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.
CausesAcute herpetic stomatitis results from herpes simplex virus. The exact cause of this disease is not known. There are many factors that are thought to be involved with the development of canker sores, including:
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
DiagnosisPhysical examination allows diagnosis. In Vincent's angina, a smear of ulcer exudate allows identification of the causative organism.
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 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.
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.
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