Афтозный стоматит — причины, симптомы, диагностика

Афтозный стоматит – это воспалительное заболевание полости рта, при котором на слизистой оболочке возникают одиночные или множественные язвы. Эти патологические образования также называют афтами (от греческого aphta – язвочка). Они способны возникнуть на любом участке слизистой оболочки рта. Язвочки отличаются болезненностью, постепенно заживают.

Несмотря на то, что в большинстве случаев афтозный стоматит не является заразным заболеванием (при условии, что не вызван вирусами или бактериями), это одна из наиболее распространенных воспалительных патологий полости рта. Ее выявляют у 10-40% детей и взрослых по всему миру.

При наличии симптомов афтозного стоматита необходимо обязательно обращаться к врачу. В афты может проникнуть инфекция, что значительно осложнит течение патологического процесса. К тому же наличие язвочек влияет на психоэмоциональное состояние пациента и значительно снижает качество его жизни. 

Классификация заболевания

Афтозный стоматит различается по характеру течения. Он может быть:

Острый. Начинается с общего недомогания, сопровождающегося повышением температуры тела и апатией. Затем на слизистой оболочке рта появляются единичные или множественные язвочки. Афты достаточно миниатюрны – обычно не превышают по размеру чечевичное зерно. Язвы имеют овальную или круглую форму. Они имеют четкие границы в виде узкой каймы красного цвета. В центре афт можно увидеть серовато-желтоватый налет. Появление язв сопровождается жжением, а во время еды пациент чувствует боль. Полное самостоятельное заживление афт происходит в течение 1–1,5 недель.

Хронический. Свойственна смена периодов обострений и ремиссий. Язвы появляются, заживают, через некоторое время возникают снова. Сопутствующие симптомы выражены не ярко, а в некоторые периоды, даже при наличии афт, могут отсутствовать. Слизистая оболочка рта время от времени отекает. Хронический афтозный стоматит является следствием острого и развивается у людей со слабым местным и общим иммунитетом или у пациентов, страдающих системными заболеваниями.

Причины афтозного стоматита

Точные причины развития заболевания до сих пор не известны. Однако установлено, что у всех пациентов с афтозным стоматитом присутствуют сбои работы иммунной системы. Наиболее распространенной является аутоиммунная теория. Считается, что иммунная система человека начинает принимать некоторые компоненты слюны за чужеродные химические агенты и начинает их атаковать. Результатом этой борьбы и являются афты.

Факторы, повышающие риск развития заболевания:

• Генетическая предрасположенность – близкие родственники трети пациентов с афтозным стоматитом тоже страдали этой патологией, а если в семье есть близнецы, то заболевание выявляется у обоих в 91% случаев, если они однояйцевые, и в 57% случаев у разнояйцевых.
• Механические травмы полости рта – примерно в 40% случаев предшествуют развитию патологии.
• Пищевая аллергия – афтозный стоматит нередко возникает после употребления некоторых продуктов, чаще всего содержащих глютен, а также морепродуктов, специй, сыров, помидоров, цитрусовых.
• Авитаминоз – у пациентов с этим заболеванием часто наблюдается нехватка фолиевой кислоты, железа, цинка, селена, витаминов С и группы B.
• Гормональный дисбаланс – афтозный стоматит нередко возникает у беременных и женщин в период менструации.
• Системные заболевания – у многих пациентов диагностируют иммунодефициты, нарушения функции ЖКТ, сбои работы кровеносной системы, после лечения которых признаки афтозного стоматита исчезают.
• Вирусные и бактериальные инфекции.
• Неправильный выбор средств по уходу за ротовой полостью – в частности во многих случаях заболевание развивается у людей, применяющих зубные пасты с лаурилсульфатом натрия (пенообразующий компонент), способствующим пересыханию слизистой оболочки.
• Нестероидные противовоспалительные средства.
• Стресс.

Хронический афтозный стоматит также способен возникать на фоне таких заболеваний, как фарингит, воспалительные патологии кишечника, болезнь Бехчета, целиакия. В ряде случаев он сопутствует ВИЧ-инфекции.

Справка! Патология может развиваться у пациентов любого пола и возраста, но чаще всего выявляется у подростков и молодых женщин.

Симптомы заболевания

Признаки афтозного стоматита зависят от формы и стадии заболевания.

Различают следующие стадии афтозного стоматита:

1. Начальная.
2. Наружные проявления.
3. Появление патологических очагов.
4. Заживление.

Начальная стадия характеризуется общим недомоганием и увеличением лимфатических узлов в области шеи, затылка и челюстей. У пациента повышается температура тела и ухудшается аппетит, он чувствует слабость.

На стадии наружных проявлений к вышеописанным признакам присоединяются местные симптомы (изменения слизистой оболочки рта). К ним относятся:

• Отеки.
• Болезненность, усиливающаяся при приеме пищи и гигиенических процедур.
• Покраснение и переполненность кровью (гиперемия).
• Ощутимый зуд.

Также у пациента могут возникнуть расстройства сна.

Во время стадии появления патологических очагов возникают одиночные или множественные афты. Они могут развиваться на любом участке слизистой оболочки рта, но чаще всего наблюдаются на щеках, губах, небе и языке. Язвочки, как правило, весьма болезненны.

На стадии заживления афты понемногу затягиваются эпителиальной тканью. В большинстве случаев рубцов не остается.

Формы афтозного стоматита:

Фибринозный афтозный стоматит – наиболее легкая форма, возникающая из-за нарушения кровообращения в поверхностном слое слизистой оболочки. Во рту появляются единичные болезненные язвочки, покрытые белым налетом. Заживление афт происходит в течение 1–2 недель.

