By their nature, inflammation in the oral cavity is no different from any other inflammatory processes, which are a protective reaction of the body in response to various stimuli - biological, physico-chemical, mechanical. Thanks to inflammation, the human immune system destroys or neutralizes damaging factors, rejects dead tissue in the lesion, and starts the process of restoring destroyed structures.
However, inflammation is not only a protective and restorative, but also a pathological process that in some cases violates the functions of vital organs and poses a danger to humans in this regard. Therefore, it requires an impact aimed not only at helping the immune system to destroy pathogenic and damaging factors, but also limiting the degree of the inflammatory process in order to reduce its negative impact on the body.
Causes of inflammation
The causes of inflammation of the oral mucosa are very diverse:
- Infections caused by viruses, bacteria, fungi.
- Injuries of various nature: physical (electric shock, high temperature), chemical (burn with acid or alkali), mechanical (shock, accidental biting of the cheek, exposure to a denture, etc.). According to statistics, 65% of people with dentures suffer from inflammation caused by rubbing the gums with orthopedic structures.
- Dental diseases: periodontitis, periodontitis, pulpitis, gingivitis.
- Disruption of various systems and organs - GIT, heart and blood vessels, endocrine glands, hematopoiesis system, etc.
- Eating disorders - A lack of nutrients, vitamins (especially vitamin C) and trace elements in the body.
- Reduced immunity.
- Unhealthy Lifestyle - overwork nervous exhaustion, smoking, alcohol abuse.
- Heavy metal poisoning (mercury, bismuth, copper).
- The use of toothpastes, containing sodium lauryl sulfate.
Taking medications that have a decrease in salivation as side effects.
- Dehydration due to various reasons - diarrhea, vomiting, inadequate intake of water, prolonged fever, diarrhea, blood loss.
- Hormonal changes (transitional age, pregnancy).
The risk of inflammation increases significantly if there are local causes, which include poor oral hygiene (plaque and stone, rotting food debris in the mouth), inaccurate dentures and metal crowns traumatic to the mucosa, etc.
The main group of inflammations of the oral cavity is stomatitis, the mechanism of occurrence of which is still not fully understood. Most specialists are inclined, however, to the fact that the main cause of stomatitis is a reduced immunity - local or general. Depending on the cause of the occurrence, all stomatitis is divided into two types:
- Vulgar (non-specific, aseptic). A feature of this group of inflammations is non-infectious nature. Infection, if any, is secondary, and other factors are the initial cause of the pathology. Aseptic include catarrhal, vesicular, ulcerative, mercury, bismuth, scurvy, aphthous stomatitis.
- Infectious (specific, septic). The defining sign of specific stomatitis is the primary infection - viral, bacterial or fungal. Inflammations of this type include vesicular, herpetic, gonorrheal, diphtheria, erysipelas, bleeding, fungal stomatitis.
In appearance, stomatitis is divided into two forms - catarrhal and aphthous. The former are inflammation of the mucosa without the formation of ulcers (aphthae), the latter have such localized lesions.
Caused by the herpes simplex virus. Most often found in children 1-3 years old. On the mucous membrane of the lips and cheeks, as well as on the red border of the lips, bubbles appear that quickly open and form erosion zones with uneven edges.
In this case, children may experience general malaise, fever, nausea, vomiting, diarrhea. Usually after 8-10 days, ulcers self-heal. Read more about the types and treatment of herpetic stomatitis here.
Adults get sick with herpetic stomatitis less often than children. However, their course is more difficult for them due to the presence of aggravating factors - carious teeth, periodontitis, smoking, eating too hot food.
Pathology is the most serious disease that develops on its own or is the result of untreated catarrhal stomatitis. Inflammation captures not only the surface layer of the mucosa, but also the internal tissues with the formation of necrotic ulcers, sometimes merging into large areas. A necrotic process can go to the jaw bones with the development of osteomyelitis.
Clinical manifestations of ulcerative stomatitis: redness, swelling, unpleasant odor, signs of intoxication (weakness, headache, temperature up to 37.5 ° C). Touching the affected mucosa is sharply painful. Regional lymph nodes increase and become painful. With ulcerative necrotic stomatitis, multiple ulcers form with uneven edges and a gray-green bloom surrounded by swelling. The process can go to the tongue and palatine.
