Stomatitis aphthosa and herpetica, symptoms, treatment and remedies

Stomatitis is an inflammation of the oral mucosa and can affect the cheeks, gums, lips and palate to meet.

Types of stomatitis

Mycotic stomatitis (also called oral candidiasis or oral thrush) is an infection of the mouth and throat with candida fungi.
It is very common in newborns and can occur in adults especially after antibiotic treatment.
Weak people are particularly vulnerable.

The Stomatitis nicotina is caused by smoking cigarettes, Caused cigars and pipes. You can recognize them by red bumps on the palate.

The Stomatitis herpetica or gingivostomatitis is caused by a viral mouth infection and is characterized by blisters that later develop into ulcers:

It usually occurs in children between 6 months and 5 years.
It is an infection caused by the herpes simplex type 1 virus (HSV-1), the same virus that is responsible for cold sores on the outside of the lips in adults.
HSV-2 causes genital herpes and is related to type 1.

The Stomatitis aphthosa leads to the formation of small ulcers (aphthae):

Pregnancy is a risk factor for this disorder.

The recurrent aphthous stomatitis is a disease with unknown causes that can cause at least one painful, superficial ulceration of the mucous membranes.

The chronic ulcerative stomatitis is a disease that is characterized by:

  • Pain,
  • recurrent ulcers, which have a white coating at the level of the gums and the inside of the lips,
  • fever,
  • enlarged cervical lymph nodes,
  • halitosis.

The Urematous stomatitis is a rare complication of uremia that can occur due to advanced renal failure.
It is an oral symptom of uremia and causes:

  • Skin redness (erythema) of various degrees of severity,
  • Accumulation of flammable liquid (exudate),
  • ulceration,
  • decreased salivation,
  • bleeding,
  • Bad breath (breath smells of ammonia),
  • burning sensation.

The Angular stomatitis is the inflammation of the lip surface with the following effects:

  • swelling,
  • cuts,
  • desquamation,
  • wounds,
  • Ulcers on both sides of the mouth.

The gangrene stomatitis (also called noma, water cancer or cheekburn) is caused by malnutrition or particularly debilitating diseases (e.g. malaria). The result is the destruction of the oral mucosa until parts of the oral cavity, such as the teeth, are exposed.

What are the causes of stomatitis?

List of possible causes

bacterial infection

  • Necrotizing periodontitis
  • Mycoplasma infection
  • syphilis
  • Gonorrhea
  • rare: actinomycosis, tuberculosis

fungal infection

  • Infection by Candida albicans (Oral thrush, oral candidiasis)
  • rare: blastomycosis, cryptococcosis, zygomycosis

viral infection

  • Herpes simples virus infection
  • Varicella zoster virus infection
  • Enterovirus infection – hand-foot-mouth disease or herpangina
  • Epstein-Barr virus infection or glandular fever (infectious mononucleosis)
  • Measles can cause Koplik spots in the mouth

Systemic diseases

  • Malnutrition, iron deficiency and lack of vitamins from the B complex (Pellagra) and vitamin C (scurvy)
  • Infectious diseases of the intestine (such as Crohn’s disease)
  • Scarlet fever
  • Behçet’s disease
  • Kawasaki disease
  • Erythema multiforme
  • Toxic epidermal necrolysis and Stevens-Johnson syndrome

Drugs and pollutants

  • Stomatitis nicotina
  • chemotherapy
  • radiotherapy
  • Lichen planus-like rash

Physical irritation

  • burns
  • Stomatitis due to dentures (e.g. braces, loose-fitting teeth, unsuitable or sharp-edged dentures)

Risk of infection in stomatitis

Depending on the cause, stomatitis may or may not be contagious.
Stomatitis caused by the herpes virus is considered contagious.
In children, the infection is usually caused by:

  • kisses,
  • eating together,
  • Play with close physical contact with other infected children.

The incubation period for stomatitis herpetica is between 2 and 12 days.
The child is contagious about 2 days before the blisters form until the blisters stop.
Stomatitis aphthosa is not contagious.

Symptoms of stomatitis

  • Blisters in the mouth, especially on the tongue or cheeks
  • Children cry and eat less even though they are hungry
  • Difficulty swallowing (dysphagia)
  • strong salivation
  • high fever (up to 40 ° C) 1-2 days before the appearance of the blisters and ulcers
  • irritability
  • Pain in the mouth, including chewing, speaking, or moving the lips
  • swollen, bleeding gums
  • Ulcers in the mouth, especially on the tongue, cheeks, usually after the vesicles have broken open.

How is the diagnosis of aphthous stomatitis?

The diagnosis is made based on the medical history and physical examination.
The medical assessment is sufficient for the diagnosis.
There is usually only one ulcer.
To confirm the diagnosis of stomatitis and rule out other diseases, the doctor can order the following examinations:

  1. Blood analysis to measure the values ​​of zinc, ferritin, serum iron, folic acid, vitamin B12.
  2. Biopsy of the ulcer, a small tissue sample is taken and examined under the microscope.

How is stomatitis treated??

The treatment goals for recurrent aphthae are:

  • Relief of symptoms
  • Shorten healing times
  • Prevent future outbreaks

Stomatitis usually heals on its own.
The doctor can prescribe medication to treat wounds.
You can prevent another outbreak, by avoiding the triggering factors, e.g. certain foods like: nuts and pineapple.

Treatment for recurrent aphthosis should be determined based on the severity of the disease.
Patients often report severe pain, although the examination reveals only a small ulcer (less than 1-2 mm in diameter).
The frequency and intensity of symptoms are also taken into account when choosing the best treatment method.