Гранулярная форма развивается из-за недостатка слюны. При этом типе заболевания поражаются малые слюнные железы, из-за чего они начинают вырабатывать меньше секрета. Из-за сухости слизистой оболочки у выводных протоков желез возникают болезненные и длительно не проходящие язвочки. У пациентов, подверженных частым простудным заболеваниям, гранулярный стоматит может перетечь в хроническую форму. Лечение достаточно долгое – оно занимает от 1 до 3 недель.

Некротический афтозный стоматит характеризуется не только наличием язв, но медленным разрушением наружного слоя слизистой оболочки рта, вследствие чего происходит отмирание тканей. В отличие от других форм заболевания, эта не сопровождается болями и дискомфортом. Этот тип патологии встречается редко. Обычно наблюдается некротический афтозный стоматит у взрослых, страдающих какими-либо тяжелыми системными заболеваниями.

Рубцующаяся форма возникает при поражении малых слюнных желез и соединительной ткани, вызванном генетическими сбоями. Язвочки поначалу небольшие, но со временем увеличиваются. Они очень болезненны. Афты при таком типе заболевания располагаются в проекции слюнных желез, слизистой оболочки зева и передних небных дужек.

Деформирующая — наиболее сложная форма. Она доставляет пациенту немало неудобств, так как сопровождается общим недомоганием и значительными болями. Язвы достаточно глубокие и долго не проходят. Они приводят к деформации губ, передних небных дужек и мягкой части неба. Также может развиться микростома (сужение ротовой щели) при поражении уголков рта.

Справка! Осложнением афтозного стоматита является распространение инфекции по тканям, а также перетекание острой формы в хроническую.

Диагностика

Афтозный стоматит обычно диагностируют после осмотра пациента, на основании клинической картины и результатов сбора анамнеза. Однако если у врача есть подозрения на наличие сопутствующих заболеваний, то назначаются дополнительные исследования, направленные на их выявление (анализы крови и мочи, УЗИ и т.д.).

Также может понадобиться дифференциальная диагностика. Важно дифференцировать афтозный стоматит от герпетического и от хронических травм слизистой оболочки полости рта. Для этого назначаются вирусологические исследования и применяется метод иммунофлюоресценции (ИФА).

Как лечить афтозный стоматит

Лечение патологии осуществляется комплексно, с применением методов местной и общей терапии. Местная терапия включает в себя:

• Антисептики.
• Противомикробные мази, гели, спреи.
• Полоскания полости рта, ускоряющие процесс заживления язвочек.

К общей терапии относятся методы, позволяющие устранить причину развития афтозного стоматита, а также в целом облегчить состояние пациента. Могут назначаться противовирусные, жаропонижающие, антигистаминные, седативные препараты.

