You know what it is stomatitis You may not know it by name, but you have suffered from or know someone who has complained of frequent mouth problems, such as sores on the lips, tongue, gums or cheeks.

According to Dr. Marcos Moura, dentist, stomatitis is related to inflammation of any part of the mouth, including the lip, tongue, gums and throat: "Any change in shape, color and volume, with or sensation of pain in the mouth area can be stomatitis," says the dentist. Generally, these oral problems are more frequent in children, but they can also appear in adults. Understandbetter the disease.

What is stomatitis?

Stomatitis is the name given to inflammation of the oral mucosa that can cause swelling and redness or appear more discreetly, as a single ulcer or as multiple ulcers. Less common is the appearance of whitish lesions, and in rare cases there may be symptoms even without apparent lesions.

In addition to the uncomfortable pain, aphthous stomatitis can also impair food and liquid intake. Secondary infections can also occasionally occur. In some people, aphthous stomatitis occurs almost continuously, that is, new ulcers appear at the same time as old ones are disappearing.

Types of stomatitis

Adult stomatitis

Stomatitis in adults, although less frequent than in children, can also occur. It can even have the same causes as in children, but generally, in adults, it tends to manifest itself in a more aggressive way. Therefore, stomatitis is more frequent in people immunosuppressed and in people who use maladjusted and/or poorly cleaned prostheses, among other situations.

Infantile stomatitis

Stomatitis can appear in babies from weaning, usually at six months, but it is more frequent in children from 2 to 5 years old, the time of socialization. Thus, closed environments, cold weather, and crowding can facilitate the proliferation of the virus. Despite its name, the disease attacks the entire inner part of the mouth, such as the cheeks, tongue, and the roof and bottom of the mouth, and can even reach the tonsils,throat and esophagus.

Recurrent aphthous stomatitis

In some cases, painful ulcers appear repeatedly in the mouth; this is called recurrent aphthous stomatitis (RAS), the most common disease of the oral mucosa. Some factors contribute to its appearance, such as oral trauma, emotional stress, and certain foods like chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, cheese, and tomatoes.The symptoms of RAS usually appear during childhood or adolescence and decrease in frequency and severity as the years pass.

Causes of stomatitis

We can list several possible causes for stomatitis, since there are several risk factors that favor the development of this problem. mouth Check out some of the causes:

• Injuries or injuries to the mouth, such as cuts or blows;
• Low immunity;
• Virus from herpes ;
• Genetic factors;
• Allergic reactions;
• Fungal infections (candidiasis, for example);
• Bacterial infections (bacterial stomatitis);
• Smoking;
• Dental caries;
• Gingivitis;
• Dental prosthesis use, braces or ill-fitting dentures;
• Alcoholism;
• Ingestion of very hot food;
• Lack of oral hygiene ;
• Vitamin and mineral deficiency;
• Cancer treatments (chemotherapy and radiotherapy sessions);
• Endocrine and systemic diseases that affect immunity ( lupus , Crohn's disease and AIDS);
• Use of medications that lower the activity of the immune system (corticoids, for example);
• Oral ulcers.

Symptoms

The main symptoms of stomatitis are lesions resembling a cold sore or oral ulcers, as well as hard-to-heal wounds on skin or mucous tissue, popularly called sores. "The symptoms depend on the main causes. But they usually cause irritation and/or redness of the mucosa, swelling, pain and ulcers," communicates the specialist. In addition, there are other symptoms ofSee which are the main ones:

• Redness and/or swelling of the gums, inside of the cheeks, tongue, lips, or throat.
• Pain in the region of the lesion;
• Sensitivity in the mouth;
• Excessive salivation;
• Presence of canker sores in the inner region of the mouth;
• Difficulty and/or pain in eating, swallowing, and speaking;
• Loss of flavor;
• Lack of appetite;
• Inflammation around the lesion;
• Burning sensation and/or dry mouth ;
• Irritability (especially in children);
• Headache;
• Fever;
• General malaise.

Is stomatitis contagious?

In stomatitis, the contagion depends on the underlying cause. Viral stomatitis, for example, is contagious and relatively easy to transmit or "catch", through droplets of saliva or direct contact with the affected area, especially when we talk about the herpes virus (herpetic stomatitis).

In these cases, the incubation of the disease (time until the first manifestations appear), can go from 2 to 12 days. On the other hand, aphthous stomatitis is no longer contagious, that is, the disease is not transmitted or "caught". In any case, in cases where the contagious factor exists, the manifestation of the disease depends largely on the general state of immunity specific to each person.

Diagnosis

The diagnosis of stomatitis is, above all, clinical, so it is important to investigate whether there is a relationship between the symptoms presented and the ingestion of food, medication, or other chemical substances, and whether the patient uses any prosthesis in the mouth.

