Aphthous stomatitis: treatment, photo. Treatment of aphthous stomatitis in children and adults Aphthous stomatitis is caused by
Aphthous stomatitis is a type of ordinary stomatitis characterized by damage to the oral mucosa. However, with aphthous stomatitis, white islands-ulcers appear in the mouth, which dot the gums, palate, and inner surface of the cheeks. In some cases, infection in adults spreads to the tonsils and the surface of the uvula.
This disease is the most severe form of the disease, since in addition to the classic signs of stomatitis, patients suffer from severe pain in the area where aphthae occurs - they feel pain when swallowing, touching the aphthae with the tongue, and while chewing food. Despite the fact that aphthous stomatitis mainly affects children, this disease also affects the oral cavity of adults.
What is it?
Aphthous stomatitis is a type of inflammation of the oral mucosa. The disease got its name because of the symptoms in the form of ulcers (ulcers) in the mouth. These manifestations are very painful and can occur individually or en masse.
Externally, aphthae have an oval, often round shape, with clear pink or red borders. Such wounds can appear on the inside of the lips, tongue, palate, and cheeks. The wounds vary in size from 3.5 mm and larger.
Causes of the disease
Among the large number of reasons that can cause the appearance and development of aphthous stomatitis, there are various infectious diseases, for example, the herpes virus, some forms of staphylococci, measles, diphtheria, adenovirus, influenza, etc.
Peculiar catalysts and accompanying factors of this state are:
- tendency to allergic reactions;
- disorders in the gastrointestinal tract;
- burn of the oral mucosa;
- mechanical damage, for example, from a sharp edge of a tooth, rough food or when biting the cheek;
- weakened immune forces of the body;
- lack of vitamins, namely B and C, as well as microelements (zinc, selenium, iron, etc.);
- unfavorable heredity;
- pathologies of the oral cavity (pulpitis, dental plaque, caries, etc.).
Very often children suffer from it, and chronic recurrent aphthous stomatitis occurs in adults. In most cases, these are people aged 20 to 40 years.
Symptoms
At different stages of development, the symptoms of aphthous stomatitis are not the same (see photo). In the initial period, the disease manifests itself with signs of ARVI:
- Weakness and malaise occur.
- Appetite worsens.
- The temperature rises to 38°C.
- The cervical and occipital lymph nodes are enlarged.
- The localization points of herpes in the mouth become red and swollen.
As pathology develops, aphthae form in the oral cavity - small individually located or grouped ulcers with a diameter of up to 5 mm. The edges of the ulcers are distinguished by a reddish tint with a gray coating. External signs of aphthous stomatitis are shown in the photo below.
The presence of defects in the mouth creates discomfort while talking, eating, or any movement of the tongue. The patient complains of increased salivation and the inability to fully perceive the taste of food.
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Subtypes of the disease
Based on the nature of the lesions of the mucous tissue in medicine, four subtypes of aphthous stomatitis are distinguished:
| Glandular | The disease is painful. Lasts at least two weeks. Most often occurs after injury to the mucous membrane in the mouth or salivary glands. An infectious disease can trigger a relapse. |
| Necrotic | It is mainly diagnosed in people with blood diseases. The course of the disease is painless. As a result of necrotic changes, the epithelium is destroyed. The duration of the disease is 2−5 weeks. |
| Deforming | This is the most severe form of aphthous stomatitis. The disease can affect the connective tissue so deeply that it leads to deformation of the palate. This occurs due to the formation of large, deep scars in the mouth. Healing of ulcers in this form of the disease requires very long treatment. |
| scarring | It is characterized by deep and extensive tissue damage in the mouth. Forms large erosions, the size of which can reach one and a half centimeters. The treatment is long-term, at least two months. Scars remain in place of healed ulcers. |
What subtype of stomatitis develops in a patient can only be determined by a dentist. Sometimes for this purpose it is necessary to take a smear for analysis in order to determine the causative agent of the infection.
Aphthous stomatitis in children is often confused with the herpes virus. In contrast, aphthous ulcers in their initial stage look like a small red dot, in the place of which a vesicle with a grayish-white head and a red rim first forms. When it breaks through, an ulcer forms. Ulcers can be a source of secondary bacterial or fungal infection. As part of general therapy, close attention should be paid to nutrition, excluding acidic foods such as citrus fruits, tomatoes, and apples from the diet.
Treatment of aphthous stomatitis in children and adults consists of a set of measures, including local effects and general therapy, and the choice of certain drugs depends on the severity of the disease.