90000 Aphthous ulcers | Ada 90001 90002 What are aphthous ulcers? 90003 90004 Aphthous mouth ulcers (aphthae) are a common variety of ulcer that form on the mucous membranes, typically in the oral cavity (mouth). Other names for aphthous ulcers include aphthous stomatitis and canker sores. 90005 90004 Aphthous ulcers are generally round in shape and form in the soft areas of the mouth such as the inside of the lips, the cheeks or the underside of the tongue. They are benign, non-contagious and can occur as single ulcers or in clusters.In most instances, aphthous ulcers are recurrent — a condition known as recurrent aphthous stomatitis (RAS) — with each episode normally lasting for between 7 and 10 days. The cause of the condition is unclear, and there is no cure, but treatment options are available to treat the pain the ulcers can cause. 90005 90004 90009 Good to know: 90010 Aphthous ulcers are the most common type of mouth ulcer, but they are not the only kind of mouth ulcers. 90005 90004 There are three main types: 90005 90014 Minor aphthous ulcers 90015 90004 These are the most common variety.They are small in size — usually less than 5 mm in diameter — and can form as a single ulcer or in a cluster. They typically do not cause much pain. 90005 90014 Major aphthous ulcers 90015 90004 These are less common, are generally 5 mm or larger and form singularly or in a pair. They can be painful, especially when eating or drinking, and last anywhere between two weeks and a number of months. 90005 90014 Herpetiform ulcers 90015 90004 These can occur when multiple pinpoint lesions fuse together and form large, irregularly shaped ulcers.Herpetiform ulcers are so called because of their similarity in appearance to herpes, however, herpetiform ulceration is not caused by the herpes simplex virus. 90005 90002 Symptoms of aphthous ulcers 90003 90004 Aside from the ulcers (aphthae) themselves, the condition has very few symptoms. Before ulceration occurs, some individuals may begin to feel a burning or itching sensation inside the mouth, which can be painful. Once the ulceration occurs, localized pain of various degrees is often present.90005 90014 What do aphthous mouth ulcers look like? 90015 90004 The ulcers (aphthae, canker sores or mouth sores) are 90009 normally shallow and begin as pale yellow in colour, generally turning grey as the condition develops. 90010 They may be ringed with red or appear fully red when inflamed. Depending on where the ulcers are located, 90009 eating, drinking and talking may become uncomfortable. 90010 90005 90004 90009 Good to know: 90010 In severe cases, aphthous ulcers can result in swelling of the lymph nodes, fever and physical fatigue or lethargy.These cases, however, are extremely rare, and the swelling of the lymph nodes is therefore unlikely to be a first sign of aphthous ulcers. If you are concerned that you may have aphthous mouth ulcers, you can do a free symptom check with Ada at any time. 90005 90002 Causes of aphthous ulcers 90003 90004 The precise cause or causes of aphthous ulcers (canker sores) are unknown, however, it is thought that ulceration is brought about by one or a combination of external triggers. It may also be partly genetic, with 40 percent of people who experience ulcers having a family history of the condition.Aphthous mouth ulcers affect around one in five people at least occasionally and most commonly begin to appear between the ages of 10 and 19. 90005 90004 Possible triggers of aphthous ulcers include: 90005 90048 90049 Emotional stress 90050 90049 Minor injury to the inside of the mouth, for example from cuts, burns or bites while eating, dental work, hard brushing or ill-fitting dentures 90050 90049 Familial tendency 90050 90049 Sodium lauryl sulfate — an active ingredient in some toothpastes and mouthwashes; this compound is not proven as a trigger, but is known to prolong the time needed for ulcers to heal 90050 90049 Certain food and drinks, including coffee, chocolate, eggs and cheese, as well as acidic or spicy foods 90050 90049 A deficiency of certain vitamins and / or minerals including zinc, B-12, folate and iron that may present with anemia 90050 90049 An allergic reaction to oral bacteria 90050 90049 Using, as well as quitting, the use of tobacco products 90050 90049 Hormonal changes associated with pregnancy 90050 90049 Having a weakened immune system, due to certain chronic conditions (Immunodeficiency) 90050 90069 90004 90009 Stress is a common cause of mouth ulcers.90010 Although stress does not directly cause mouth ulcers, it does increase the chances of developing them and can affect their healing process. Mouth ulcers can also cause stress by affecting how and what the affected person can eat and drink. 90005 90004 90009 Good to know: 90010 Dentists are able to advise on ways to reduce the risk of developing aphthous mouth ulcers, for example recommending toothpastes and mouthwashes that do not contain sodium lauryl sulfate or advising on correct brushing equipment and technique to reduce the chance of injury to the inside of the mouth.90005 90004 90009 Some medications are also linked to the development of ulcers 90010, however, they may not always cause the aphthous variety of ulcers. They include: 90005 90048 90049 Nicorandil, a drug used to treat angina pectoris, a heart condition 90050 90049 Ibuprofen and other anti-inflammatory medicines 90050 90049 Oral nicotine replacement therapy opposed to patch replacement therapy 90050 90049 Medicines such as aspirin if left to dissolve in the mouth instead of being swallowed 90050 90049 Illegal drugs such as cocaine 90050 90069 90004 Very rarely, recurrent ulceration can be a possible sign of several serious diseases, including: 90005 90004 The ulcers that are symptomatic of these disorders, however, are technically not aphthous but closely resemble aphthous ulcers and are therefore called aphthous-like ulceration.People who experience recurrent outbreaks of ulcers or ulcers that are slow to heal, especially painful or accompanied by other symptoms should see a doctor as soon as possible. If you or someone you know has recurrent mouth ulcers or ulcers that do not heal, you can do a free symptom check with the Ada app at any time. 90005 90002 Diagnosing aphthous ulcers 90003 90004 In most cases, especially when the condition is not recurrent, diagnosis will be based around medical examination and an investigation of an individual’s medical history.90005 90004 90009 A proper evaluation and diagnostic work-up of recurrent ulceration is important due to its links to other, more serious conditions such as celiac disease, inflammatory bowel diseases like Crohn’s disease or conditions causing a weakened immune system, such as HIV / AIDS. 90010 The diagnostic process may involve the ruling out of these conditions through blood tests or, less often, using a gastroscopy or colonoscopy, possibly also obtaining tissue samples. The course the diagnostic work-up will take will depend on the doctor’s evaluation of the severity of an individual’s condition and the presence of any other symptoms.90005 90002 Complications of aphthous ulcers 90003 90004 Although most mouth ulcers will clear up within two weeks, 90009 in very rare cases they may become infected with bacteria. 