Chronic stomatitis: symptoms and treatment
Chronic stomatitis — is a rather unpleasant ailment, in which there is a course of recurrent inflammation affecting the shell of the oral cavity. The causes of the development of the disease will be slightly different depending on its variety. In some cases the source is autoimmune processes, in others the pathological effect of pathogenic bacteria, and in the third — allergic reactions.
The clinical picture is as unordinary as the etiological factors, which means that each type of disease has its own symptomatology. The most frequent symptoms are reddening of the oral mucosa, the formation of vesicles and sores, as well as increased salivation.
In establishing the correct diagnosis, a major role is played by the laboratory examination of the scraping from the oral cavity — to determine the form of the course of the disease. The basis of treatment is etiotropic therapy, aimed at eliminating the cause that caused the appearance of the disease or relapse.
The international classification of diseases distinguishes a separate meaning for the chronic form of stomatitis. The code for the ICD-10 is K 12.
Often, the formation of stomatitis is promoted not only by local factors, but also by problems in the functioning of various internal organs and systems. It is for this reason that this pathology is relevant not only for specialists in the field of dentistry, but also for doctors from other fields of medicine.
The origin of the disease is determined by a kind of inflammatory process on the oral mucosa. Thus, chronic recurrent aphthous stomatitis can develop against the background:
- Dental diseases
- insufficient mouth hygiene
- clusters of dental plaque;
- diseases of the digestive system, in particular gastritis of any nature, nonspecific ulcerative colitis, Crohn’s disease, Behcet’s syndrome, intestinal dysbacteriosis, dyskinesia of the gallbladder or bile ducts, etc.
- A bacterial allergic reaction to protaeus, staphylococci, streptococci and Escherichia coli. It is these microorganisms that most often cause inflammation of the oral mucosa;
- thermal or chemical damage;
- adenovirus infection;
- hormonal imbalances observed during puberty or during pregnancy
- the formation of malignant neoplasms in the neck or nasopharynx;
- severe dehydration
- genetic predisposition.
As for the sources of the ulcerative-necrotic form of the disease, they are represented by the unfavorable influence of several bacteria at the same time — a specific rod having a spindle shape and Vincent’s spirochaetes, which is also called Vensana chronic stomatitis. The activation of such a pathogenic microflora is due to a decrease in the resistance of the immune system.
Chronic recurrent herpetic stomatitis causes a similar virus as the causative agent of herpes simplex.
In addition, among the predisposing factors of inflammation are:
- the pathological effect of fungi — most often a yeast-like fungus of the genus Candida becomes a provocateur of an ailment
- uncontrolled intake of certain groups of medications, in particular antibiotics
- increased susceptibility to the components of dentures
- insufficient or improper care of dentures
- incorrectly selected or faulty denture, which leads to permanent microtrauma of the oral cavity;
- long-standing addiction to bad habits, especially to cigarette smoking
- long-term stress effects
- Vitamin deficiency
- chronic infectious processes affecting ENT organs
It is also worth noting that chronic stomatitis is formed due to the complete absence or inadequate treatment of the acute form of such a disease.
It is very often diagnosed such a clinical form of the disease as chronic aphthous stomatitis. It occurs in 5% of cases among various forms of pathology affecting the mucous layer of the mouth, is expressed in a recurring eruption, prolonged course and periodically arising periods of exacerbation.
In addition to the main variety, the following types of inflammation of the mouth proceed according to the type of chronic stomatitis:
- herpetic stomatitis — chronic herpetic stomatitis is often diagnosed in children under the age of up to four years
- prosthetic stomatitis
- Vincent’s ulcerative-necrotic stomatitis is an inflammatory-destructive oral lesion that is most often found in males of working age
- candidal stomatitis — also called chronic fungal stomatitis
- smoker’s stomatitis
In addition, the disease, as it progresses, can go through several stages:
- mild — characterized by the development of single aft or ulcers that appear every few years
- Moderately severe — painful small lesions in the mouth appear several times a year
- heavy — differs in that it recurs constantly, i.e. monthly.
As each type of disease has its own causes, it is only natural that the clinical picture will also be slightly different.
For example, chronic recurrent aphthous stomatitis is expressed in:
- increased salivation;
- swelling and redness of the oral mucosa
- the formation of clearly restricted sores — most often aphthae with volumes of not more than five millimeters affect the palate, the wall of the pharynx, the tongue, the gum and the inner surface of the lips. Neoplasms can be separate, grouped or merged into foci;
- discomfort and discomfort during eating or talking;
- regional lymph node inflammation
- increase in body temperature;
- drowsiness and increased irritability
- Lack of appetite and, as a result, weight loss
- emetic urges that appear immediately after a meal
- violation of the act of defecation, namely in constipation;
- a pronounced unpleasant odor from the mouth.