Diagnostics
Diagnosis is carried out at a dentist's appointment. A visual examination determines: the stage of stomatitis, lesions of the mucous membrane, and treatment method. The patient is asked a series of questions - how long ago did the inflammation begin, is there an increase in temperature, etc.
During the examination, the doctor looks at the structure of aphthae, which are in the acute phase and do not heal within 12-15 days. This may be a sign of cancer. To ensure the accuracy of the diagnosis, tests are prescribed - blood, biopsy, culture. After receiving the results, treatment is prescribed.
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How to treat aphthous stomatitis?
For local treatment at home, antiseptic rinses and anti-inflammatory gels are prescribed. In adults, medications may vary depending on the type and duration of aphthous stomatitis; an otolaryngologist or dentist will be able to give recommendations on the choice of medications:
- Most often, Miramistin is prescribed in the form of a solution or spray, which is used to irrigate the oral cavity. It has antiseptic properties, fights primarily against the herpes virus, but is nevertheless suitable for normalizing healthy microflora of the oral cavity.
- Anti-inflammatory ointments with an anesthetic effect are often prescribed due to the pain inherent in aphthous stomatitis. Among the popular remedies are Kamistad, Clobetasol, Trasylol.
- Also at the initial stage, Cholisal-gel is used. It is applied to the dried affected areas after rinsing. Procedures must be carried out at least four times a day.
- For rinsing in case of predisposition to allergies, use a suspension of Diphenhydramine.
- Also popular anti-inflammatory and analgesic ointments are Xicaine and Benzocaine. Treatment with such ointments should not be long-term, as there are significant side effects. When using them, you must strictly adhere to the course.
- An effective remedy for combating canker sores is Stomatofit-A balm, which consists of medicinal plants and an anesthetic. It is applied with a cotton swab directly to the sores. The action of the drug is aimed at reducing pain and inflammation.
- If signs of secondary infection appear, the use of antibacterial agents is recommended: Hexoral, Tantum Verde, Orasept.
- As soon as the ulcers resolve, it is worth continuing treatment with epithelializing agents that will restore the mucous membrane. Solcoseryl gel is prescribed as such a drug.
What else can you do to help? For aphthous stomatitis, it is necessary to adhere to a special diet, the main purpose of which is to reduce irritation of the oral mucosa and nourish the body with a complex of vitamins and nutrients. In this case, doctors recommend adhering to certain rules:
- eat pureed, boiled or stewed food;
- exclude smoked, spicy, salty, sour and fried foods from the diet;
- give up processed foods, fast food and carbonated drinks;
- Regularly monitor oral hygiene, regardless of the state of development of the disease, and the toothbrush should only be new and with soft bristles.
Also, the causative agent of aphthous stomatitis can be toothpaste, which contains sodium lauryl sulfate, which accompanies the development of the disease. Therefore, when purchasing oral hygiene products, you need to pay attention to this first.
Chronic recurrent aphthous stomatitis
This form of the disease is observed to one degree or another in every fifth inhabitant of the planet. Recurrent aphthous stomatitis is characterized by the appearance of ulcers on the oral mucosa after a sufficiently long period of time. So, for example, with apparent well-being, aphtha occurs after a few months, and sometimes after a few years.
Statistics show that women are more likely to suffer from canker sores than men. Recurrent aphthous stomatitis does not occur on its own - it is preceded by risk factors - trauma to the oral mucosa, allergies to certain foods, poor-quality water, sweet, sour, spicy foods.
Doctors are quite wary of recurrent aphthous stomatitis, since the disease can be a sign of more serious disorders in the body - Crohn's disease, anemia, celiac disease, human immunodeficiency virus, malabsorption syndrome, ulcerative colitis and others.
Treatment of recurrent aphthous stomatitis should solve three problems for the patient:
- elimination of discomfort and pain;
- accelerating the healing of aphthae;
- prevention of relapse of disease.
Local treatment of recurrent aphthous stomatitis begins with painkillers and anti-inflammatory drugs. To relieve painful sensations, applications with anesthetics are used - a solution of lidocaine, benzydamine hydrochloride, benzocaine. A solution of diclofenac, amlexonox, and a solution of tetracycline has a good effect. To suppress the action of inflammatory mediators, triamcinolone acetonide, flucinodide, clobetasol propionate are prescribed. Preparations with these active ingredients are applied to the ulcers several times a day after meals. For large canker sores, cauterization with silver nitrate is possible. At the time of healing of aphthae, vinylin, caratolin, sea buckthorn oil, rosehip oil, Actovegin-gel, and solcoseryl are used.
