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Stomatitis And Other Oral Infections

A common infection, stomatitis-inflammation of the oral mucosa-may extend to the buccal mucosa, lips, and palate. It may occur alone or as part of a systemic disease.

There are two main types: acute herpetic stomatitis and aphthous stomatitis. Acute herpetic stomatitis is common and mild. Aphthous stomatitis is common in young girls and female adolescents.

Acute herpetic stomatitis is usually short-lived and easily recognized; however, It may be severe and, in neonates, may be generalized and potentially fatal. Aphthous stomatitis usually heals spontaneously, without a scar, in 10 to 14 days.

Other oral infections include gingivitis, periodontitis, Vincent's angina, and glossitis.

Causes

• weakened immune system
• certain allergies may cause the lesions to appear, such as:
  
  • coffee
  • chocolate
  • cheese
  • nuts
  • citrus fruits
  • potatoes

• stress
• viruses and bacteria
• trauma to the mouth
• poor nutrition
• certain medications

Aphthous stomatitis is usually seen in children and adolescents from the ages of 10 to 19 years. For about one-third of the children affected, lesions continue to reappear for years after the initial outbreak.

Signs and symptoms

• Fever, may precede appearance of blisters and ulcers by 1 or 2 days
• Irritability
• Blisters in the mouth, often on the tongue or cheeks
• Ulcers in the mouth, often on the tongue or cheeks -- these form after the blister pops
• Swollen gums
• Pain in mouth
• Drooling
• Difficulty swallowing ( dysphagia )

Diagnosis

Treatment

For acute herpetic stomatitis, treatment is conservative. For local symptoms, management includes warm-water mouth rinses (antiseptic mouthwashes are contraindicated because they're irritating) and a topical anesthetic to relieve mouth ulcer pain.

CLINICAL TIP A course of acyclovir (200 to 800 mg, 5 times daily for 7 to 14 days) may shorten the course nnd reduce postherpetic pain.

Supplementary treatment includes bland or liquid diet and, in severe cases, I.V. fluids to maintain hydration, and bed rest.

For aphthous stomatitis, primary treatment is application of a topical anesthetic. Effective long-term treatment requires alleviation or prevention of precipitating factors.

Alternate treatment

Alternate treatment of stomatitis mainly involves prevention of the problem. Patients with dental appliances such as dentures should visit their dentist on a regular basis

Botanical medicine can assist in resolving stomatitis. One herb, calendula ( Calendula officinalis ), in tincture form (an alcohol-based herbal extract) and diluted for a mouth rinse, can be quite effective in treating aphthous stomatitis and other manifestations of stomatitis.

Prevention

Stomatitis caused by local irritants can be prevented by good oral hygiene, regular dental checkups, and good dietary habits. Problems with stomatitis caused by systemic disease can be minimized by good oral hygiene and closely following the medical therapy prescribed by the patient's health care provider.