Sanitation of the oral cavity, mandatory for chronic forms of inflammation, is contraindicated in acute ulcerative stomatitis.
Gum disease often has a odontogenic (associated with teeth) nature. The most common gum disease is gingivitis. Its main reason is non-compliance with the rules of oral hygiene. Due to the formation of a microbial film on the teeth, there is a rapid development of pathogenic microorganisms that cause gum inflammation. Gingivitis manifests itself by redness and swelling (sometimes bleeding) of the gums in the area of the affected tooth.
Dental nerves are located in the pulp - a gel-like substance located in the pulpous chamber inside the tooth. In addition to nerves in the pulp, there are also blood vessels that feed the dental tissue with everything necessary for growth and development.
With inflammation of the pulp, depending on the severity and stage of the pathological process, there is weak or severe pain, redness and swelling of the gums in the area of the diseased tooth. Read more about the causes and treatment of inflammation of the dental nerve here.
The cause of inflammation of the palate can be stomatitis, a burn when eating too hot food, infection (tonsillitis, tonsillitis, pharyngitis, rhinitis). Clinical manifestations of palatine stomatitis: redness, swelling, sores, pain (especially when swallowing), impaired articulation. With the infectious nature of the disease, a fever is possible.
The type of focus of inflammation on the palate can say a lot about its etiology. In the presence of white plaque, it can be assumed that the fungus was the cause of the pathology. Red swollen palate speaks in favor of an infectious disease (tonsillitis, tonsillitis, etc.).
Language and Sublingual Area
Inflammation of the tongue is called glossitis. Pathology can be independent or secondary, infectious and aseptic, with a deep or superficial lesion. The septic form can spread to the salivary glands located under the tongue.
Inflammation under the tongue is relatively rare, manifests itself as painful swelling and / or ulcers under the tongue. Swallowing becomes painful, discomfort and pain increase with food.
With the development of inflammation, redness and swelling increase, exudate may appear in the form of a cloudy liquid or pus. In case of untimely treatment, the pathology can become chronic with the formation of growths under the tongue, which will create an obstacle to food intake.
Inflammation, manifested by redness of the oral mucosa without the formation of aphthae, is called catarrhal stomatitis. The disease often begins with redness, swelling and bleeding of the gum papillae.
In the future, inflammation spreads to other areas of the mucosa. White plaque may appear, acquiring a brown tint over time. Pathology causes burning sensation, pain when eating, excessive salivation, unpleasant odor.
Candidiasis stomatitis (thrush)
The causative agent is Candida fungus. Often occurs in children under 3 years of age during the cutting of milk teeth, with the growth of which the integrity of the mucosa is impaired. Clinically manifests itself by burning, dryness, the formation of a cheesy plaque, when removed, bleeding occurs.
Viral, fungal and bacteriological stomatitis are contagious to others, transmitted through hands, dishes, toys, when coughing, sneezing, talking, etc.
Red spots in the mouth
They are aphthous stomatitis, developing as an independent pathology (most often in children) or as a result of diseases of various organs and systems. Inflammation in the form of aphthae is one of the most common types of stomatitis, which affects up to 40% of children and adults. It looks like small yellowish-gray sores of the correct form with a red rim around.
Touching the tongue or food causes sharp pain and burning sensation. In some cases, aphthous stomatitis is accompanied by fever. With normal immunity, aphthae usually heal by themselves after 7-10 days. If the immune system is weakened, aphthous stomatitis can become chronic. In some cases, it can be confused with lichen planus in the oral cavity. To exclude this possibility, you need to do a bacterial analysis.
The main way to diagnose inflammation of the RP is to examine the patient by a dentist. In most cases, the clinical symptomatology of the pathology allows you to make a conclusion about its form, stage and severity. It is important to determine the cause of the disease (infection, trauma, vitamin deficiency, the condition of internal organs, etc.) because it determines the treatment tactics.