In case of a protracted course of the disease, when some aphthae have not yet had time to heal, and new ones have already appeared, a course of corticosteroids is prescribed - prednisolone and betamethasone in the dosage specified by the doctor. For epithelization of severe aphthae, delargin is used (intramuscular administration). The inclusion of immunomodulators (levamisole, kemantan and others) in therapy is also useful.
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Chronic recurrent aphthous stomatitis
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Prevention
Simple measures to prevent the disease:
- regular sanitation of the oral cavity;
- compliance with the rules of oral hygiene;
- rational nutrition;
- minimal consumption of food that can cause mechanical or chemical damage to the mucous membrane;
- isolation of the patient from healthy people if stomatitis is contagious;
- avoiding trauma to the oral mucosa;
- exclusion of substances that can cause allergies;
- supporting the adult immune system with multivitamin complexes.
Situations where epithelial or aphthae defects appear in the mouth are quite common. These are erosions or superficial ulcerations that affect the mucous membrane. Why they occur, how the disease progresses and what should be done to eliminate it are the main aspects that require attention.
Oral ulcers are a consequence of so-called aphthous stomatitis. This is an inflammatory disease of the mucous membrane, which develops under the influence of a large number of factors. The central place among the causes of the disease is given to infectious agents: viruses (influenza, measles, herpes, adenoviruses), bacteria (staphylococci, diphtheria bacillus, mycobacteria, treponema pallidum) or fungi. The following can also contribute to pathology:
- Injuries (biting with teeth, damage from solid food).
- Burns (hot food, chemical compounds).
- Food allergies (cereals, citrus fruits, seafood, chocolate).
- Deficiency of vitamins (group B, ascorbic acid) and minerals (zinc, selenium, iron).
- Dental problems (caries, pulpitis, poor-quality installation of dentures).
- General diseases (digestive tract, hematological, rheumatic, immunodeficiency).
- Using toothpastes and rinses containing sodium lauryl sulfate.
- Bad habits (smoking, alcohol abuse).
- Hormonal surges (for example, during menstruation in women).
- Psycho-emotional stress.
- Genetic predisposition.
In the mechanism of aft formation, a significant role is played by the reaction of the immune system against certain molecules contained on the mucous membrane or in saliva. They are recognized as foreign and provoke the migration of lymphocytes and other processes that initiate inflammation. And prolonged exposure to unfavorable factors leads to the persistence of ulcers and the transition of stomatitis to a chronic form.
Stomatitis, in which aphthous ulcers occur in the mouth, develops under the influence of external unfavorable factors and against the background of internal problems in the body.
Symptoms
The formation of aphthae is one of the stages of stomatitis, and perhaps the most unpleasant. At the beginning, the mucous membrane turns red and swells slightly, patients feel a slight burning sensation and dry mouth. Then (mainly when infected with candida), whitish plaques may appear covering the tongue, palate, inner surface of the cheeks and lips, which are sometimes combined with “stubs”. Further, erosions or superficial ulcers form directly in these places. They are small in size (several millimeters), round or oval in shape, covered with a white-yellow coating and framed by a red corolla.
The number of aphthae with stomatitis varies: from single specimens to multiple defects. They are located on the mucous membrane of the cheeks, lips, floor of the mouth, and soft palate. Subjectively, pain is characteristic, especially during eating, when moving the tongue or lips. Additional signs of stomatitis include bad breath and increased salivation.
Stomatitis, which occurs against the background of a microbial infection, is often accompanied by fever and malaise, especially in childhood. In infants, the disease is characterized by decreased appetite and breast refusal, irritability and tearfulness. The aphthous process occurs in two clinical forms: acute and chronic. The first occurs suddenly and is characterized by fairly rapid healing of ulcers (no longer than 10 days). But chronic inflammation can last for a longer time. It subsides, going into remission, but with respiratory infections or hypothermia, aphthae reappear. Moreover, recurrent stomatitis also has several varieties:
- Fibrinous.
- Necrotic.
- Glandular.
- Deforming.
Fibrinous stomatitis is characterized by the appearance of a few aphthous ulcerations, which may be preceded by small nodules. The surface of the erosions is covered with a whitish coating. In the necrotic form, aphthae are practically painless; they are accompanied by degeneration and death of surface tissues. The period of epithelization of such defects can reach one month.