90010 This usually only happens in severe cases, where the ulcerated area is extensive. 90005 90004 In the case of a secondary bacterial infection, an antibiotic mouthwash and a means of managing the pain and discomfort may be prescribed. In some cases, oral antibiotics may also be needed (see the section below on treatment).90005 90002 Aphthous ulcers treatment 90003 90004 90009 There is no cure for aphthous ulcers, aphthae or canker sores, 90010 but there are ways to manage the symptoms. 90009 In the majority of cases, the ulcers will disappear without treatment 90010 and avoiding hard or irritative foods, like e.g. pineapples, applying cold substances to the affected area and if needed using numbing preparations, like topical lidocaine or benzocaine will be enough to manage the pain. 90005 90004 When further treatment is required, there are several possible options, with the chosen route depending on a doctor’s judgement of how well each may work, based on the location and severity of the ulceration, and the affected person’s general health.90005 90014 Anti-inflammatory treatment 90015 90004 Over-the-counter, topical anti-inflammatory pastes applied directly to the problem area may be effective in managing the symptoms of aphthous ulcers (aphthae / canker sores), particularly of the minor variety. These pastes should be applied between two and four times per day, please follow the specific recommendations of your pharmacy or doctor. 90005 90014 Antiseptic and Antibiotic treatment for aphthous ulcers 90015 90004 The use of an antiseptic mouthwash e.g. containing chlorhexidine, twice per day or as per your doctor’s recommendations can be part of a treatment regimen of aphthous ulcers. In rare cases a doctor may prescribe topical or oral antibiotics, such as tetracycline or minocycline, which can be effective in treating ulcers. They are typically administered in mouthwash form, with the antibiotic being dissolved in water, swilled around the mouth and spat out. This may be necessary several times per day for a number of days. 90005 90004 90009 Good to know: 90010 Antibiotic mouthwashes containing tetracycline should be avoided in children younger than eight years of age or even older, depending on your doctor’s recommendations, as they can cause the teeth to become discolored.90005 90014 Other treatments for aphthous ulcers 90015 90004 Other treatments may include topical or, rarely, oral steroids, typically used when the ulcers are unresponsive to other treatment methods; silver nitrate ;; other local anaesthetics / numbing agents; and nutritional supplements (containing folate, zinc or vitamin B-12, for example). 90005 90140 Home remedies for aphthous ulcers 90141 90004 There are a number of popular home remedies for aphthous ulcers, including: 90005 90048 90049 Rinsing the mouth with salt water 90050 90049 Rinsing the mouth with a solution of baking soda / sodium bicarbonate and water 90050 90049 Application of milk of magnesia to the ulcer after rinsing 90050 90049 Application of ice chips or cubes to the affected area to reduce swelling 90050 90049 Teething ointments containing local anaesthetic to manage pain and discomfort 90050 90049 Reducing stress 90050 90049 Avoiding hard foods or foods that may scratch the interior of the mouth 90050 90069 90004 Nutritional supplements such as Vitamin B-12 capsules, Vitamin D capsules, folate tablets, or zinc tablets can also reduce the risk of developing canker sores.90005 90002 Aphthous ulcers prevention 90003 90004 To lessen the likelihood of an ulcer outbreak, especially for those with a history of recurrent aphthous ulcers (aphthae), a number of measures can be taken. 90005 90048 90049 Avoiding foods that may trigger ulceration in the individual person 90050 90049 Focussing on a healthy, balanced diet containing sufficient amounts of nutrients and vitamins 90050 90049 Maintaining good dental hygiene and using a soft toothbrush to avoid irritation 90050 90049 Reducing stress and getting plenty of sleep 90050 90069 90002 Aphthous ulcers prognosis 90003 90004 Aphthous ulcers (aphthae) are 90009 generally non-serious and will go away without any particular treatment.90010 90005 90004 Ulcers that heal on their own within a few weeks are 90009 not an indication of oral cancer 90010 and are non-infectious. The ulcers, however, can be very painful and inconveniencing, especially if they are recurrent. Many people will find that they stop getting aphthous ulcers as they get older. 90005 90004 90009 Good to know: 90010 If an ulcer or group of ulcers does not heal within three weeks, or lasts for longer than three weeks, the affected person should see a doctor as soon as possible for a proper diagnostic workup.In some cases, a persistent ulcer may indicate oral cancer. 90005 90002 Aphthous ulcers FAQs 90003 90004 90009 Q: Are there any home remedies for aphthous ulcers (aphthae)? 90010 90195 90009 A: 90010 There are a number of popular home remedies for aphthous ulcers, including: 90005 90048 90049 Rinsing the mouth with a warm salt water / saline solution 90050 90049 Applying a small amount of milk of magnesia to the ulcer after rinsing 90050 90049 Sucking ice chips or cubes to reduce swelling 90050 90049 Teething ointments containing local anaesthetic 90050 90049 Avoiding hard foods or foods that may scratch the interior of the mouth or may cause irritation due to their acidic nature, like e.g. pineapple, lemons, oranges or tomatoes while the ulcer sore is present 90050 90049 Reducing stress 90050 90069 90004 90009 Q: Can I get aphthous ulcers (aphthae) in the genital region? 90010 90195 90009 A: 90010 Yes, although oral aphthous ulcers are most common, aphthous ulcers may also appear in the genital region. This is most common in women, with the ulcers normally forming on the vulva or adjacent skin. The ulcers are in most cases of similar appearance to the oral version and may be similarly painful.90005 90004 90009 Q: Is it safe to have oral sex if the performing partner has mouth ulcers? 