rule, disappear.
Treatment of such stomatitis is reduced to the elimination of a traumatic factor( for example, polishing of the acute edge of the filling or chipped tooth), treatment with antiseptic solutions to prevent further infection( furacillin, 3% hydrogen peroxide) and, in the presence of ulcers, applications of so-called "keratoplastics", t.e.drugs that accelerate the recovery of the mucous membrane( oil solution of vitamin A, sea buckthorn oil, dogrose oil, solcoseryl, etc.).
Permanent( chronic) mechanical injuries occur quite often. The cause of their appearance can be a sharp edge of the tooth if it is damaged by caries or an incorrect position in the dentition, an "unsuccessful" prosthesis, orthodontic constructions and bad habits( biting cheek or lip, gnawing sharp objects, etc.).On the effect of these factors, the mucosa of the oral cavity may respond from a slight reddening and swelling to the formation of an ulcer.
Treatment of with stomatitis is, first of all, in eliminating the traumatic factor. In the case of erosion or ulceration, they are also treated with solutions of antiseptics and keratoplastics.
The physical traumatic factors of include the effect of high( then a burn) and low( frostbite) temperatures, electric shock, and radiation injuries. The peculiarity of such lesions is often irreversible damage to the oral mucosa - necrosis, but this is only in extreme cases. Basically, such lesions are accompanied by the appearance of severe pain, reddening of the mucous membrane, the formation of blisters, ulceration. Treatment consists in the preventive antiseptic treatment of inflammatory elements, the appointment of analgesic and anti-inflammatory therapy, the application of keratoplastics to accelerate healing.
Stomatoses of chemical origin occur when the mucous membrane contacts acid and alkali in a sufficiently strong concentration. This can happen when mistakenly used in everyday life and at work, at a dentist's reception, often when attempting suicide. Acid burn is characterized by the appearance of a dense film at the site of the lesion, around which there is swelling, redness, soreness. When burned with alkalis, such a film does not form, the damage spreads to the innermost layers of the oral mucosa, very painful, slowly healing erosions and ulcers are formed.
Treatment of begins with immediate removal of the damaging chemical agent and rinsing with a neutralizing solution. When burned with acid, you can use 0.1% solution of ammonia( 15 drops per glass of water), soapy water and other weak alkalis. Alkalis are neutralized with a 0.5% solution of acetic or citric acid. Further treatment of patients with chemical burns is reduced to anesthesia, the appointment of antiseptic solutions and accelerating epithelization, keratoplasty in the form of rinsing, mouth baths or appliques.
Infectious stomatitis symptoms and treatment.
To viral stomatitis include diseases caused by the herpes simplex virus, the virus of chicken pox, influenza, parainfluenza, adenovirus and some others.
The most common infection is the loss of the oral cavity and the lips of the herpes simplex virus( according to WHO, the incidence of this virus ranks second after the flu), so we should dwell on it in more detail.
The first encounter with the virus occurs, as a rule, in early childhood and causes acute herpetic stomatitis .The disease begins with a general malaise, headache, fever, to 37-41 C. After 1-2 days, these symptoms are joined by pain in the oral cavity, increasing during conversation and eating, the mucous membrane of the oral cavity becomes swollen. Then on it appear small( size with millet grain) bubbles, located in groups( from 2-3 to several tens) or merging into large, filled with transparent contents of the bubbles. After 2-3 days they burst, forming small and large erosions, covered with white coating.
Salivation is increased, it becomes viscous.
Often, the mouth, mouth, nasal mucosa, and mucous membranes of other organs join the oral cavity.
After 5-15 days( depending on the severity of stomatitis) there is a recovery, scars are not formed.
After the primary herpetic infection, the virus in most cases remains in the human body. Man becomes a virus carrier. With a decrease in the protective properties of the body( after injuries to the oral cavity mucous membrane, hypothermia, the transferred disease, premenstrual period, etc.), the disease manifests itself as chronic recurrent herpetic stomatitis .Recurrent herpes in the oral cavity is more often localized on the hard palate, cheeks, tongue.
Vesicles with herpetic stomatitis appear immediately by the group, merge, burst, forming a very painful erosion. The general condition, unlike the acute form, as a rule, does not suffer.