Glandular stomatitis with painful aphthae forms at the site of the excretory ducts of the small salivary glands. And the deforming scar process is a sluggish disease with “creeping” ulcers, which, on the one hand, epithelialize, and on the other, grow. When deep defects heal, scars are formed that disrupt the smooth surface of the oral mucosa.
Aphthous elements in the mouth can be a sign of systemic diseases. Then, along with the clinical picture of stomatitis, other signs may be present. Behcet's disease is characterized by damage to the eyes, genitals, nasal mucosa, skin, and joints. Stevens-Johnson syndrome is characterized by a bullous rash (blistering), conjunctivitis, fever and weakness. And with Crohn's disease, diarrhea mixed with blood, abdominal pain, and flatulence occurs.
The clinical picture of aphthous stomatitis is quite characteristic. It makes it possible to establish a diagnosis with high probability.
Additional Research
To clarify the nature of the process and find out its cause, it is necessary to use additional methods. The doctor may refer the patient to the following procedures:
- Complete blood count (leukocyte count, ESR).
- Immunogram (activity of the cellular and humoral components).
- Serological tests (antibodies to infections and own tissues).
- Allergy tests (skin tests, scarification tests, injection tests).
- A smear from the surface of aphthae (microscopy, culture, PCR).
It is necessary to differentiate aphthae in the oral cavity from other diseases with a similar clinical picture. First of all, we are talking about herpetic infection, ulcerative necrotic stomatitis.
Treatment
Therapy for aphthous stomatitis should be comprehensive. Therapeutic measures include influencing the cause, development mechanisms and symptoms of the pathology. In each case, an individual approach to the patient is important in order to take into account all the characteristics of his body. The nature of the diet requires increased attention, because it is necessary to reduce the damaging effects of food on the mucous membrane. This is expressed in the exclusion of spicy, sour, salty, hard and hot foods. That is, food should be gentle in all aspects (chemical, mechanical, thermal). Those substances that can cause an allergic reaction are also removed from the diet. They mainly recommend soups, vegetable and fruit purees, and steamed dishes.
Traditional treatment is implemented at the local and general levels. The first includes medications for rinsing, application, and resorption in the oral cavity. Based on the clinical picture and origin of aphthous stomatitis, the following may be prescribed:
- Antiseptics (chlorhexidine, furatsilin, hydrogen peroxide).
- Antimicrobial (Metrogil Denta, nystatin, acyclovir ointment).
- Local anesthetics (Anestezin, novocaine, lidocaine)
- Glucocorticoids (Lorinden C, triamcinolone).
- Proteolytic enzymes (trypsin, chymotrypsin).
- Enhancing regeneration (Solcoseryl, Citral, vitamin E).
In addition to local remedies, systemic drugs are also used - antihistamines, antivirals, non-steroidal anti-inflammatory drugs, immunomodulators, sedatives. Physiotherapy (electro- and phonophoresis, laser therapy) is used as an addition to drug treatment. The goal of correction should be complete clinical recovery, and in case of chronic stomatitis, elimination of acute phenomena, normalization of the patient’s condition and achievement of stable remission.
Mouth aphthae is a fairly common problem. These are erosions or small ulcers that are a sign of stomatitis. And it, in turn, can develop for many reasons. But to establish the source of the problem and effectively eliminate it, a doctor’s intervention will be required.
Aphthous stomatitis is an unpleasant disease that is very painful. It often makes eating difficult due to the formation of ulcers.
Treating this problem with traditional methods is dangerous and unwise, since stomatitis can become chronic.
There are many types of this disease, so a visit to the doctor cannot be avoided.
What you need to know about the disease
The name of the disease comes from the word “aft”, which means “ulcer”. This type of stomatitis is manifested by damage to the oral mucosa with the formation of ulcers. They can appear separately or be localized in a group, affecting a large area of tissue.
The most common location of aphthae is the front of the mouth, on the inside of the lips and cheeks. This is due to the fact that this area is much more likely to be damaged than others, such as accidental bites or scratches from food.
Less commonly, aphthous stomatitis appears on the tongue. Sometimes the disease is accompanied by weakness and a slight increase in temperature.
The average duration of the disease is 8-10 days.
Aphthae are round or oval erosive areas of skin covered with a white or gray coating and surrounded by an inflamed, bright red halo. The size of the aphthae does not exceed a centimeter in diameter.
In the normal course of the disease, one ulcer appears, in rare cases the number reaches three. When touched, aphthae cause severe pain, so eating is often difficult.
Causes and provoking factors
Experts in the field of studying aphthous stomatitis still cannot come to a consensus on what exactly causes this form of the disease. Various reagents have been identified that are equally capable of causing other forms of stomatitis.
