stomatitides

Causes. The causes of stomatitis vary widely, from a mild local irritant to a vitamin deficiency or infection by a possibly dangerous disease-producing organism. Inflammation may arise from actual injury to the inside of the mouth, as from cheek-biting, jagged teeth, tartar accumulations, and badly fitting dentures. Irritating substances, including alcohol, and tobacco, may also cause stomatitis. Other causes are infectious bacteria, such as streptococci and gonococci or those causing necrotizing ulcerative stomatitis, diphtheria, and tuberculosis; the fungus causing thrush; or the viruses causing herpes simplex and measles. Extreme vitamin deficiencies can result in mouth inflammation, as can certain blood disorders. Poisoning with heavy metals, such as lead or mercury, can also cause stomatitis.

Symptoms. There is generally swelling and redness of the tissues of the mouth, which may become quite sore, particularly during eating. The mouth may have an unpleasant odor. In some types of stomatitis the mouth becomes dry, but in others there is excessive salivation. Ulcerations may appear, and, in extreme cases, gangrene (gangrenous stomatitis).

Other forms of stomatitis may occasionally cause more severe symptoms, including chills, fever, and headache. Sometimes bleeding or white patches in the mouth can be seen. In thrush, the symptoms themselves may be slight (white spots in the mouth resembling milk curds) but the disease may give rise to serious infections elsewhere in the body. In some cases, stomatitis causes inflammation of the parotid glands.

Stomatitis resulting from certain diseases presents special identifying symptoms. Syphilitic stomatitis produces painful ulcers in the mouth; in scarlet fever the tongue first has a strawberry color, which then deepens to a raspberry hue; in measles, Koplik's spots appear.

Treatment and Prevention. The treatment varies according to the cause. When the inflammation is caused by anemia, vitamin deficiency, or any infection of the body, both the underlying disease and the stomatitis are treated. Antibiotics often are effective against the infection and prevent its spreading to the parotid glands. Severe stomatitis can be a side effect of chemotherapy and radiation to the head and neck as treatment for cancer. Measures to alleviate the inflammation and promote healing include increasing fluid intake and using artificial saliva to minimize dryness and help buffer acidity in the mouth, avoiding liquids and foods that are chemically irritating or extremely hot, and frequent and consistent mouth care.



With proper care, many cases of stomatitis can be prevented. Cleanliness is essential, especially of the mouth, teeth, dentures, and feeding utensils. Infants may acquire mouth infection from the mother's oral flora, dirty bottles, or the mother's nipples. In the case of a prolonged fever or of any severe general illness, dryness of the mouth should be avoided by ingestion of increased amounts of fluids.