Treatment of viral stomatitis is carried out in the following directions :
• Neutralization of the virus, prevention of new rashes( antiviral drugs( acyclovir, oxolin, arbidol, zovirax, etc. in the form of tablets and ointments for topical administration) are used, with relapsing stomatitisantiherpetic polyvalent vaccine);
• Withdrawal of general intoxication( anti-inflammatory and antiallergic drugs);
• Strengthening the body's resistance( vitamin A and C), immunocorrecting drugs, for example, immunall, imudon, etc.)
• Pain relief, acceleration of the healing period of erosions, ulcers( keratoplasty drugs - vitamin A,rosehip oil, solcoseryl, carotolin, physiotherapy);
Bacterial stomatitis, as already clear from their name, is provoked by bacteria( diplococci, streptococci, staphylococcus, spirochetes, clostridia, gonococci, etc.).
Most common bacterial stomatitis occurs in the form of erosive stomatitis , caused by diplococcus. Both men and women of different ages are affected. In most cases, erosive stomatitis develops after a flu, sore throat, or other infection. They promote the development of trauma, burns of the oral mucosa.
With erosive stomatitis, first itching, burning, soreness in the oral cavity at mealtime. Further, in the region of the lips( predominantly the lower one), at the boundary of the hard and soft palate, rarely - on the cheeks and tongue appears a limited reddening of a small size, which is then transformed into erosion. Small erosions can merge, reaching more than 2 cm. Plaque and films do not occur on them. The disease lasts from 4 to 10 days.
In the treatment of erosive stomatitis, as a rule, there is enough local exposure. It consists in the treatment with anesthetics and antiseptics or a combination of them( in the form of pastes, powders, ointments, gels), applications of anti-inflammatory and epithelial drugs, or, also, their combination. If necessary, the doctor can prescribe general treatment( antibiotics or sulfanilamides).To prescribe such treatment to yourself is by no means impossible!
A much more serious form of bacterial stomatitis is ulcerative-necrotic stomatitis( Vincent ).It is caused by microflora( fusospirochetes), which is normally found in the oral cavity( in the interdental and dentogingival spaces, in the depths of carious cavities, in the tonsils), but under certain conditions becomes pathogenic. Such conditions can be hypothermia, stress, trauma, teething "wisdom".Poor oral hygiene, the presence of carious teeth, smoking, working in unfavorable conditions promote the development of the disease.
Ulcerative necrotic stomatitis can be only a symptom of some very serious diseases, such as leukemia, poisoning with heavy metals salts, gastrointestinal tract pathologies, radiation injuries, immunodeficiencies, therefore, when symptoms of ulcerative necrotic stomatitis appear, you should immediately consult a doctor!
Symptoms of ulcerative necrotic stomatitis at the onset of the disease are similar to those of other infectious diseases - weakness, headache, fever, joint aches. Then the intensity of these manifestations increases, in the oral cavity there are very strong pains even from the slightest touch, eating and hygienic care become practically impossible. A sharp putrid smell appears from his mouth.
Ulceration begins with the gums, and necessarily from those areas where there is any traumatic factor( tartar, improperly placed crowns, broken teeth), then the contact spread of inflammation occurs.
In this disease, a very characteristic change in the gums occurs: they are swollen, loosened, very painful, easily bleed even when lightly touched. Gradual necrosis( "dying off") of the interdental papilla papillae begins, starting from the apex and spreading to the base, they take the form of a truncated cone.
Unfortunately, the disease can go into a chronic form, but, as a rule, there is a complete recovery.
Treatment begins with antibiotic therapy aimed at the destruction of fusospirochetes( antibiotics - penicillin, ampioks, kanamycin, lincomycin, etc.).The choice of antibiotic and its dosage is carried out only by a doctor! Along with this, anti-inflammatory and antiallergic drugs, vitamins are prescribed.
After anesthesia, the oral cavity is treated with solutions of antiseptics( 3% hydrogen peroxide, potassium permanganate, metrogyl, trichopolum, dioxidine) or antibiotics( penicillin, gentamicin, etc.) are most effective. Necrotized( "dead") tissues are surgically removed. To accelerate healing, keratoplastic preparations are prescribed( solcoseryl, metacil, calanchoe juice, aloe).The sanitation of the oral cavity is mandatory.