With uncomplicated stomatitis, the main sign is the appearance of ulcerations, their location, the frequency of pathology (recognized from the anamnesis). The tissue surrounding the ulcers has a normal state, in most cases, systemic manifestations (fever, worsening of general condition) are absent. Although advanced forms of stomatitis (especially in children) can sometimes cause poor health and fever.
As additional diagnostic methods, bacterioscopy is used (to determine the type of microorganisms that caused the infection) and a general blood test (reveals anemia, leukocytosis, and an increase in ESR).
In particularly difficult cases, in order to accurately determine the type of bacteria and their sensitivity to antibiotics, it may be necessary to plant microorganisms on nutrient media.
X-ray of teeth with a suspicion of the ontodontic nature of the inflammation reveals granulating and granulomatous periodontitis, which can cause damage to the gingival tissues.
Other studies may be needed if it is suspected that the cause of mucosal inflammation was the condition of internal organs and systems.
The basis of the treatment of inflammation of RP is etiotropic (aimed at the cause of the disease) therapy. At the same time, symptomatic (analgesic, antiallergic), immunostimulating and general strengthening agents are used.
As the first treatment for most stomatitis, treatment of the oral cavity with antiseptics in the form of solutions, sprays, gels is indicated. Chlorhexidine, boric acid, furatsilin, inhalipt, hexoral, lugol, cholisal, kamistad, inhafitol, eukarom, stomatidine, cameton are used.
Effectively rinse with decoctions of medicinal herbs (calendula, sage, chamomile). In many cases, antiseptic treatment is enough to get rid of the disease.
The temperature of the rinse should not exceed 45-50 ° C.
With the traumatic nature of inflammation, the factors causing injury are eliminated. The sharp edges of the teeth and dentures are processed, the latter, if necessary, are replaced with new ones. Refusing too hot food is recommended.
With mycosis, antifungal agents are used - dactarin, nystatin ointment, mycosone, levorin, miconazole.
Viral inflammation is treated with local and systemic antiviral drugs - serol, acyclovir, zovirax, interferon, tebrofen, bonafton, oxolin.
With the bacterial nature of the disease, which may be indicated by the purulent nature of the inflammation, systemic and local antibiotics are used - lincomycin, claforan, bayotax, augmentin, amoxiclav, amoxicillin, metronidazole, suprax.
For antibiotics, the following rules must be observed. Drugs can only be prescribed by a doctor. Reception of antibiotics by children is possible only in exceptional cases, when the disease has acquired a complex form, and other drugs have been ineffective. Before taking, it is advisable to conduct a bacterioscopy to determine the sensitivity of pathogenic microflora to antibiotics.
As symptomatic and restorative agents are used:
- antihistamines (anti-allergenic) drugs - tavegil, suprastin, cetril, loratodine, claritin, fenistil,
- immunostimulating agents - imudon, galavit, derinat, immunal, amiksin,
- painkillers - anestezin, dermatol, benzocaine, chlorhexidine, lidocaine, chlorhexidine,
- agents that accelerate the healing of the mucous membrane - solcoseryl, carotoline, betacarotene, rosehip and sea buckthorn oil, vinyl (Bals. Shostakovsky), proposol.
With all types and forms of inflammation in the oral cavity, proper nutrition with a sufficient amount of vitamins (mainly A, D, C, B12) and trace elements is required. The diet for stomatitis includes the inclusion in the menu of products that provide a shift of the medium to the alkaline side.
Features of the treatment of certain types of inflammation:
- Gums. The basis of the treatment of odontogenic inflammation is professional brushing, indoor and outdoor curettage. To relieve pain and inflammation, ibuprofen and paracetamol are indicated. In severe gingivitis, antibiotics are prescribed.
- Tooth nerve. Inflammation caused by pulpitis requires dental treatment. Both endodontic (depulpation) and vital treatments that keep the pulp viable can be performed. In addition, topical treatment of the gums with antiseptic solutions or ointments may be indicated.
- Glossitis. With superficial inflammation of the tongue, local anti-inflammatory and analgesics are prescribed that activate salivation. With the localization of inflammation in the thickness of the tongue, antibiotics and sulfonamides are indicated. The presence of an abscess or severe lesion of the salivary glands may require surgical intervention, including removal of the salivary glands.