90010 90195 90009 A: 90010 Mouth ulcers, because they are breaks in the skin inside the mouth, increase the risk of contracting sexually-transmitted infections such as herpes, gonorrhea, syphilis and chlamydia. This risk can be reduced if the receiving partner wears a condom or if a dental dam is used. Good oral care and proper oral hygiene techniques can reduce the chances of developing some mouth ulcers or other breaks in the oral skin.90005 90004 90009 Q: Can smoking cause mouth ulcers? 90010 90195 90009 A: 90010 Smoking can make mouth ulcers worse. The nicotine in cigarette smoke may reduce the amount of blood that flows to the mouth and gums, which may then slow down the healing process for any ulcers, cuts or scrapes inside the mouth. 90009 Slow healing means that the painful period is prolonged and increases the chance of infection. 90010 90005 90004 At the same time, it seems to be the case that smoking may reduce the chance of 90237 developing 90238 mouth ulcers, because it hardens the surface of the epithelial cells in the mouth.90009 However, smoking has many other harmful effects on the body and should be avoided. 90010 90005 90004 90009 Q: What is recurrent aphthous stomatitis (RAS)? 90010 90195 90009 A: 90010 Recurrent aphthous stomatitis (RAS) is the name given to the condition of experiencing frequent bouts of aphthous mouth ulcers (aphthae). Although a single bout of aphthous stomatitis is possible, recurrent episodes are the norm. Episodes of recurrent aphthous stomatitis (RAS) typically occur at intervals of between a few months to a few days and last for between 7 and 10 days at a time.90005 90004 90009 Q: What is the relationship between aphthous ulcers (aphthae) and Behçet syndrome? 90010 90009 A: 90010 Behçet syndrome is characterized by inflammation in various areas of the body. Behçet syndrome is by some experts considered an autoimmune disorder and by others an autoinflammatory disorder. Autoinflammatory disorders, like autoimmune disorders, are caused by an overactive immune system attacking the body’s tissues and causing inflammation. One of Behçet syndrome’s distinguishing symptoms is the presence of aphthous ulceration in the oral cavity (mouth), as well as ulceration on others parts of the body, including the genitals and additionally often present inflammation of part of the eye, called uveitis.Although mouth ulcers are a symptom of Behçet syndrome, mouth ulcers are common, and Behçet Syndrome is rare. Only very few people who experience mouth ulcers are affected by Behçet syndrome. 90005 90004 90009 Q: What is complex aphthosis? 90010 90195 90009 A: 90010 Complex aphthosis is the given name to the condition of having almost constant oral aphthae or recurrent oral and genital aphthae without having Behçet syndrome. When complex aphthosis is suspected, medical attention should be sought for diagnosis and treatment.90005 90004 90009 Q: Can systemic lupus erythematosus cause mouth ulcers? 90010 90195 90009 A: 90010 Mouth ulcers can affect about half of all people with systemic lupus erythematosus, an autoimmune disorder. 90009 Lupus-related ulcers are not aphthous mouth ulcers, and while they may be painful in some people, they are often not painful for many others. 90010 They commonly affect the roof of the mouth, but can also appear on the gums, lips and inside of the cheeks. They resemble aphthous mouth ulcers, being red sores, but may also be more varied in presentation, e.g. some may have a whitish, radiating halo. People with lupus may also experience ulcers in the nose. 90005 90004 90009 Q: Can gastroesophageal reflux disease (GERD / GORD) cause mouth ulcers? 90010 90195 90009 A: 90010 Gastroesophageal reflux disease, commonly known as acid reflux, is a condition in which gastric acid leaks up into the esophagus or, less likely, also into the oral cavity / mouth. If acid enters the mouth, GERD can cause the erosion of tooth enamel and an acidic taste. Mouth ulcers can develop.GERD may also cause a feeling of a sore throat and, in some cases, throat and esophageal inflammation and ulcers may develop. If GERD causes ulcers, they will more likely be found at the back of the mouth, the back of the tongue and the back of the throat, because of the path of the acid coming up from the stomach. 90005 90004 90009 Q: Can chemotherapy cause mouth ulcers? 90010 90195 90009 A: 90010 Yes, chemotherapy often causes mouth ulcers. Chemotherapy can cause inflammation of the mucosal lining of the throat and mouth, leading to sores in the mouth.Technically, if occurring in the mouth, the painful condition and ulcers caused by chemotherapy are known as stomatitis and may be related to mucositis, a condition which affects a larger area of ​​the digestive tract’s mucosal lining. For more information, read this resource on the side effects of chemotherapy. 90005 90004 90009 Q: Can Hepatitis C cause mouth ulcers? 90010 90195 90009 A: 90010 Yes, Hepatitis C or its treatment can sometimes cause mouth ulcers and other mouth conditions, such as tooth decay or a sensitive mouth by e.g. affecting saliva production and causing a dry mouth. Because Hepatitis C is a complex condition, people who have Hepatitis C should consult their care teams regarding any concerns and before starting any treatment program. 90005 90004 90009 Q: Are mouth ulcers a sign of cancer? 90010 90195 90009 A: 90010 A mouth ulcer that does not clear up is sometimes a sign of oral cancer. However, 90009 very few mouth ulcers are a sign of cancer. 90010 Mouth ulcers associated with cancer are generally solitary rather than in clusters and appear without any apparent cause.If a mouth ulcer persists 90009 longer than three weeks, causes symptoms the person can not handle like not being able to eat or drink sufficiently due to pain and / or does not respond to treatment 90010, the affected person should 90009 see a doctor 90010 . 90005 90004 Other symptoms of oral cancer may include: 90005 90048 90049 White or red patches on the gums, cheek lining or tonsils that are persistent or do not get better 90050 90049 Persistent mouth pain 90050 90049 A lump in the cheek 90050 90049 Persistent throat pain 90050 90049 The sensation of something stuck in the throat 90050 90049 Difficulty swallowing, chewing, moving the jaw or moving the tongue 90050 90069 90004 90009 Q: Can aphthous mouth ulcers occur on the gums? 90010 90195 90009 A: 90010 Yes, mouth ulcers can affect the gums.They may also affect the tongue, the inside of the cheeks, and the inside of the lips. 90005 90004 90009 Q: What are the differences between cold sores and canker sores? 