Often the disease occurs due to the appearance of an infection in the human body or is a residual phenomenon of a viral disease due to a weakened immune system. Popular infections include:
In addition, pathology is often the result of an allergic reaction to food, medications, or microbes that have entered the body. Chronic diseases of the gastrointestinal tract also contribute to the occurrence of aphthae.
In addition to the main catalysts of the disease, ideal conditions for the development of stomatitis must be formed in the body. These include:
At least one of the described factors can push the reagents to take active action, causing the first symptoms of aphthous stomatitis to appear, requiring treatment at the initial stage.
Classification of the disease
In medicine, there is a division of aphthous stomatitis into two types: acute and chronic:
There is a classification of the disease depending on the nature of the damage to the oral mucosa.
Aphthous stomatitis can be:
The photo shows necrotic aphthae
- Necrotizing aphthae is an accumulation of dead mucosal cells, which become covered with epithelium during the course of the disease. Most often, this subtype of aphthous stomatitis is found in patients with blood pathologies.
- Granular stomatitis is caused by trauma to the mucous membrane, as a result of which bubbles first appear, then painful ulcers appear in their place.
- During scarring stomatitis, the aphthae are covered with connective tissue. With intensive treatment, the connection is broken - the tissue is resorbed.
- Deforming is the most severe form of the presented ones, since aphthae changes the surface of the gums. After they heal, noticeable scars will remain.
The degree of damage to the mucous membrane and the type of disease can only be determined by a doctor after analysis. Only on the basis of this data can a full-fledged treatment be prescribed that will effectively cope with the disease.
Main symptoms and duration
The symptoms of the disease directly depend on the form of its course.
Acute form of the disease - everything is unexpected and abrupt
Acute aphthous stomatitis appears unexpectedly. The patient begins to complain of malaise, sometimes a slight increase in temperature is noticeable.
Already at the initial stage, pain is felt in the mouth, which worsens while eating or while talking. Bubbles form on the mucous membrane, quickly developing into erosions, covered with a gray-white coating.
Around the aphthae, the mucous membrane becomes inflamed and becomes loose. You may notice a white coating on the tongue.
As the number of ulcers increases, it becomes difficult to eat solid food; you have to switch to purees and pates.
The duration of this type of disease usually does not exceed two weeks, at the end of which the mucous membrane is restored to its previous state. Very rarely, in the case of a complicated form, minor scars remain.
Chronic form
With chronic aphthous stomatitis, as in the photo on the right, the mucous membrane swells and becomes pale.
Ulcers are located on the inside of the lips, cheeks, and under the tongue. Less commonly, aphthae are localized on the palate and gums.
The size of the lesion reaches a centimeter, the halo swells, becomes red, and a dirty gray coating appears. In the case of extensive necrosis, the ulcers become more inflamed and protrude above the surface.
Chronic aphthous stomatitis usually lasts 12-15 days. If treatment is not started in a timely manner, aphthae will begin to grow deeper, affecting the mucous membrane.
At this stage, the sores will begin to bleed, causing even more pain. In addition, this condition is dangerous due to infection. Deep aphthae may leave scars after healing.
What you need to know about disease therapy
Treatment of aphthous stomatitis should be comprehensive and under the supervision of a doctor. Even after visible signs disappear, you should not stop taking the prescribed medications. This is due to the fact that the disease can return and subsequently develop into a chronic disease.
Local treatment of aphthae
For local treatment in adults, antiseptic rinses and anti-inflammatory gels are prescribed. Drugs may vary depending on the type and duration of the disease; an otolaryngologist or dentist will be able to give recommendations on the choice of drugs:
Antiallergic drugs
Treatment of allergic stomatitis is accompanied by the use of antihistamines. These include Diazolin, Claritin, Suprastin, Tavegil.
You can also use other medications to relieve allergy symptoms. Typically, the course of treatment with desensitizing drugs lasts 10-12 days.
Sanitation of the oral cavity
Aphthous stomatitis develops against the background of diseases of the gums and teeth, for this reason, during the treatment of ulcers, it is necessary to carry out complete sanitation of the oral cavity.
Eliminating pockets of possible erosion on the mucous membrane will reduce the duration of stomatitis, and will also reduce the likelihood of its secondary occurrence.
It is especially important to carry out sanitation of the oral cavity, if this has not been done previously, in case of chronic stomatitis. The presence of tartar, caries, and pulpitis has a beneficial effect on the formation and development of aphthae.