For more information on the causes and treatment of inflammation in the oral cavity, see the video
Oral inflammations have different etipatogenesis. Mild forms such as aphthous or catarrhal stomatitis self-heal or go away after several antiseptic treatments. The most complex forms - leukoplakia, ulcerative necrotic stomatitis and some others - in the absence of adequate treatment can cause serious complications up to cancer. Therefore, the most correct solution when detecting inflammation of the oral mucosa is to immediately consult a doctor for the purpose of diagnosis and adequate treatment.
Basic preventive measures:
- proper oral hygiene (brushing 2 times a day, using dental floss and various rinses),
- regular visits to the dentist (at least 2 times a year),
- timely treatment of dental diseases, professional brushing (removal of plaque and deposits),
- a healthy diet with all the necessary vitamins (especially C and B12) and trace elements.
As a first measure, if a pathology is detected (before visiting a doctor), it is recommended to rinse your mouth with an antiseptic solution or a decoction of herbs. Sometimes one or two rinses are enough for a complete cure.
Causes of stomatitis
The causes of stomatitis are very diverse, but can be combined into the following groups:
1. Stomatitis of traumatic origin (the injury 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 vitamin deficiencies, 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 an anamnesis (will conduct a survey), then will conduct an examination of the oral cavity.Sometimes this is enough, but in some cases it is necessary to conduct special studies - staining of the lesion elements with special dyes, luminescent examination, general and biochemical blood tests, microscopic examination of scraping from the lesion element, allergic tests.
Traumatic stomatitis symptoms and treatment.
The mucous membrane of the oral cavity has a certain "margin of safety" to the effects of various traumatic factors. In the case of intense influence of one or another factor in excess of this physiological reserve, a traumatic lesion of the oral mucosa 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 struck, injured by some object or when accidentally biting. First, pain appears at the site of the lesion, and then a small hematoma (hemorrhage), erosion, or an ulcer can form. After 1-3 days, all symptoms usually disappear.
The treatment of such stomatitis comes down to eliminating the traumatic factor (for example, grinding the sharp edge of the fillings or chipped teeth), treating with antiseptic solutions to prevent further infection (furatsillin, 3% hydrogen peroxide) and, in the presence of ulcers, application of the so-called “keratoplastics”, etc. e. drugs that accelerate the restoration of the mucous membrane (oil solution of vitamin A, sea buckthorn oil, rosehip oil, solcoseryl, etc.).
Persistent (chronic) mechanical injuries are quite common. The cause of their occurrence may be the sharp edge of the tooth when it is damaged by caries or in the wrong position in the dentition, an “unsuitable” prosthesis, orthodontic designs and bad habits (biting the cheek or lip, biting sharp objects, etc.). The mucous membrane of the oral cavity can react to the action of these factors from slight redness and swelling to the formation of an ulcer.
Treatment such stomatitis consists, first of all, in eliminating the traumatic factor. In the event of erosion or ulcers, they are also treated with solutions of antiseptics and keratoplastics.
To physical traumatic factors include the effect of high (then a burn) and low (frostbite) temperatures, electric shock, and radiation injuries. A feature 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, redness of the mucous membrane, the formation of blisters, ulcerations. The treatment consists in the prophylactic antiseptic treatment of inflammatory elements, the appointment of analgesic and anti-inflammatory therapy, the application of keratoplastics to accelerate healing.
Chemical stomatitis occur upon contact of the mucous membrane with acids and alkalis in a fairly strong concentration. This can happen if they are mistakenly used in everyday life and at work, at the dentist’s appointment, often when suicide is attempted. A burn with acids is characterized by the appearance of a dense film at the site of the lesion, around which swelling, redness, and soreness appear. With a alkali burn, such a film does not form, the lesion spreads to the deepest layers of the oral mucosa, and very painful, slowly healing erosions and ulcers form.
Treatment begins with the immediate removal of the damaging chemical agent and washing with a neutralizing solution. For acid burns, you can use a 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 boils down to anesthesia, the appointment of antiseptic solutions and accelerating epithelization, keratoplastics in the form of rinses, oral baths or applications.