Drug treatment for stomatitis

Often prescribed:

  1. Anti-inflammatory drugs from the group of non-steroidal anti-inflammatory drugs (e.g. benzydamine) or cortisone-containing agents and immunomodulators (e.g. ciclosporin) in the first stages of the disease.
    Anti-inflammatories are available as:
    – Gargle solution,
    – ointment,
    – paste,
    – oil,
    – spray (Tantum verde),
    – Topical gel: in the event of a virus infection, the doctor prescribes medication to combat the virus (antivirals). Acyclovir is used most often.
  2. Gargle solutions reduce the bacterial load, thus alleviating bacterial infections:
    – the inflammation,
    – Accelerate the healing process. One representative is chlorhexidine digluconate.
    Topically applied lidocaine or benzocaine are anesthetics used to relieve pain.
  3. A concentrated, bio-adhesive gel (GELCLAIR®) forms a protective film to relieve the pain.
  4. Patients may need medication to treat pain and lower fever, paracetamol (such as ben-u-ron) is recommended.

Treatment of stomatitis herpetica

If a child is affected by herpes-induced stomatitis, the parents are challenged and they must ensure that the child drinks enough.
Drink mild liquids such as:

Water ice or sherbet relieves the pain.
In severe stomatitis, the doctor can give fluids intravenously to avoid dehydration.
The doctor can prescribe acetaminophen if the fever rises above 38.5 ° C.
Oral anesthetics, such as lidocaine or topical anesthetics, only work for a short time, and the child can bite or hurt the ulcers if they don’t feel anything.
Antibiotics do not help if the stomatitis is caused by the herpes virus or candida. However, in severe cases, the doctor may use a virus-fighting agent, such as acyclovir, to accelerate healing in the first days of the disease.

Treatment of stomatitis aphthosa

As a rule, aphthous stomatitis does not need to be treated with medication, except in the following cases:

  1. The aphthae are larger than 1 cm.
  2. They persist for more than 2 weeks. In this case, treatment and medical evaluation may be necessary.

Oral or topical tretracycline (antibiotic) is usually prescribed.

Tetracylines are not prescribed during the development of permanent teeth because they irreversibly fuse with the dentine and lead to gray, yellow or brown discoloration.

A gentle mouthwash with salt water or over-the-counter garlic solutions can help.
Over-the-counter, local remedies are applied directly to the ulcers to relieve symptoms in the area.
To prevent bacterial infections in children, parents should encourage children to use toothbrushes and dental floss daily.

Home remedies and prevention

  • Hygiene and thorough oral care are fundamental to all types of stomatitis. Wash your hands and yours before meals your child.
  • Chilled drinks can relieve the pain in the child’s mouth.
    Ice cubes also bring relief. If the child has blisters on the lips or on the Tongue, a straw should be used.
  • After eating, rinse the child’s mouth with lukewarm water.
  • The doctor can recommend mouthwashes with salt water or bicarbonate.
  • Use a toothbrush with soft bristles, teeth and gums must be brushed carefully.
  • Apply a few drops of tea tree oil to the aphtha with a cotton swab twice a day.

To the herbal remedies belong:

  • mallow – According to the theories of the blood group diet, it is suitable for everyone and acts on the stomach, intestines, mouth and throat. Soak a handful of mallow flowers and leaves in water for one night; heat on low flame without boiling, filtering and drinking.
  • propolis – a natural antibiotic with wound closure capabilities. Take 20 drops of mother tincture three times a day.

What to eat Diet and nutrition for stomatitis

  • Do not drink fruit juices from citrus fruits (e.g. orange or lemon juice) or carbonated drinks (soda water), as these could increase the pain in the mouth.
  • The child can eat soft foods more easily.
    Stomatitis offers:
  • yogurt,
  • Mashed potatoes,
  • Fruit ice cream without gluten and milk,
  • Applesauce and porridge.
  • Spicy, hard and salty dishes are unsuitable.
    Top foods such as tortilla chips, pretzel sticks and French fries should be avoided.
  • After Blood Type Diet stomatitis and cold sores can be caused by:

    • Pork or sausages,
    • Milk and milk products, such as yogurt, cheese and milk chocolate,
    • excessive enjoyment of nuts, almonds and seeds.

    The Natural medicine from Lezaeta and the natural hygiene recommend a plant-based diet, of which at least 50% is raw food.
    Stomatitis could act as a kind of drain valve that frees the body of toxins.
    The occurrence is also possible:

    • during fasting,
    • on a weight loss cure,
    • when changing your diet, when you start eating raw and natural foods.

    The organism uses natural and effective defense mechanisms for detoxification.
    According to this theory, one should not act against the body and therefore wait until the Disorder disappears on its own, without medication or ointments.

    How long are the healing times?

    The healing prognosis for stomatitis depends on the cause of the disease.
    Many ulcers are benign and heal on their own without special treatment.
    Herpes virus stomatitis heals on its own within about 10 days.
    Acyclovir can accelerate healing.
    In most cases, aphthous stomatitis is short-lived, renewed outbreaks are rare and only last a few days.

    Possible complications

    Herpetica keratoconjunctivitis is a secondary infection of the eye that can develop as a result of stomatitis herpetica.
    The disease is a medical emergency because it can lead to blindness.
    The patient, especially if it is a child, can become dehydrated if he does not want to eat and drink to avoid the pain.


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    Christina Cherry
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