Common Causes of Stomatitis, a Painful Inflammatory Condition
The mouth with all its various parts is one of the most sensitive — and useful — parts of the body. It’s where you experience the sublime taste of your favorite gelato and what you use to kiss your baby on the forehead, not to mention where you take care of the crucial functions of breathing and hydrating. So when something goes wrong there, it can be very painful and impact several aspects of your daily life.
That’s why it’s so important to know about stomatitis, inflammation of the mucous lining the mouth, which can affect the tongue, gums, lips, roof, and floor of the mouth. “This inflammation can cause discomfort, redness and swelling, making activities like eating and speaking more difficult,” says Karen Man, DDS, a dentist and owner of SmileGrove Dental in Oakville, Ontario. In addition to sores, blisters and ulcers, stomatitis can cause discoloration of the inner lips, inner cheeks, and tongue, adds Brynna Connor, MD, a family medicine specialist in Austin, TX, and healthcare ambassador at NorthWestPharmacy.com.
Inflammation is the body’s natural response to injury or infection, explains Dr. Man. “When the mucous membranes in the mouth are irritated or damaged, the immune system increases blood flow to the area to promote healing, and this leads to redness and swelling,” she explains. In addition, “chemical mediators released during inflammation can stimulate nerve endings, causing pain or discomfort," she says. "In some cases, ulcers or sores may form. These symptoms are your body's way of signaling that something isn't right.”
Different types of stomatitis
Stomatitis can manifest in different locations and with different symptoms, depending on the cause of the damage. Common types include:
Canker sores
Officially known as aphthous ulcers, these are small sores that appear inside your mouth, commonly on the inner lip, but sometimes on the roof of your mouth or under your tongue. They are typically white or yellowish with a red border. Canker sores are not contagious, but can feel very uncomfortable, with a burning or tingling sensation, making it difficult to eat or speak. “Canker sores can be caused by trauma to the mucosal membranes, oral hygiene issues, poor nutrition, and/or stress,” says Dr. Connor. It's estimated that 20% of the population experiences this type of recurrent stomatitis.
Cold sores
These fluid-filled blisters appear on the lips as a symptom of an oral herpes infection. Unlike canker sores, cold sores are contagious. Once you are infected with the herpes simplex virus (HSV), the virus remains in your system and cold sores can appear at any time
Thrush
This fungal infection is most common in babies, toddlers and children; adults over 65; and people with a weakened immune system, but can affect anyone. It causes white, creamy lesions in the tongue and cheeks that may result in irritation, a cottony feeling and difficulty eating.
Angular cheilitis
This form of stomatitis causes irritation and cracks in the corners of your mouth. It may be caused by a fungal or bacterial infection, or excessive moisture, says Dr. Man.
Denture stomatitis
This type of stomatitis occurs in people who wear dentures (as many as 80% of denture wearers may experience this at some point). The risk increases if your dentures don't fit well, or you don't clean them properly or often enough, which causes Candida-containing polymicrobial biofilms to emerge on your mucosa.
Causes
Anything that irritates the mucosa in the mouth can cause stomatitis. This includes:
Viruses
Gum disease
Irritation from dentures or braces
Biting your cheek
Burning your mouth with hot food
Smoking or chewing tobacco
Allergic reactions to food
Excessive alcohol
Excessive stress
Hormonal changes due to pregnancy or menopause
Reaction to certain medications, including chemotherapy and some drugs for rheumatoid arthritis or epilepsy
According to Dr. Man, systemic illnesses such as diabetes, autoimmune diseases and GI disorders such as Crohn’s disease can also manifest in symptoms in the mouth. In addition, some cases of stomatitis may be caused by vitamin deficiencies (such as vitamin B), says Maria Cespedes, DDS, of Edition Dental in Toronto. In some cases, angular cheilitis can a sign of sleep apnea. “There are other reasons why they occur, and deciphering the reason for them must be done on a case-by-case basis because every case is different,” Dr. Cespedes adds.
Is stomatitis ever a sign of systemic inflammation?
“Diseases like inflammatory bowel disease, celiac disease or autoimmune disorders such as lupus can have oral manifestations, including stomatitis. This means that inflammation in the mouth may be connected to inflammation elsewhere in the body. If you're experiencing recurrent mouth sores or inflammation along with other symptoms, it's crucial to consult with your doctor or dentist to explore underlying causes,” says Dr. Man.
Additional signs of inflammation include:
Swelling: lump, bump or enlarged area
Redness: discoloration may occur when blood vessels dilate
Heat: an affected area feels warm when touched
Pain: can be constant or just when the area is touched
Loss of function: difficulty moving a joint, an infection in the lungs, immobility
Treatment
Treatment depends on the source of the inflammation. Medications include antivirals, antibiotics, and antifungals to get to the source of the inflammation.
To soothe symptoms, you may use:
Pain medications such as ibuprofen or acetaminophen
Antimicrobial mouthwash
Corticosteroid gels
Anesthetic rinses
Salt water rinses
Prevention is also key. “If you’re prone to stomatitis, make sure you’re properly and adequately brushing your teeth, avoiding salty, spicy, and/or acidic foods and avoiding carbonated and caffeinated drinks as well as alcohol,” says Dr. Connor.
Bottom line
“Typically, these conditions aren't dangerous, but they can be incredibly painful," adds Dr. Cespedes. "They can fade on their own, but the pain could be enough to send you to a doctor or dentist."
You Might Also Like