Infectious stomatitis symptoms and treatment.
Viral stomatitis includes diseases caused by the herpes simplex virus, chickenpox virus, influenza, parainfluenza, adenovirus and some others.
The most common is the damage to the oral cavity and lips by the herpes simplex virus (according to the WHO, the incidence of this virus takes second place after the flu), so you 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 general malaise, headache, fever up to 37-41 C. After 1-2 days, these symptoms are joined by pain in the oral cavity, aggravated by talking and eating, the mucous membrane of the oral cavity becomes edematous. Then small (about the size of a millet grain) bubbles appear on it, arranged in groups (from 2-3 to several tens) or merged into large bubbles filled with transparent contents. After 2-3 days, they burst, forming small and large erosions, covered with white coating.
Salivation is increased, it becomes viscous.
Often, lips, the mucous membrane of the nasal passages, as well as the mucous membranes of other organs join the lesion of the oral cavity.
After 5-15 days (depending on the severity of stomatitis), recovery occurs, scars do not form.
After a primary herpetic infection, the virus in most cases remains in the human body. A person becomes a virus carrier. With a decrease in the protective properties of the body (after injuries of the oral mucosa, hypothermia, disease, in the premenstrual period, etc.), the disease makes itself felt in the form chronic recurrent herpetic stomatitis . Recurrent herpes in the oral cavity is often localized in the hard palate, cheeks, and tongue.
Bubbles with herpetic stomatitis appear immediately as a group, merge, burst, forming a very painful erosion. The general condition, in contrast to the acute form, as a rule, does not suffer.
Treatment of viral stomatitis is carried out in the following areas:
• Neutralization of the virus, preventing the appearance of new rashes (for this, antiviral drugs (acyclovir, oxolin, arbidol, zovirax, etc. in the form of tablets and ointments for topical use) are used, with relapsing stomatitis, a herpes-resistant multivalent vaccine is used),
• Removal of general intoxication (anti-inflammatory and anti-allergic drugs),
• Strengthening the body's resistance (vitamin therapy (vit. A and C), immunocorrection drugs, for example, “immunal”, “imudon”, etc.)
• Relieving pain, accelerating the healing period of erosion, ulcers (keratoplastics - vitamin A, rosehip oil, solcoseryl, carotoline, physiotherapy),
Bacterial stomatitis, as is already clear from their name, is provoked by bacteria (diplococci, streptococci, staphylococci, spirochetes, clostridia, gonococci, etc.).
Most often, 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. Favors the development of trauma diseases, burns of the oral mucosa.
With erosive stomatitis, itching, burning, and soreness in the oral cavity during eating occurs first. Further in the area of the lips (mainly the lower one), on the border of the hard and soft palate, less often - on the cheeks and tongue there is a limited reddening of a small size, which then turns into erosion. Small erosions can merge, reaching more than 2 cm. There is no deposit and films on them. The disease lasts from 4 to 10 days.
In the treatment of erosive stomatitis, as a rule, local exposure is sufficient. It consists in the treatment of painkillers and antiseptics or a combination thereof (in the form of pastes, powders, ointments, gels), applications of anti-inflammatory and epithelizing drugs, or, also, a combination thereof. If necessary, the doctor may prescribe a general treatment (with antibiotics or sulfa drugs). In no case should you prescribe such a treatment to yourself!
A much more serious form of bacterial stomatitis is ulcerative necrotic stomatitis (Vincent ) It is caused by microflora (fusospirochetes), which is normally located in the oral cavity (in the interdental and gingival 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, and working in adverse conditions contribute to the development of the disease.
Ulcerative necrotic stomatitis can only be a symptom of some very serious diseases, such as leukemia, poisoning with heavy metal salts, pathology of the gastrointestinal tract, radiation injuries, immunodeficiencies, so if you have symptoms of ulcerative necrotic stomatitis, you should immediately consult a doctor!
Symptoms of ulcerative necrotic stomatitis at the onset of the disease are similar to the symptoms of other infectious diseases - weakness, headache, fever, aching joints. Further, the intensity of these manifestations increases, very strong pains arise in the oral cavity even from the slightest touch, eating and hygienic care become almost impossible. A sharp putrid smell appears from the mouth.