In addition, it is important to know if the patient has any risk factors for developing oral lesions, such as chemotherapy, immunosuppression, or sexually transmitted infections (STIs). Nonspecific symptoms that suggest chronic illness (weight loss, for example) and risk factors for HIV infection should also be investigated.

In cases of recurrent stomatitis, in which there are lesions of longer duration, the CBC Biopsy can also be used, but is indicated only in cases where malignancy is suspected or in persistent lesions.

Is stomatitis curable?

Dr. Marcos Moura informs that stomatitis cannot be classified as a disease, since there is control after the process is installed. But yes, it is possible to achieve a cure, as long as it is diagnosed and treated correctly.

Treatments

The good news is that there is treatment for stomatitis, so the oral health specialist recommends avoiding contact with the product that triggers the problem and maintain good oral hygiene In addition, the application of therapeutic laser has been widely used nowadays, because the laser acts by promoting a repair in the affected cells and a fast regeneration", explains the endodontist.

Remedies for stomatitis

1. Anti-inflammatory drugs prescribed by dentists or doctors, presented in tablet, ointment, mouthwash, oral gel, or spray form;
2. A week-long antibiotic treatment with tetracycline, if the stomatitis ends with only one cycle of medication;
3. Antipyretic analgesics, such as paracetamol In cases where the stomatitis causes fever above 38 degrees;

In some cases, it is also possible to resort to home treatments, such as rinsing with warm water and salt to alleviate the symptoms. However, it is essential to use only medicines prescribed by doctors and dentists.

Diet: what to eat and what to avoid?

What to Eat

Generally, the diet should be liquid and cold during the most acute phase of the disease (phase with more lesions in the mouth area), in order to reduce pain and discomfort. Some dietary care includes

• More liquid and paste-like foods, preferably cold, such as non-acidic fruit juice, gelatin, yogurt, ice cream (sugar-free is best), and coconut water;
• Also worthwhile are soups blended in a blender without seasoning and at room temperature or even cold;
• In the case of older children, who already eat a different type of food, it is important to avoid carbonated beverages (soft drinks) as well as heavily spiced purees.

What to Avoid

At first, the ideal is to avoid very acidic foods, such as citrus fruits. This is the only rule for those with stomatitis. However, some foods can help prevent aphtha, which is one of the main symptoms of the disease. These are:

• Pepper and very spicy foods
• Foods with excess salt
• Soft drinks that have acids in their composition
• Chocolates and sweets with a lot of sugar
• French bread

Different medical specialties involved in the care

When these symptoms are identified, a specialist should be sought for the treatment of stomatitis. The diagnosis can be made by the physician dentist In children's cases, it should be performed by the physician pediatrician , dentist, gastroenterologist, immunologist, or even a general practitioner .

What to ask the doctor in the consultation

Does stomatitis cause pain and fever?

The term stomatitis is sometimes used to describe a childhood stomatitis, which presents symptoms such as pain and fever. The duration of the episode varies from 7 to 10 days and although it is more common in children, it can also affect adults.

How long does a fever last in people with stomatitis?

The number of days of fever varies according to the type and severity of the stomatitis, but generally tends to remain high for 3 days or more.

After having stomatitis, are there chances of having it again?

Stomatitis is a pathology generally caused by viruses, so this type of infection can recur, but if the condition is prolonged or recurrent, other causes should be investigated, such as immunological deficiencies.

Can recurrent aphthous stomatitis bleed?

It can, because it is an erosive lesion, and depending on the layer of tissue injured, it can lead to bleeding. In the case of recurrent aphthous stomatitis, bleeding can occur if there is trauma at the site, which is relatively common in the mouth. Besides, these lesions, because they are erosive or ulcerated, are fragile, making it easier to rupture and bleed.

Can stomatitis cause diarrhea and vomiting?

No, stomatitis does not cause diarrhea or vomiting. The main symptom is the appearance of blisters or sores (canker sores) on the mucous membrane of the mouth, which can also affect the gums, tongue, inner part of the cheeks, roof of the mouth, and throat.

What are the precautions during treatment?

There are some precautions that need to be taken during treatment. Maintaining general health for a quick recovery is one of them, according to the specialist. In addition, it is recommended to avoid foods that can cause damage to the mucosa, such as hot, citric and spicy foods. In this way, there are other types of care that can help in the recovery. For example:

• Avoid salty and acidic foods.
• Do not touch the wound and anywhere else afterwards;
• Drink plenty of water during treatment to maintain hydration;
• Brushing your teeth Toothpaste, floss, and use antiseptic mouthwash several times a day.

How long does stomatitis last?

According to the oral health specialist, the duration of a stomatitis will depend on the cause and the affected area.doctors and try to relieve the pain.

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Source: Dr. Marcos Moura, dentist, endodontist from UNESP/Araraquara and member of the Brazilian Halitosis Association (ABHA).

Useful Links

MSD Manuals - Stomatitis

Virtual Health Library of the Ministry of Health

Regional Council of Pharmacies of the State of Paraná

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