90010 90195 90009 A: 90010 Cold sores, also known as herpes labialis, are caused by Herpes Simplex Virus 1 or 2. Aphthous mouth ulcers 90009 are not caused by viruses. 90010 Cold sores primarily affect the corners of the mouth, the lips, the nostrils and the philtrum, the area between the upper lip and the nose. 90005 90004 Cold sores are 90009 extremely contagious.90010 Aphthous mouth ulcers typically affect the inside of the mouth, do not affect the nose and are 90009 not contagious. 90010 90005 .90000 Canker Sores (Aphthous Stomatitis Or Recurrent Mouth Ulcers) 90001 90002 What Is It? 90003 90004 This disease causes painful, round ulcers to develop on the linings of the cheeks and lips, the tongue or the base of the gums. The tendency to develop these ulcers is inherited. Ulcers also can be associated with other diseases, particularly connective tissue diseases such as lupus or Behçet’s syndrome, which cause symptoms on the eyes and genitals as well as the mouth.There can be one or many ulcers at the same time, and they are recurrent, which means they keep returning. Multiple ulcers are scattered across the lining of the mouth, not clustered. Most people get one to three of these lesions at each episode, but a small number of people get more than a dozen ulcers at a time. 90005 90004 The cause of canker sores is not known, but most theories involve an immune abnormality. Certain blood diseases, vitamin and mineral deficiencies, allergies, trauma and Crohn’s disease cause similar ulcers.Canker sores are often confused with cold sores, which are caused by a herpes virus. 90005 90004 Approximately 17% of the population has recurrent aphthous stomatitis, which is classified into three categories: 90005 90010 90011 90012 Minor ulcers 90013 are less than 1 centimeter (slightly less then ½inch) in diameter and do not leave scars. The sores usually heal within two weeks. 90014 90011 90012 Major ulcers 90013 (also called Sutton’s disease) are almost ½ inch or more in diameter, take longer than minor ulcers to heal and may leave scars.90014 90011 90012 Herpetiform ulcers 90013 are clusters of dozens of smaller ulcers. This form is rare. 90014 90023 90004 People tend to have two to six ulcers per episode and have several episodes each year. For most people, canker sores are merely an annoyance, but some people experience large, painful, frequent sores that can reach 2 to 4 centimeters in diameter. The ulcers can interfere with speech and eating and can last for weeks to months, causing significant pain and disability.When they do heal, they may leave scars that can make it more difficult to move the tongue and can destroy oral tissue. 90005 90002 Symptoms 90003 90004 You may feel a burning or tingling sensation in an area of ​​inflammation before an ulcer appears. An ulcer takes two to three days to form completely. The sores are round, shallow and symmetric, which means they are the same on all sides. The are painful. They usually are found on the inner part of the lips and cheeks and the tongue.90029 90005 90002 Diagnosis 90003 90004 Canker sores are the most common recurring oral ulcers and are diagnosed mostly by process of elimination. If the ulcers become more frequent or severe, are accompanied by other symptoms (such as rashes, joint pain, fevers or diarrhea) or are larger than about ½inch in diameter, you should visit your dentist or physician. He or she will try to rule out blood diseases, connective tissue diseases, drug reactions and skin disorders. A biopsy and blood tests may be required to rule out other conditions or diseases.90029 90005 90002 Expected Duration 90003 90004 The painful stage lasts 3 to 10 days, and most canker sores disappear within 2 weeks. 90029 90005 90002 Prevention 90003 90004 There is no way to prevent canker sores. 90029 90005 90002 Treatment 90003 90004 Treatment focuses on relieving symptoms. Rinsing with a warm-water solution and eating bland foods can minimize discomfort. Anesthetic medications or over-the-counter agents that are placed directly on the sores to coat them also may help.90005 90004 People with more severe disease may need steroid medications placed on the lesions. These medications significantly shorten the healing time of the ulcers and prevent them from becoming larger. Other possible treatments include placing a medication called chlortetracycline (Aureomycin) on the sores or injecting steroids into the sores. In very severe, disabling cases, your dentist may prescribe oral medication. 90005 90002 When To Call a Professional 90003 90004 Canker sores usually are painful but are not a significant risk to your health.However, if you have severe, recurring canker sores, or if they are becoming worse, consult your dentist or physician. He or she may do tests to look for blood problems such as anemias or deficiencies of iron, folate or vitamin B12. Some research has shown that canker sores improve when these deficiencies are treated. Persistent or large ulcers can also occur as a part of other, more significant, disorders, including inflammatory bowel disease, connective tissue diseases, drug allergies, arthritic disorders, inflammatory skin disorders and cancer.90005 90002 Prognosis 90003 90004 Most canker sores clear up without treatment and do not leave scars, although they usually return. 90029 90005 90002 Additional Info 90003 90004 90012 American Academy of Family Physicians 90013 90029 Consumer Information Site 90029 11400 Tomahawk Creek Parkway 90029 Leawood, KS 66211-2672 90029 Toll-Free: 1-800-274-2237 90029 E-mail: [email protected] 90029 http: / /familydoctor.org/ 90005 90004 90029 © 2001-2007 Aetna All rights reserved.90005 90004 90005 .90000 aphthous stomatitis and hypersensitivity reactions at Boston University Goldman School of Dental Medicine 90001 Continue with Google 90002 To login with Google, please enable popups 90003 Continue with Facebook 90002 To login with Google, please enable popups 90003 90002 or 90003 90002 Do not have an account? Sign up 90003 Continue with Google 90002 To signup with Google, please enable popups 90003 Continue with Facebook 90002 To signup with Google, please enable popups 90003 90002 or 90003 Sign up with Email 90002 Sign up with Google or Facebook 90003 90002 or 90003 90002 Name 90003 90002 Email 90003 90002 Password 90003 90002 Birthday 90003 ? 