Increasing local immunity
Fermented toothpastes are prescribed as local immunostimulating drugs. They should contain the following substances: lactoperoxidase, lactoferrin, lysozyme or glucose oxidase. 
These enzymes help increase the resistance of the mucous membrane and destroy bacteria and viruses.
You can buy Imudon lozenges. They are used six times a day, following a course of 10 days.
Good immunomodulators are: ginseng, echinacea, propolis, thymogen, immunofan. Don't forget about vitamins.
The disorder is manifested by severe pain when touching the ulcers. For this reason, preference should be given to liquid and mushy foods.
Pastes, soups, purees, porridges are dishes with which you can create a completely balanced diet. You need to eat right, saturating the body with proteins, fats and carbohydrates, so that the immune system can provide full resistance to the disease.
Cabbage, carrots, potatoes, peaches, parsley, olives, sea buckthorn juice - all these are desirable foods that help improve immunity, restore healthy microflora and have an antibacterial effect.
Treatment at home
When the first signs of stomatitis appear, it is necessary to urgently take action using the means that are available in every home. Until a diagnosis has been established, it is necessary to maintain hygiene and rinse the mouth frequently. A solution prepared with salt or soda has an antibacterial effect.
It is also good to use a low concentration hydrogen peroxide solution for irrigation. You can dilute a tablespoon in a glass of water and rinse your mouth after each meal.
Often, for the disease, solutions of furatsilin or chlorhexidine are used.
Honey water effectively helps with illness. By adding a tablespoon of honey to a glass of water, you can get an antiseptic and antiviral agent that will stop the development of the disease until a course of treatment is prescribed.
Preventive measures
For prevention purposes, dentists recommend following the principles of a healthy lifestyle in everything. Excessive consumption of spicy, sweet, sour and salty foods has a negative impact on oral health. Diseases that change the environment in the oral cavity may develop.
If you still cannot change your eating habits, you should not forget about the rules of personal hygiene. Clean hands and oral care are important components in maintaining good health.
What can we say about bad habits? It's no secret that they have a detrimental effect on the entire body, starting their negative impact from the oral cavity.
Taking multivitamins, especially during periods of hypovitaminosis, will help increase the body's resistance. Hardening and physical exercise contribute to overall health.
The main rule to avoid aphthous stomatitis is the timely treatment of infectious diseases, which, if left untreated, cause the appearance of aphthous stomatitis in the oral cavity.
The seriousness of the disease is beyond doubt, so its treatment must be approached comprehensively, based on the recommendations of specialists. By following preventive measures, you can protect yourself from unwanted diseases for a long time.
Aphthous stomatitis is one of the most common dental diseases. A characteristic sign of this disease is the appearance of painful ulcers on the oral mucosa.
The causes of the disease are very different. And in the presence of concomitant pathologies and weakened immunity, the disease may become chronic.
What is it?
Aphthous stomatitis is an inflammatory disease of the oral mucosa. It is characterized by disruption of the surface layer of the mucosa with the formation of single or multiple aphthae (erosions) - painful ulcers.
About 20% of the population have experienced aphthous stomatitis at least once. It can occur at any age, but children and adolescents are most often affected. The disease occurs slightly more often in women than in men.
Causes of aphthous ulcers
Clinical observations suggest that many causes may contribute to the disease, although the etiology of aphthous stomatitis has not been fully elucidated.
The most reliable causes in children and adults are:
- Immune reaction- the most justified reason at the moment. In this case, the immune system cannot recognize the molecules of substances that are present in saliva. As a result, lymphocytes are activated, which attack the chemical agent as foreign, and aphthae are formed. Weakened immunity contributes to the transition of the disease to a chronic form.
- The influence of viruses. Sometimes it is preceded by viral diseases - influenza, adenovirus, herpes virus, measles.
- Hormonal fluctuations- adolescence, pregnancy, menopause.
- In favor hereditary predisposition The fact is that a third of patients with chronic aphthous stomatitis suffered from one or both parents.
- The occurrence of aphthous stomatitis can be provoked by allergic reactions. Patients are advised to adhere to a hypoallergenic diet.
- Diseases of the gastrointestinal tract, diseases of the teeth and gums can also become a trigger in the development of aphthous stomatitis.
- Traumatic lesions due to biting, scratches with a chipped tooth, burns from hot food, adversely affect the health of the oral mucosa.
- About 40% of patients with aphthous stomatitis associate the onset of the disease with traumatic damage to the oral mucosa.