Ulcers begin with gums, and always from those areas where there is some traumatic factor (tartar, improperly planted crowns, damaged teeth), then there is a contact spread of inflammation.
With this disease, a very characteristic change in the gums occurs: they are swollen, loose, very painful, bleed easily even with a light touch. There is a gradual necrosis ("death") of the interdental gingival papillae, starting from the apex and spreading to the base, they take the form of a truncated cone.
Unfortunately, the disease can turn into a chronic form, but, as a rule, a full recovery occurs.
Treatment begins with antibiotic therapy aimed at the destruction of fusospirochetes (antibiotics - penicillin, ampiox, kanamycin, lincomycin, etc.). The choice of antibiotic and its dosage is carried out only by a doctor! Along with this, anti-inflammatory and anti-allergic drugs, vitamins are prescribed.
After anesthesia, the oral cavity is treated with antiseptic solutions (the most effective are 3% hydrogen peroxide, potassium permanganate, metrogil, trichopolum, dioxidine) or antibiotics (penicillin, gentamicin, etc.). Necrotic ("dead") tissues are removed surgically. To accelerate healing, keratoplastic drugs are prescribed (solcoseryl, metacil, Kalanchoe juice, aloe). Mandatory oral sanitation.
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 oral dysbiosis, it becomes a pathogen.
An important prerequisite for the occurrence of the disease is a special condition in the oral cavity - moisture, temperature, decreased acidity in the oral cavity (with poor hygiene, the carbohydrate nature of food, violation of the rules for using removable prostheses, carious cavities, lichen planus, tuberculosis, etc.).
Often candidiasis occurs in infants, weakened by infectious diseases, premature. In older children - with rickets, diathesis, hypovitaminosis .
Candida stomatitis is better known under the name “thrush”, associated with the characteristic symptoms of the disease. White spots or white “curdled” plaque appear on the oral mucosa, upon removal of which there remains a focus of reddened, swollen mucosa. If the coating is not removed, then its layers are layered on top of each other, a dense film is formed under which even erosion can form.
In addition to these symptoms, dryness and burning in the mouth, soreness when 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 prostheses are treated with weak alkali solutions (2-4% solution of borax, soda), aniline dyes, iodine preparations (Lugol's solution, Yoks) and, necessarily, antifungal ointments (1% nystatin, 5% levorin, miconazole gel ”, etc.).
In the diet, carbohydrates (sweet, flour, starchy foods) are limited.
It is important to identify and cure (together with an endocrinologist, gastroenterologist, therapist and other specialists) the cause of candidiasis, the cause of an 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.
Today, it is established that every third inhabitant of the planet in one way or another suffers from allergies. In addition to allergies to food, dust, pollen and other irritants, there are many drugs, 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 in contact with any medications or dentures. Patients complain of burning, dry mouth, pain when eating food. The mucous membrane of the oral cavity and tongue are swollen, tooth prints are visible on it. Against this background, different size spots, erosion, ulcers may appear. It is characteristic that foci of inflammation occur only in the area of the prosthetic bed or in the area of contact with the allergen.
When treating contact stomatitis, it is important to identify and eliminate the allergen (stop using the prosthesis, replace the filling material, cancel the suspected drug). Inside, antihistamines (anti-allergic) drugs are prescribed (suprastin, tavegil, clarotadine), they can also be prescribed in the form of applications on the affected areas of the mucosa. In the presence of erosion, keratoplastic preparations are prescribed (oily solution of vitamin A).
Often, allergic stomatitis manifests itself in the form of chronic recurrent aphthous stomatitis. With this disease, single aphthae occur in the same place, appearing and disappearing again over many years. As a rule, at the onset of the disease, relapses (recurrences) occur periodically (in spring and autumn), and then unsystematically. In some patients, aphthae occur due to trauma to the oral cavity, contact with washing powder, hair dye, or it depends on the menstrual cycle in women.
Aphthae (translated from Greek as an ulcer) is distinguished by a clear round shape, small size (5-10 mm), covered with a grayish coating, and is very painful.