The most common fungal infection of the oral cavity is Candidiasis .Normally, the causative agent of this disease( Candida fungus) is in the oral cavity, being the so-called saprophytic( normal) microflora. But with a decrease in the protective properties of the body, with the development of dysbacteriosis of the oral cavity, becomes a pathogen.
An important condition for the onset of the disease is a special condition in the oral cavity - moisture, temperature, decreased acidity in the mouth( with poor hygiene, carbohydrate food, violation of the rules for using removable dentures, the presence of carious cavities, lichen planus, tuberculosis, etc.)..
Often candidiasis occurs in infants, weakened by infectious diseases, premature infants. In older children - with rickets, diathesis, hypovitaminosis .
More commonly known is candidiasis stomatitis called "thrush", associated with the characteristic symptoms of the disease. On the mucous membrane of the oral cavity there appear white spots or white "curdled" plaque, with the removal of which remains the focus of reddened, edematous mucosa. If the plaque is not removed, then layers are layered on each other, a dense film is formed, under which even erosion can form.
In addition to these symptoms, dryness and burning sensation in the oral cavity, soreness in eating, the appearance of painful cracks in the corners of the mouth are also observed.
Treatment of fungal stomatitis begins with the appointment of antifungal drugs( nystatin, levorin, clotrimazole, fluconazole, etc.).The oral cavity and removable dentures are treated with weak solutions of alkalis( 2-4% borax solution, soda), aniline dyes, iodine preparations( Lugol's solution, "Yoks") and, necessarily, antifungal ointments( 1% nystatin, 5% levorin, miconazole-gel ", etc.).
In the diet limited carbohydrates( sweet, floury, starchy dishes).
It is important to identify and cure( in conjunction with an endocrinologist, gastroenterologist, therapist and other specialists) the cause of candidiasis, the cause of imbalance in the oral cavity. Candidiasis in young people who consider themselves healthy, is an "indicator" disease in HIV-infected patients and patients with diabetes mellitus.
Allergic stomatitis.
For today, it is established, every third inhabitant of the planet in one way or another suffers from allergies. In addition to allergies to food, dust, pollen of plants and other irritants, there are many medicines, including anti-allergic drugs, which can to some extent cause an allergic reaction, including in the oral cavity.
The most common form of allergic stomatitis is contact stomatitis. It can occur when in contact with any medication or dentures. Patients complain of burning, dry mouth, pain when eating. The mucous membrane of the mouth and tongue are swollen, there are prints of teeth on it. Against this background, there may appear different sizes of spots, erosion, ulcers. It is characteristic that the inflammation focuses only in the area of the prosthetic bed or in the contact zone with the allergen.
In the treatment of contact stomatitis, it is important to identify and eliminate the allergen( discontinuation of the use of the prosthesis, replacement of the filling material, cancellation of the suspect drug).Inside are prescribed antihistamine( antiallergic) drugs( suprastin, tavegil, clarotidine), they can also be prescribed in the form of applications on the affected areas of the mucosa. In the presence of erosions, keratoplastic preparations( an oily solution of vitamin A) are prescribed.
Often allergic stomatitis is manifested as a chronic recurrent aphthous stomatitis. In this disease, single aphids appear in the same place, appearing and disappearing again for many years. As a rule, at the beginning of the disease, relapses( recurrences) occur periodically( in spring and autumn), and then haphazardly. Some patients develop aphthae due to an injury to the oral cavity, contact with a detergent, hair dye, or it depends on the menstrual cycle in women.
Afts( translated from the Greek language - ulcer) are distinctly rounded in shape, small in size( 5-10mm), covered with a grayish coating, very painful.
The general condition of patients does not suffer. The period of existence of aphthae lasts 7-10 days.
In the treatment of chronic recurrent aphthous stomatitis, it is important to pay attention not so much to local treatment of aphtha, as to revealing the cause of the disease( allergen), to preventing relapses.
