Stomatitis refers to an inflammatory process that affects the mouth.
It can be acute or chronic and affect males or females of any age.
The most sensitive areas are: the inside of the cheeks, the palate, the tongue, the gums and the lips.
Symptoms affect only the mucous membrane of the oral cavity and are accompanied by one or more of the following manifestations:
- Painful minor ulcers (canker sores).
- Gingivitis.
- Glossites.
- Cheilitis.
The pain caused by stomatitis can compromise diet and nutritional status (dehydration and malnutrition).
The published material is intended to allow quick access to general advice, suggestions and remedies that doctors and textbooks usually dispense for the treatment of Stomatitis; such indications must in no way replace the opinion of the treating physician or other health specialists in the sector who are treating the patient.
What to do
- Promptly recognize stomatitis: although it is a mild disorder, it is extremely annoying and, if left untreated, it can worsen. Symptoms are: pain (especially when eating, talking or brushing your teeth), hypersensitivity to heat and spiciness, swelling, redness, pustules, canker sores, mouth ulcers (canker sores) and sometimes blood loss.
- Differentiate stomatitis from lip ulcers caused by herpes simplex, which instead appear outside the oral cavity and are contagious. Ulcers associated with stomatitis, on the other hand, cannot be transmitted.
NB. The diagnosis is of medical interest
- Look for the triggering causes and establish a specific cure (remembering that many stomatitis are defined as idiopathic):
- Food intolerances or allergies (even from contact): eliminate the allergen or the non-tolerated molecule.
- Nutritional deficiencies: follow a proper diet.
- High psycho-physical stress: resizing habits and lifestyle to reduce stress.
- Reduction of oral immune defenses: it is impossible to increase localized immunity; therefore, in addition to following some rules that allow you to improve all the body's defenses, there are no other opportunities.
- Endocrine, metabolic and autoimmune disorders: the solution consists in treating the disease in question; in this case, stomatitis represents a secondary objective.
- Taking medication: if possible, it is necessary to replace the drug responsible for the stomatitis with another that is well tolerated.
- Chemically or physically irritating agents: should be avoided but sometimes not possible. A prime example is mobile dental prostheses.
- It is known that the presence of a genetic polymorphism that increases the concentration of two inflammation factors (IL-1 and TNF-alpha) is related to the presence of stomatitis. In this case it is not possible to intervene in any way on the primary cause.
- Infections: although the mouth should have sufficient immunity to fight infections, it is still necessary to adopt correct oral hygiene to reduce the concentration of pathogens (bacteria, fungi, viruses).
- Use antiseptic mouthwashes: useful for disinfecting the oral cavity.
- Taking over-the-counter medications: they help relieve symptoms (see below).
What NOT to do
- Ignore the first symptoms and risk aggravation.
- Do not contact your doctor to make a diagnosis and differentiate the disorder from Herpes simplex: the risk is to follow an ineffective therapy or to promote the infection of Herpes.
- Forget the research tests for allergies and intolerances.
- Continue with the use or intake of products responsible for adverse reactions.
- Eating an unbalanced diet that is potentially responsible for nutritional deficiencies.
- Follow periods of high psycho-physical stress.
- Neglecting or inappropriately treating endocrine, metabolic and autoimmune disorders.
- Continue taking poorly tolerated medications.
- Use chemically or physically irritating products.
- Not respecting proper oral hygiene.
- Not adhering to drug therapy (over-the-counter or prescribed).
- Consume foods and drinks that are harmful or that worsen symptoms.
- To smoke.
What to eat
- Foods rich in nutrients whose deficiency can promote stomatitis or which can optimize the immune system:
- Iron: muscle tissue of terrestrial and aquatic animals (horse, bovine, swine, avian, fish, whole molluscs, whole crustaceans, etc.), eggs (any, especially the yolk), offal and fifth quarter (especially spleen and liver, but also marrow, diaphragm, heart, etc.).
- Zinc: fish, red meat, cereals, legumes and dried fruit.
- Vitamin C: Peppers, citrus, parsley, kiwi, lettuce, pineapple, broccoli, chicory, new potatoes, tomatoes, cap, cherries, strawberries etc. Fresh and possibly raw.
- Folic acid: liver, vegetables (e.g. tomatoes), fruit (orange, apple, etc.) and legumes (e.g. beans).
- Vitamin B12: the same foods as a source of heme iron;
- Vitamin B1: legumes and whole grains, liver, kidney and other offal.
- Vitamin B5: offal, eggs, whole grains and mushrooms.
- Vitamin PP: meat, offal and fishery products; cereals contain moderate quantities.
- Vitamin D: fish, fish oil and egg yolk.
- Probiotics: they are mainly contained in fermented foods such as yogurt, tofu, tempeh, buttermilk etc.
What NOT to Eat
There are some products related to the onset of stomatitis or the worsening of symptoms:
- Alcoholic.
- Coffee and drinks or foods that contain high amounts.
- Very hot food and drinks.
- Spicy foods.
- In case of celiac disease it is strictly necessary to exclude gluten from the diet
Natural Cures and Remedies
- Herbal medicine: there are plants with officinal action, phytotherapeutic remedies and food supplements able to reduce the symptoms of stomatitis and prevent its onset:
- Immunostimulating plants to be taken in the form of herbal tea or extract: Androgafis, Astragalus, Echinacea, Eleutherococcus, Mistletoe, Uncaria, Cordyceps, Garlic, Aloe gel, Turmeric
- Calendula: anti-inflammatory and healing.
- Currants: anti-inflammatory action.
- Rosehip: contains vitamin C in high concentration.
- Lemon: disinfectant properties and contains vitamin C.
- Propolis: Antiseptic property.
- Immunostimulating food supplements:
- Vitamin C: immunostimulating and antioxidant: accelerates the healing of oral ulcers.
- Vitamin D: immunostimulating.
- Probiotics: they are based on bifidobacteria and lactobacilli. To be taken on an empty stomach for at least two weeks.
Pharmacological treatment
- Medicated mouthwashes (by prescription) that contain specific molecules:
- Dexamethasone: corticocosteroid able to relieve the typical symptoms of inflammation (swelling, pain, heat).
- Tetracycline: antibacterial inhibitor of protein synthesis (especially indicated in case of aphthous ulcers).
- Nystatin: antibiotic inhibiting the functions of the cytoplasmic membrane; it binds to the membrane of the pathogen and neutralizes it.
- Diphenhydramine: antihistamine and local anesthetic.
- Anti-inflammatory: in the form of ointment or gel to be applied locally:
- Dexamethasone: for example Soldesan ®.
- Triamcinolone: for example Kenacort ®.
- Amlexanox: for example Amlenox ® and Aphthasol ®.
- Antibiotics, antifungals or antivirals: to be taken in case of infection and on the advice of a doctor.
- Anesthetics and pain relievers, to relieve the sensation of pain related to the presence of the lesion:
- Sucralfate: for example Dermamed ®.
- Lidocaine: for example Luan ®.
- Protective or barrier medications.
Prevention
- It affects the triggering cause. Obviously it is not possible to predict the onset of a disease, except for cases in which there is a previous clinical history.
- More generally:
- Respect a thorough oral hygiene.
- Use the toothbrush.
- Use mouthwash.
- Follow a balanced diet free of non-tolerated molecules.
- Limit alcohol consumption.
- Not smoking.
- Avoid chemical and physical stress with an irritating action (for example correcting dental prostheses).
Medical Treatments
There are no medical treatments for stomatitis. The only exception is made up of dental interventions and corrections, but these are valid only if the stomatitis is caused by an attached problem.
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