90002 To sign up you must be 13 or older.Other people will not see your birthday. 90003 90002 Month January February March April May June July August September October November December 90003 90002 Day 12345678910111213141516171819202122232425262728293031 90003 90002 Year 90003 Sign up .90000 definition of stomatitis by Medical dictionary 90001 90002 Stomatitis 90003 90004 Definition 90005 Inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. The word «stomatitis» literally means inflammation of the mouth. The inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene, poorly fitted dentures, or from mouth burns from hot food or drinks, or by conditions that affect the entire body, such as medications, allergic reactions, or infections .90004 Description 90005 Stomatitis is an inflammation of the lining of any of the soft-tissue structures of the mouth. Stomatitis is usually a painful condition, associated with redness, swelling, and occasional bleeding from the affected area. Bad breath (halitosis) may also accompany the condition. Stomatitis affects all age groups, from the infant to the elderly. 90004 Causes and symptoms 90005 A number of factors can cause stomatitis; it is a fairly common problem in the general adult population in North America.Poorly fitted oral appliances, cheek biting, or jagged teeth can persistently irritate the oral structures. Chronic mouth breathing due to plugged nasal airways can cause dryness of the mouth tissues, which in turn leads to irritation. Drinking beverages that are too hot can burn the mouth, leading to irritation and pain. Diseases, such as herpetic infections (the common cold sore), gonorrhea, measles, leukemia, AIDS, and lack of vitamin C can present with oral signs. Other systemic diseases associated with stomatitis include inflammatory bowel disease (IBD) and Behçet’s syndrome, an inflammatory multisystem disorder of unknown cause.Aphthous stomatitis, also known as recurrent aphthous ulcers (RAU) or canker sores, is a specific type of stomatitis that presents with shallow, painful ulcers that are usually located on the lips, cheeks, gums, or roof or floor of the mouth. These ulcers can range from pinpoint size to up to 1 in (2.5 cm) or more in diameter. Though the causes of canker sores are unknown, nutritional deficiencies, especially of vitamin B 90010 12 90011, folate, or iron is suspected. Generalized or contact stomatitis can result from excessive use of alcohol, spices, hot food, or tobacco products.Sensitivity to mouthwashes, toothpastes, and lipstick can irritate the lining of the mouth. Exposure to heavy metals, such as mercury, lead, or bismuth can cause stomatitis. Thrush, a fungal infection, is a type of stomatitis. 90004 Diagnosis 90005 Diagnosis of stomatitis can be difficult. A patient’s history may disclose a dietary deficiency, a systemic disease, or contact with materials causing an allergic reaction. A physical examination is done to evaluate the oral lesions and other skin problems.Blood tests may be done to determine if any infection is present. Scrapings of the lining of the mouth may be sent to the laboratory for microscopic evaluation, or cultures of the mouth may be done to determine if an infectious agent may be the cause of the problem. 90004 Treatment 90005 The treatment of stomatitis is based on the problem causing it. Local cleansing and good oral hygiene are fundamental. Sharp-edged foods such as peanuts, tacos, and potato chips should be avoided. A soft-bristled toothbrush should be used, and the teeth and gums should be brushed carefully; the patient should avoid banging the toothbrush into the gums.Local factors, such as ill-fitting dental appliances or sharp teeth, can be corrected by a dentist. An infectious cause can usually be treated with medication. Systemic problems, such as AIDS, leukemia, and anemia are treated by the appropriate medical specialist. Minor mouth burns from hot beverages or hot foods will usually resolve on their own in a week or so. Chronic problems with aphthous stomatitis are treated by first correcting any vitamin B 90010 12 90011, iron, or folate deficiencies.If those therapies are unsuccessful, medication can be prescribed which can be applied to each aphthous ulcer with a cotton-tipped applicator. This therapy is successful with a limited number of patients. More recently, low-power treatment with a carbon dioxide laser has been found to relieve the discomfort of recurrent aphthae. Major outbreaks of aphthous stomatitis can be treated with tetracycline antibiotics or corticosteroids. Valacyclovir has been shown to be effective in treating stomatitis caused by herpesviruses.90018 Patients may also be given topical anesthetics (usually a 2% lidocaine gel) to relieve pain and a protective paste (Orabase) or a coating agent like Kaopectate to protect eroded areas from further irritation from dentures, braces, or teeth. 90019 90004 Alternative treatment 90005 90018 Alternate treatment of stomatitis mainly involves prevention of the problem. Patients with such dental appliances as dentures should visit their dentist on a regular basis. Patients with systemic diseases or chronic medical problems need to ask their health care provider what types of oral problems they can expect from their particular disease.These patients must also contact their medical clinic at the first sign of problems. Common sense needs to be exercised when consuming hot foods or drinks. Use of tobacco products should be discouraged. Alcohol should be used in moderation. Mouthwashes and toothpastes known to the patient to cause problems should be avoided. 90019 90018 Botanical medicine can assist in resolving stomatitis. One herb, calendula (90025 Calendula officinalis 90026), in tincture form (an alcohol-based herbal extract) and diluted for a mouth rinse, can be quite effective in treating aphthous stomatitis and other manifestations of stomatitis.90019 90018 More recently, a group of researchers in Brazil have reported that an extract made from the leaves of 90025 Trichilia glabra 90026, a plant found in South America, is effective in killing several viruses that cause stomatitis. 90019 90004 Prognosis 90005 90018 The prognosis for the resolution of stomatitis is based on the cause of the problem. Many local factors can be modified, treated, or avoided. Infectious causes of stomatitis can usually be managed with medication, or, if the problem is being caused by a certain drug, by changing the offending agent.90019 90004 Prevention 90005 90018 Stomatitis caused by local irritants can be prevented by good oral hygiene, regular dental checkups, and good dietary habits. Problems with stomatitis caused by systemic disease can be minimized by good oral hygiene and closely following the medical therapy prescribed by the patient’s health care provider. 