- Lack of nutrition negatively affects the health of the oral mucosa, which contributes to the occurrence of aphthae. Often the disease is combined with hypovitaminosis C, B, A, as well as a deficiency of zinc, folic acid, selenium and iron.
- Neuropsychic tension and stress. 16% of people suffering from stomatitis confirm that ulcers develop after stressful situations.
Diagnostics
To make a diagnosis of aphthous stomatitis, an experienced doctor only needs to see the clinical picture.
Aphthous ulcers of the oral cavity are a typical symptom of the disease.
To confirm the diagnosis, the doctor collects an anamnesis: specifies the time of onset of the first symptoms, the pain of aphthae, the presence of traumatic injuries and burns of the oral cavity, food allergies, and the presence of similar diseases in close relatives.
Sometimes they resort to laboratory tests to identify the pathogen.
Differences from herpetic stomatitis
It is necessary to carry out differential diagnosis with herpetic stomatitis, since their symptoms are similar.
Photo: Comparison of aphthous (left) and heretical (right) stomatitis
Stages and symptoms
In its development, the disease goes through several stages, each of which is characterized by special clinical manifestations.
- Prodromal stage. The disease begins with a general malaise, the symptoms of acute respiratory infections predominate, such as: fever up to 40 ° C, chills, headache, loss of appetite, lethargy, possibly enlarged and painful occipital and cervical lymph nodes. Changes in the mucous membrane of the oral cavity, tongue and gums are observed. They become bright, dry and shiny. Areas of redness appear, which turn into areas of ulceration. Already at this stage, pain may appear in the mouth, at the site of aphthae formation.
- Aphthous stage. The main symptom of the next stage of the disease is the formation of painful aphthae. Afta are single or multiple ulcers, grouped into several pieces, with a diameter of up to 5 mm. Aphthae form on the mucous membrane of the cheeks, lips, floor of the mouth, tonsils, and lateral surfaces of the tongue. The aphtha usually has a round or oval shape, with clear boundaries in the form of a narrow red border. Its center is covered with a grayish-yellow fibrin coating. During the period of active rash, general symptoms and pain in the mouth intensify. There is a change in the blood test: the number of leukocytes sharply decreases ((to 1–1.2) * 109/l), ESR increases to 45 mm/hour.
- Healing stage. The final stage of the disease is recovery, which occurs 1–2 weeks from the onset of the disease. The fibrous film separates on its own, healing occurs at the site of the aphthae without scar formation, but for a few more days hyperemia, that is, redness, is observed.
Forms
- Depending on the nature of the lesion in aphthous stomatitis, the following forms are distinguished:
- Fibrinous. (the clinical picture is described above).
- Necrotic. Aphthae cause dystrophic disorders of the mucous membrane, necrosis and necrobiosis of epithelial tissue occurs. This form of stomatitis is diagnosed most often in people with blood diseases and severe somatic diseases. Aphthae are almost painless and epithelialize in 2 to 4 weeks.
- Grandular. Develops due to damage to the ducts of the salivary glands. The glands do not work in the usual way and provoke the formation of aphthae, which are localized next to the ducts of the salivary glands. Aphthae are painful and heal in 1–3 weeks.
- Scarring. Occurs when the acini of the salivary glands are damaged. Aphthous elements are located at the exit site of the salivary gland ducts, on the palatine arches, and on the mucous membrane of the pharynx. Aphthae develop into large, painful ulcers up to one and a half centimeters in diameter. Epithelization begins after at least 3 months. After healing, scars remain.
- Deforming- the most severe form of the disease. Characterized by the presence of deep destructive changes in connective tissue. Ulcers heal slowly; after epithelization, deformations of the palatine arches, lips, and soft palate occur.
Photo: scarring form of chronic aphthous stomatitis
Types of disease
Depending on the nature of the course of aphthous stomatitis, two types of disease are distinguished: acute and chronic.
Acute form
Acute aphthous stomatitis is characterized by the appearance of single or multiple aphthae on the oral mucosa.
Aphthae disappear after 1–2 weeks, but if left untreated, the disease can become chronic.
Chronic relapsing
Chronic recurrent aphthous stomatitis is characterized by the periodic appearance of aphthous elements over many years, with periods of remission and exacerbation.
The most likely causes of the development of the disease are: mechanical trauma to the mucous membrane, decreased immunological reactivity, chronic diseases.
This type of stomatitis differs from acute stomatitis in the absence of an acute reaction of the body, the appearance of single aphthae and a recurrent course.
