A Family Doctor's Tale - STOMATITIS

DOC I HAVE STOMATITIS

Again this topic may come under the conditions seen by dental surgeons or ENT surgeons but it is frequently seen by family doctors. An infected mouth occurs usually due to poor oral hygiene, infections, smoking, medications and lack of vitamins especially the vitamin B group.

Stomatitis is inflammation of the mouth


There are many many disorders which can cause Stomatitis:
1.Bacteria, viruses, fungal 

2.avitaminosis especially vitamin B


3.leukemia( A Simple Guide to Blood Cancer), agranulocytosis 

4.Dental problems,poor fitting denture, poor dental hygiene

5.smoking

6.medicines: phenytoin, iodides, barbiturates


Stomatitis usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums. 

They may begin with a tingling or burning sensation, followed by a red hyperemia of the inside of the lining of the cheek, gums or tongues.

The inflamed surfaces may develop into mouth ulcers( A Simple Guide to Mouth Ulcers)
Occasionally, a severe occurrence may be accompanied by fever, lymphadenopathy(enlarged lymph nodes) and lethargy.
Most mouth ulcers are not infectious.

Oral mucosal smears may be necessary to determine those with bacterial or fungal infections.


The exact treatment will depend on the cause of the Stomatitis. Sometimes all that is required is to remove the cause of the Stomatitis such as an ill fitting denture.


The following measures may help to reduce pain from Stomatitis:
Proper oral hygiene:
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1.keep your mouth clean at all times,

2.avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,

3.eat a healthy diet that includes fresh fruit and vegetables,

4.gargle with warm salt water or use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the ulcers last.
5.sprays and rinses are also available for pain relief.

Medical treatment:
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The main treatment of the Stomatitis is application of topical corticosteroids (Kenalog in orabase or Oracorte E), or other soothing preparations. 

Where bacteria are present the appropriate antibiotic will treat the Stomatitis. 
Antifungal agents are used to treat fungal infection.

Vitamin B are important in patients with deficiency of the vitamins.

Treatment of underlying conditions:
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Treatment of systemic condition causing the Stomatitis such as leukemia


1.Good oral hygiene may help in the prevention of some types of mouth ulcers or complications from mouth ulcers.
This includes brushing the teeth at least twice per day, flossing at least daily, and going for regular dental checkup and cleaning.

2.Live a healthy lifestyle by making sure you eat a balanced diet, take regular exercise and learn to manage stress.

3.Most importantly do not SMOKE.