90019 90004 Resources 90005 90042 Books 90043 90018 Beers, Mark H., MD, and Robert Berkow, MD., Editors. «Disorders of the Oral Region.» In 90025 The Merck Manual of Diagnosis and Therapy 90026.Whitehouse Station, NJ: Merck Research Laboratories, 2004. 90019 90042 Periodicals 90043 90018 Cella, M., D. A. Riva, F. C. Coulombie, and S. E. Mersich. «Virucidal Activity Presence in 90025 Trichilia glabra 90026 Leaves.» 90025 Revista Argentina de microbiologia 90026 36 (July-September 2004): 136-138. 90019 90018 Miller, C. S., L. L. Cunningham, J. E. Lindroth, and S. A. Avdiushko. «The Efficacy of Valacyclovir in Preventing Recurrent Herpes Simplex Virus Infections Associated with Dental Procedures.»90025 Journal of the American Dental Association 90026 135 (September 2004): 1311-1318. 90019 90018 Mirowski, Ginat W., DMD, MD, and Christy L. Nebesio.» Aphthous Stomatitis. «90025 eMedicine 90026 September 24, 2004. 90063 http://www.emedicine.com/derm/topic486.htm 90064. 90019 90018 Sciubba, James J., DMD, PhD. «Denture Stomatitis.» 90025 eMedicine 90026 June 11, 2002. 90063 http: // www. emedicine.com/derm/topic642.htm 90064. 90019 90018 Shulman, JD, MM Beach, and F. Rivera-Hidalgo.»The Prevalence of Oral Mucosal Lesions in U.S. Adults: Data from the Third National Health and Nutrition Examination Survey, 1988-1994.» 90025 Journal of the American Dental Association 90026 135 (September 2004): 1279-1286. 90019 90018 Wohlschlaeger, A. «Prevention and Treatment of Mucositis: A Guide for Nurses.» 90025 Journal of Pediatric Oncology Nursing 90026 21 (September-October 2004): 281-287. 90019 90042 Organizations 90043 90018 American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611.(312) 440-2500. 90063 http://www.ada.org 90064. 90019 90018 American Medical Association. 515 N. State St., Chicago, IL 60612. (312) 464-5000. 90063 http://www.ama-assn.org 90064. 90019 90004 Key terms 90005 90063 Aphthous stomatitis 90064 — A specific type of stomatitis presenting with shallow, painful ulcers. Also known as 90025 canker sores 90026. 90063 Stomatitis 90064 — Inflammation of the lining of the mouth, gums, or tongue. 90063 Thrush 90064 — A form of stomatitis caused by 90025 Candida 90026 fungi and characterized by cream-colored or bluish patches on the tongue, mouth, or pharynx.90002 stomatitis 90003 (sto-ma-tit’is) [90063 stomato- 90064 + 90063 -itis 90064] 90108 90109 90018 STOMATITIS: As caused by herpes simplex virus 90019 Inflammation of the mouth (including the lips, tongue, and mucous membranes) . See: 90025 illustration 90026; noma; thrush 90004 Etiology 90005 90018 Stomatitis may be associated with viral infections, chemical irritation, radiation therapy, mouth breathing, paralysis of nerves supplying the oral area, chemotherapy that damages or destroys the mucous membranes, adverse reactions to other medicines, or acute sun damage to the lips.The nasal and oral mucosa are esp. vulnerable to trauma from dental appliances, nasal cannula, nasotracheal tubes, or catheters administering nutrients. These areas may also be damaged during surgery when an endotracheal tube is in place. 90019 90004 Symptoms 90005 90018 Symptoms include oral pain, esp. when eating or drinking, bad breath, or difficulty in swallowing. Findings include oral ulcers, friability of the mucous membranes, swollen cervical lymph nodes, and sometimes fever. 90019 90004 Patient care 90005 90018 Treatment depends on the cause but is often symptomatic.The mucous membranes should be kept moist and clear of tenacious secretions. Care of the teeth and gingival tissues should be comprehensive and include flossing. The pain of stomatitis may be alleviated by systemic analgesics or application of anesthetic preparations to painful lesions. It is important for patients with dentures to clean their dentures thoroughly. Dentures should be removed from unconscious or stuporous patient. See: toothbrushing 90019 90004 aphthous stomatitis 90005 Aphthous ulcer.90004 corrosive stomatitis 90005 90018 Stomatitis resulting from intentional or accidental exposure to corrosive substances. 90019 90004 denture stomatitis 90005 Stomatitis on the oral mucosa covered by full or partial dentures, most commonly seen on the palate although the inflammation may also be seen overlying the mandible. 90042 Patient care 90043 90018 Although most patients are asymptomatic (the finding is noticed by dental professionals during oral examination, rather than by the patient), the condition should be treated to prevent progression to more serious oral diseases.Removal of plaque from dentures (as by brushing them carefully), removal of dentures at night, and sanitizing dentures regularly (as with an overnight soak in a chlorhexidine solution) all prevent the condition from occurring. Antifungal medications are used if fungi are isolated on culture swabs. 90019 Synonym: chronic atrophic candidiasis 90004 diphtheritic stomatitis 90005 90018 Stomatitis caused by infection with 90025 Corynebacterium diphtheriae 90026. 90019 See: diphtheria 90004 herpetic stomatitis 90005 90018 Stomatitis seen with primary infection with herpes simplex virus.90019 90004 major aphthous stomatitis 90005 90018 Stomatitis in which large recurring or migrating painful ulcers appear within the oral cavity (on the gingiva and soft palate) and sometimes on the lips. 90019 90004 membranous stomatitis 90005 90018 Stomatitis accompanied by the formation of a false or adventitious membrane. 90019 90004 mercurial stomatitis 90005 90018 Stomatitiss seen in those exposed to elemental mercury or mercury vapors. 90019 90004 mycotic stomatitis 90005 Thrush. 90004 nicotine stomatitis 90005, 90063 stomatitis nicotina 90064 90018 Fissuring and the formation of hyperkeratotic papules on the palate, usually caused by habitual pipe smoking.It is a form of precancer. 90019 90004 simple stomatitis 90005 90018 Stomatitis occurring in patches on the mucous membranes. 90019 90004 traumatic stomatitis 90005 90018 Stomatitis resulting from mechanical injury as from ill-fitting dentures, sharp jagged teeth, or biting the cheek. 90019 90004 ulcerative stomatitis 90005 Necrotizing ulcerative gingivitis. 90004 vesicular stomatitis 90005 Aphthous ulcer. 90004 Vincent stomatitis 90005 Necrotizing ulcerative gingivitis. .