When examining the oral cavity, aphthae can be detected at various stages of development. The exacerbation lasts 7–10 days, after which remission occurs.
Treatment
Treatment is aimed at eliminating the cause, as well as the clinical manifestations of the disease. To achieve the desired effect, you need to apply a whole range of therapeutic manipulations and procedures.
Drug treatment
Drug treatment consists of the use of local and general medications.
Local treatment is aimed at eliminating inflammation in the oral cavity.
For rinsing, antiseptic solutions are used - chlorhexidine, hydrogen peroxide, furatsilin. In case of severe pain, aphthae are treated with Proposol aerosol or a glycerin suspension (5-10%) with novocaine or lidocaine.
General treatment includes the use of antihistamines, desensitizing drugs, and antiviral drugs. In some cases, treatment with antibiotics and steroids is prescribed. All patients are prescribed a course of vitamin therapy and immunomodulation.
Patients are prescribed a gentle hypoallergenic diet, with the exception of solid and rough foods.
Symptomatic treatment is antipyretic and painkillers.
At home
How to treat aphthous stomatitis at home? Indeed, in addition to traditional methods of treating stomatitis, there are many folk remedies and recipes.
This composition can also be used to disinfect the oral cavity. Mix 60 ml of water with the same amount of hydrogen peroxide, add 1 tsp. soda and 1 tsp. salt, stir. Rinse your mouth with this solution several times throughout the day.
Another antiseptic solution for treatment at home is calendula infusion (1-2 teaspoons of dry herb per glass of boiling water).
No less effective are infusions of lemon balm and chamomile leaves, sage and burdock, knotweed, St. John's wort, yarrow and thyme.
To increase immunity from homeopathy preparations, echinacea is used in tablets and infusions.
In adults
Treatment in adults allows us to expand the list of acceptable drugs.
Treatment plan:
- For pain relief, local painkillers are used: Anestezin powder, Hexoral-tabs, Lidocaine Asept, Lidochlor gel.
- Mouth rinsing, local ointments, sprays and gels help cure aphthous ulcers, which include: sprays - Ingalipt, Cameton, Hexoral, Vinilin and Lugol; gels - Cholisal, Kamistad, Actovegin.
- The following drugs have a healing effect: Solcoseryl, Karatolin, sea buckthorn oil, Vinilin and propolis spray.
- Vitamin therapy - Vit B1, B6, B12, C, nicotinic and folic acid.
Photo: Hexoral-Tabs and Lugol spray
In children
If symptoms of stomatitis appear in children, you should seek medical help and under no circumstances self-medicate.
Before visiting a doctor, adults should provide the child with a gentle diet, excluding sour, spicy and hot foods, as they can cause increased pain. Food should be tender and contain a large amount of vitamins and microelements.
For pain relief, doctors usually prescribe teething gels for children. They are applied around the aphthae.
If the temperature increases significantly, antipyretic drugs based on paracetamol are prescribed.
For antiseptics, the child’s oral cavity is treated with Miramistin solution, as well as herbal tinctures.
Children, like adults, are prescribed antihistamines and vitamins.
Research and Innovation
Modern research into aphthous stomatitis is mainly aimed at studying defects in the immune system of patients with this disease. An important question in their work is why some people are susceptible to repeated outbreaks of the disease and others are not?
Scientists conducted a blood study of two groups of people - patients with aphthous stomatitis and healthy ones. The result showed differences in the functioning of the subjects' immune systems. However, scientists cannot say that it is these differences that cause aphthous stomatitis; this requires additional research.
Research in the field of pharmacology is carried out annually. New drugs are being developed and tested for the treatment of recurrent aphthous stomatitis, aimed at changing the functions of the immune system of patients.
They will be able to go on sale only after their safety and effectiveness have been proven.
One of the latest pharmacological developments that is currently at the testing stage is the drug Amlexanox. The drug has anti-inflammatory and antiallergic effects. There is already evidence of its effectiveness.
Photo
Photos will help to better present the picture of this disease.
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Often aphthae signal disturbances in the gastrointestinal tract, hematological diseases, problems of the ENT organs, caries, etc.
The clinical picture depends on the stage of the disease, of which there are three: prodromal, aphthous and convalescent.
Aphthous stomatitis in children occurs with high fever, which must be treated with antipyretic drugs.
It is important not to forget about etiological treatment.
Wound healing agents promote rapid regeneration of the mucosa without scar defects. For this purpose, you can use Solcoseryl.
In most cases, traditional methods of treatment complement traditional therapy.
You can also use the following method.
