Stomatitis is literally the swelling of mouth and to be medically specific, it is the inflammation of any part of the mucous membrane present in the mouth. This can include any of the inner parts of the cheeks, lips, tongue, gums and even the throat. Such inflammation is quite common and people have experienced it at some point of time. The condition can be acute as well as chronic and can range from mild to serious.
But Stomatitis is a broad definition and can be classified depending on where and how it’s caused. Sometimes it can be due to infections and sometimes it may be due to non-infective causes. Some viral forms of Stomatitis are granular fever, herpes, etc. Bacterial conditions causing Stomatitis are usually due to sore throats and even syphilis. Sometimes the condition may be result of fungal infection. However, the commonest forms of Stomatitis are the results of mouth ulcers. And apart from that other common forms are results of vitamin deficiency and chronic stomach diseases.
There are numerous causes which can lead to Stomatitis. They can range from fungal and bacterial infection to bad lifestyle habits like smoking.
Bacteria can sometimes be responsible for causing inflammation of the mouth. The common cause of such condition is often periodontal diseases. The common among these are the ulcerative gingivitis which affects only the gums; ulcerative periodontosis which results in loss of the tissue surrounding the teeth and necrotizing Stomatitis, the condition where the tissue damage is more. Sometimes syphilis and gonorrhea can also lead to ulcers in the mouth.
Herpes simplex is one of the most common causes of Stomatitis. The conditions that we generally refer to as cold sores and fever blisters are caused by a type of herpes simplex virus. Herpes zoster infection or the virus that cause shingles can sometimes be the cause. Enterovirus causing hand-foot-and –mouth disease and Epstein Barr virus can be other causes.
This is one of the common causes. Candida, a type of yeast, is the commonest of all and the condition called oral candidiasis or oral thrush is often the source of Stomatitis. Such condition can be the result of underlying diseases of the mouth.
Causes related to systemic disorders
Sometimes, the person does not need to get infected to get Stomatitis. Such condition may be caused by various systemic malfunctions like inflammatory bowel diseases, iron deficiency, vitamin C deficiency, and other conditions like Behcet disease and Kawasaki disease. Sometimes malnutrition can also be a cause of Stomatitis.
This is the condition when the mouth gets blisters all over. The general cause is autoimmune disorder where the antibodies target the skin of the mouth and small blisters appear. Oral pemphigus is the name of this condition and the commonest form is pemphigus vulgaris.
This is a type of Stomatitis that is caused by the oral membrane coming into contact with some irritant which can be anything from sharp food, food of highly acidic nature, allergic foods, some forms of toothpaste or oral rinse, etc.
Sometimes simple matters like extremely hot or cold food can cause inflammation of the mucous membrane of the mouth leading to Stomatitis. Sometimes wearing dentures may lead to Stomatitis.
Drug induced conditions
Sometimes drug induced Stomatitis may be also noticed in patients. Nicotine is one of the commonest of these. A person undergoing chemotherapy may also get it due to the toxicity of the drugs.
The other causes that can also lead to Stomatitis include chronic form of the condition itself; canker sores, oral lichen planus, migratory glossitis, oral leukoplakia, and other forms of disorders that are noticed within the mouth. Dryness of mouth due to breathing from mouth and irregular shape of the teeth may also cause Stomatitis.
Symptoms of Stomatitis
Normally the commonest symptom of Stomatitis is appearance of open mouth sores. However, it may not be all or the first signs. Here are the common symptoms that can accompany or precede the sores.
• Appearance of red patches in the mouth, especially at the points where inflammation has occurred;
• appearance of mouth ulcers on the surface of the lips, tongue, inner surface of the cheeks, gums and the oral cavity;
• appearance of blisters which can be filled with clear fluid or pus;
• peeling of the skin from the inside of the mouth;
• swelling of the inflamed portions; and,
• numbness of the mouth or the affected areas (oral dysaenthesia).
Sometimes swelling, blisters, etc. may not appear at all but the area which is affected may feel a burning sensation continuously.
Treatment of Stomatitis
Since Stomatitis can be caused by various factors, the treatment too depends on the factors which have caused the condition. However, there are some common matters that need to be treated in similar ways in case of all cases of Stomatitis.
Since all forms of Stomatitis can cause pain, pain relievers are the commonest form of medication that is used. Acetaminophen is often used orally and topical anesthetics like xylocaine and lidocaine are applied topically in case of ulcers. In cases the condition gets quite unbearable, corticosteroids are also used for relieving the condition. Application of ice on the affected portions also helps in reducing pain.
This is a very common treatment of Stomatitis. Using simple saline solution to specially prepared medicated oral rinses can be used depending on the severity of the condition. Benzydamine solutions can be helpful when used for about a week. Similarly, cholorohexidine gluconate solutions can also bring relief.
In cases of open sores, sometimes antibiotic topical ointments may be applied on the sores to prevent infection.
Generally, the risk factors of Stomatitis are linked to oral hygiene. However, at times some forms of diseases may also lead to Stomatitis. So the risk factors that are likely to lead to the condition are ¬–
1. Chronic breathing through the mouth due to blockage of nasal passage;
2. Loosely fitted dentures and other dental appliances;
3. Irregular arrangement of the teeth like jagged teeth;
4. Drinking too hot beverages;
5. Continuous and excessive intake of highly spicy, acidic food and alcohol;
6. Nutritional deficiency especially in case of intake of vitamin B and C;
7. Diseases like measles, common cold, gonorrhea, etc.;
8. Smoking or chewing tobacco; and,
9. Exposure to irritants and heavy metals.