One of the leading directions in the treatment of recurrent aphthous stomatitis is the appointment of antiallergic drugs( fenistil, klemastin, suprastin, fenkarol).An integral component of the treatment is vitamin therapy( B vitamins, folic acid, vitamins C, PP).
Local treatment of aphtha is carried out by anesthetics, antiseptic and keratoplastic preparations and their combinations in the form of pastes, gels( "Kholisal", "Kamistad", solcoseryl, actovegin).
Stomatitis in systemic diseases.
Organs and tissues of the oral cavity are in close connection with various internal organs and human systems, so a large group of lesions of the mucosa occurs due to the disease of certain internal organs. Sometimes they become early manifestations of clinical signs of such a disease even before its objective symptoms appear, and force patients to turn first to the dentist. Such manifestations appear in the oral cavity with the defeat of most internal organs. Especially often they are found in diseases of the gastrointestinal tract, blood, endocrine disorders.
Changes in the mucosa during diseases of the gastrointestinal tract occur most often. Most often observed signs such as changes in color of the mucous membrane, plaque in the tongue, ulcerative lesions.
Cardiovascular disease often causes cyanosis( cyanosis) of the oral mucosa. Blood circulation in the mouth, as in the whole body, is broken, so trophic changes appear, up to ulcers. Such ulcers are of different sizes, they are covered with a gray coating, have a sharp fetid odor, are very painful when touching and eating.
Stomatitis in endocrine diseases also have an important diagnostic value, becausehelp identify the disease in the early stages.
For example, diabetes mellitus causes dryness of the mouth( xerostomia), gum disease( gingivitis), fungal stomatitis, fungal jaeda( cracks in the corners of the mouth), trophic disorders( erosion, ulcers).
With Addison's disease( disruption of the adrenal cortex), characteristic small spots or bands of blue or grayish-black appear. Subjectively, patients do not feel them at all.
With blood diseases, especially with leukemia, severe ulcerative necrotic lesions occur in the oral cavity, caused by a sharp decrease in the protective properties of the body.
Treatment of such "symptomatic" stomatitis is carried out together with a specialist doctor( endocrinologist, gastroenterologist, therapist and others) and depends on the nature and severity of manifestation in the oral cavity.
Treatment of stomatitis with folk remedies
The most frequent and most painful manifestation of stomatitis in the oral cavity are erosions and ulcers. Their treatment is carried out with antiseptic and keratoplastic preparations. From the traditional medicine popular and effective rinsing infusions of medicinal herbs that have anti-inflammatory effect: chamomile, eucalyptus, cottonwood and calendula. Promote epithelization of all oily solutions( rosehip oil, sea buckthorn oil), as well as aloe and calanchoe( applying juice or leaves).
In the treatment of fungal stomatitis, it is possible to rinse with a weak soda solution( 0.5 teaspoon per glass of water), treatment with Lugol solution, a weak pink solution of "manganese"( especially in the treatment of stomatitis in infants), rinsing with antiseptic solutionsdecoctions of juniper, yarrow, calendula).
In "thrush" - yeast stomatitis - honey and potatoes are popular, but these products contain carbohydrates, which, firstly, are food for fungi, and secondly, reduce the pH of the oral cavity in the acidic side, which contributes totheir vital activity, so that the use of these drugs is not only inefficient, but also unacceptable in the treatment of fungal lesions of the oral cavity.
The use of traditional medicine is possible only after consulting a dentist. Self-medication for any ulcerative lesions of the oral cavity is unacceptable, becauseulcers, especially long-term non-healing, can be a sign of very serious diseases!
Prevention of stomatitis
As with any other dental disease, the main advice is the timely access to the dentist. It will help to eliminate traumatic factors( sharp edges of teeth, improper prostheses), improve oral hygiene, eliminate all sources of infection in the oral cavity( carious teeth, periodontal pockets).
A good prevention of stomatitis will be the correction of diet( reduction in the diet of sweet, floury, starchy) and hardening. And following the rules of a healthy lifestyle, rejection of bad habits( especially smoking) will make an excellent contribution not only to the health of the oral cavity, but to the whole organism, and this is the guarantee of a long and quality life.
Doctor dentist Knyazeva EV