The general condition of patients does not suffer. The period of existence of aphtha lasts 7-10 days.
When treating chronic recurrent aphthous stomatitis, it is important to pay attention not so much to the local treatment of aphthae as to identifying the cause of the disease (allergen) and preventing relapses.
One of the leading areas in the treatment of recurrent aphthous stomatitis is the appointment of antiallergic drugs (fenistil, clemastine, suprastin, fencarol). An integral component of treatment is vitamin therapy (B vitamins, folic acid, vitamins C, PP).
Local treatment of aphthae is carried out with painkillers, antiseptic and keratoplastic drugs and their combinations in the form of pastes, gels ("Cholisal", "Kamistad", solcoseryl, actovegin).
Stomatitis with systemic diseases.
The organs and tissues of the oral cavity are closely connected with various internal organs and systems of a person, therefore a large group of lesions of the mucous membrane occurs as a result of the disease of certain internal organs. Sometimes they become early manifestations of the clinical signs of such a disease even before its objective symptoms occur, and force patients to go to the dentist first. Such manifestations occur 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 mucous membrane in diseases of the gastrointestinal tract occur most frequently. Most often, signs such as discoloration of the mucous membrane, plaque on the tongue, ulcerative lesions are observed.
При сердечно-сосудистой патологии часто появляется цианоз (синюшность) слизистой оболочки полости рта. Кровообращение в полости рта, как и во всем организме, нарушено, поэтому появляются трофические изменения, вплоть до язв. Such ulcers come in different sizes, they are covered with a gray coating, have a pungent fetid odor, and are very painful when touching and eating.
Stomatitis in endocrine diseases also have important diagnostic value, because help identify the disease in the early stages.
So, in diabetes mellitus, dry mouth (xerostomia), gum disease (gingivitis), fungal stomatitis, fungal seizure (cracks in the corners of the mouth), trophic disorders (erosion, ulcers) occur.
In Addison's disease (violation of the adrenal cortex), characteristic small spots or stripes of blue or grayish-black color appear. Subjectively, patients do not feel them at all.
With blood diseases, especially with leukemia, severe ulcerative necrotic lesions occur in the oral cavity, due to a sharp decrease in the protective properties of the body.
The treatment of such "symptomatic" stomatitis is carried out jointly with a specialist doctor (endocrinologist, gastroenterologist, general practitioner and others) and depends on the nature and severity of the manifestation in the oral cavity.
Treatment of stomatitis with folk remedies
The most common and most painful manifestation of stomatitis in the oral cavity is erosion and ulcers. Their treatment is carried out with antiseptic and keratoplastic drugs. Using traditional medicine, rinsing with infusions of medicinal herbs that have anti-inflammatory effects: chamomile, eucalyptus, cinquefoil and calendula is popular and effective. All oil solutions (rosehip oil, sea buckthorn oil), as well as aloe and Kalanchoe (applying juice or leaves) contribute to epithelization.
In the treatment of fungal stomatitis, as an aid to the main treatment, it is possible to rinse with a weak soda solution (0.5 teaspoon per glass of water), treat with Lugol's solution, a slightly pink solution of potassium permanganate (especially in the treatment of stomatitis in infants), rinse with antiseptic solutions (decoctions juniper, yarrow, calendula).
With thrush - yeast stomatitis - honey and potato treatments 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 direction, which contributes to their life, so the use of these funds is not only ineffective, but also unacceptable in the treatment of fungal infections 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, because ulcers, especially non-healing ones, can be a sign of very serious diseases!
As with any other dental disease, the main advice is a timely visit to the dentist. It will help eliminate traumatic factors (sharp edges of teeth, unsuitable dentures), establish oral hygiene, eliminate all sources of infection in the oral cavity (carious teeth, periodontal pockets).
A good prevention of stomatitis will be diet correction (a decrease in the diet of sweet, starchy, starchy) and hardening. And following the rules of a healthy lifestyle, giving up bad habits (especially smoking) will make an excellent contribution not only to the health of the oral cavity, but also to the whole body, and this is the key to a long and high-quality life.