The duration of relapse is often several weeks, a maximum of a month. Frequent exacerbations lead to the development of severe apathy in patients.
Symptoms of ulcerative-necrotic stomatitis Vincent:
- bleeding gums;
- abundant saliva secretion
- severe pain syndrome
- Putrid odor from the mouth
- pathological redness of the affected areas of the oral mucosa
- compaction of the subordinate and lower jaw lymph nodes
- signs of chronic gingivitis.
Chronic herpetic stomatitis has this symptomatology:
- the appearance of small bubbles, which in a short period of time are transformed into erosion, covered with plaque. Neoplasms often occur on the mucosa of the tongue or lips, palate or cheeks;
- strong pain that hampers the process of cleaning your teeth, eating and talking …
- swelling of the oral mucosa;
- highlighting a large amount of saliva.
Chronic prosthetic stomatitis is found in every second person who uses removable dentures, the clinical picture is as follows:
- redness of the prosthetic bed
- the appearance of decubital ulcers that appear due to permanent trauma to the mucous prosthesis
- local bleeding;
- severe soreness in the area of inflammation
- Mucosal hyperplasia;
- signs of traumatic papillomatosis of the oral cavity.
The clinical manifestation of chronic stomatitis of smokers is presented:
- the acquisition of mucous bluish-brown hue
- hyperkeratosis of the palate, ie, its excessive thickening
- the appearance of a white touch;
- signs of nicotine glossostomatitis.
It should be noted that stomatitis in adult smokers acts as the main risk factor leading to the formation of oral cavity oncology.
Chronic candidiasis is accompanied by:
- burning not only in the oral cavity, but also in the larynx
- the appearance of white plaques in the mouth and on the tongue
- pain in the mouth and difficulty swallowing
- decreased appetite
- an unpleasant aftertaste in the mouth
- loss of taste;
- local bleeding.
All the above symptomatology is appropriate to refer to both adults and children.
If one or more anxiety symptoms occur, it is advisable to consult the dentist as soon as possible. It is this specialist who will carry out the diagnostics, if necessary, send the patient for additional examinations to the more narrow clinicians and tell how to treat chronic stomatitis.
In order to find out the causes that have become the source of the development of the disease, the doctor needs:
- get acquainted with the medical history of not only the patient, but also his immediate family
- collect a life history of a person
- conduct a thorough dental check — to determine the location and number of tumors in the mouth
- to interview the patient in detail — to find out the time of appearance and intensity of the symptomatology. This will provide an opportunity to establish the frequency of relapses.
Laboratory diagnosis involves the implementation of:
- PCR scrapings from the oral cavity
- pathohistological examination of the edges of the mouth;
- bacteriological studies
- the study of print smears — to determine the histological pattern
- Saliva analysis — to estimate the concentration of substances such as lysozyme and immunoglobulins
- general clinical analysis and blood biochemistry — to search for concomitant disorders
- microscopic examination of stool masses
Instrumental examinations are limited to the implementation of an X-ray — to identify chronic foci of infection in the oral cavity.
After this, the patient can be referred for additional examination to other clinicians. Each of the doctors will assign specific laboratory and instrumental examinations to the patient.
Despite the existence of several varieties of the disease, the tactics of therapy of all varieties of chronic stomatitis are common and aimed at eliminating the causes that become a source of inflammation.
Thus, treatment of chronic stomatitis can include:
- dental cleaning of the oral cavity
- sanation of infection areas
- applications using anesthetics and enzymatic substances
- treatment of affected areas of the oral mucosa with antiseptics
- application to the keratoplasty foci;
- oral administration of immunomodulators, antibiotics, antiviral and antiallergenic agents
- physiotherapy procedures, in particular UV, ultraphonophoresis and laser therapy.
In cases with the development of chronic prosthetic stomatitis, an orthopedic dentist will be required to repair or replace the prosthesis.
Cure the disease can also be done with the help of folk remedies, but only as a complex therapy, and not the only method of eliminating the disease. To do this, it is recommended to rinse the mouth with decoctions prepared on the basis of:
- Calendula and chamomile;
- flax and dog rose
- sea buckthorn oil
Prevention and Forecast
In order to avoid problems with the development of chronic stomatitis, first of all, timely and full treatment in adults and children of acute forms of inflammation is recommended.
To avoid relapse, one should follow simple rules:
- completely abandon bad habits;
- Do not neglect hygienic procedures
- accept only those medicines that the attending physician will appoint;
- Seek professional dental prosthetics and, if necessary, inform the dentist of any problems with the prosthesis
- provide the body with enough vitamins
- avoid supercooling;
- In the early stages of progression, treat those ailments that lead to the development of stomatitis in the child and adult
- undergo a full medical examination several times a year.
The forecast of CHRAS or any other type of disease is favorable. The complex approach in therapy allows to completely cure the disease or achieve a stable remission.