STOMATITIS

Stomatitis - inflammation of the oral mucosa. It can have a traumatic, infectious, allergic origin, arise as a result of intoxication with salts of heavy metals. Inflammatory changes in the mucous membrane of the oral cavity are possible with hypovitaminosis, endocrine disorders, diseases of the gastrointestinal tract, cardiovascular and nervous system, blood, diffuse connective tissue diseases. Often they are ahead of the appearance of the main symptoms, so the presence of stomatitis requires a thorough examination. Traumatic stomatitis develops as a result of a mechanical trauma of the oral mucosa, including when it is injured by sharp edges of the teeth, dentures, dental stones or the effects of chemicals, hot food, ionizing radiation on it. First, there is catarrhal inflammation of the mucous membrane with edema and hyperemia, then erosion and a painful ulcer, surrounded by inflammatory infiltration, which can subsequently be complicated by a purulent infection or candidiasis. The prolonged action of a weak traumatic factor, such as a poorly fitted denture, can lead to hypertrophy of the mucosa and the appearance of papillomatous growths on them. The diagnosis is made on the basis of a characteristic clinical picture. Treatment consists in eliminating the traumatic factor, treating the oral cavity with solutions of antiseptics (preferably plant origin). With a sharp pain, applications of painkillers are shown. A thorough sanitation of teeth is necessary. If the cause of stomatitis is the exposure of chemicals, as an emergency aid, rinsing of the oral cavity with water or neutralizing solutions is prescribed, and preparations that promote epithelialization are additionally used. The prognosis is favorable. However, there are cases of development of leukoplakia, malignancy of ulcers.

Infectious stomatitis can be one of the manifestations of a number of common infectious diseases, in which the oral mucosa is involved in the pathological process. The most common acute herpetic stomatitis, which is considered as a manifestation of primary infection of the oral cavity with herpes simplex virus. It occurs mainly in children. The mucous membrane of the oral cavity is edematic, hyperemic, with a large number of small vesicles rapidly turning into erosion, covered with bloom. Characterized by acute catarrhal gingivitis. There is an increase in body temperature to 38 - 40 ° C, an increase in ESR up to 20 mm / h, and leukopenia . Lechenie consists in the appointment of funds that stimulate the body's defenses (prodigiozana, lysozyme), the oral cavity is treated with antiseptic solutions, preparations of proteolytic enzymes. The prognosis is favorable. Prevention is the timely conduct of anti-epidemic measures (isolation of the sick, etc.).

Vesicular stomatitis causes one of the rhabdoviruses, which is transmitted to a person from sick pets or people by food or airborne droplets. Vesicular stomatitis resembles a flu-like infection. The incubation period is 1-5 days. The disease begins with a sudden rise in body temperature, the appearance of pain in the joints, muscles, headache. On the third day from the onset of the disease, vesicles (vesicles) form on the oral mucosa, which persist for 10-12 days and are subsequently transformed into erosion. The diagnosis is made on the basis of the clinical picture and the results of a virological study of washings from the nasopharynx and the contents of the vesicles. Treatment is carried out with antiviral drugs (oxoline, tebrofenovaya, redoxol ointment, etc.), rinses are prescribed, the oral cavity is treated with antiseptic solutions. The prognosis is favorable. Prevention is to comply with the rules of personal hygiene and hygiene rules for keeping pets.

Vincent's ulcerative-necrotic stomatitis (ulcerative stomatitis, ulcerative-membranous stomatitis, fusospirochetozny stomatitis, ulcerative gangrenous stomatitis, Plauta-Vincent's stomatitis) causes a spindle-shaped bacterium in symbiosis with the usual spirochaete of the oral cavity. The emergence of the disease contributes to a decrease in the general resistance of the body, vitamin deficiency. The disease is characterized by the appearance of erosions or ulcers, an increase in body temperature to 37.5 - 38 ° C, there are soreness and bleeding gums, hypersalivation, putrefactive odor from the mouth. The process often begins with the gingival margin, then spreads to other parts of the oral mucosa. The diagnosis is established on the basis of a characteristic clinical picture and the results of bacteriological examination of scrapings from the surface of ulcers. In the treatment of crucial importance are the careful removal of calculus and soft plaque, treatment of the oral mucosa with antiseptic solutions, the administration of multivitamins inside. The prognosis for timely treatment is favorable. Prevention is the maintenance of oral hygiene.

Allergic stomatitis can manifest itself in the form of catarrhal, hemorrhagic, vesical-erosive, ulcerative-necrotic, and also combined lesions. The process can be diffuse or localized in a limited area of ​​the mucosa. When allergies to various medications, which are most often found in dental practice, the lesion is usually catarrhal or catarrhal-hemorrhagic. Patients complain of burning sensation, itching, dry mouth, soreness when eating. The mucous membrane of the oral cavity is edematic, hyperemic, sometimes there is atrophy of the tongue papillae (the so-called lacquered tongue). The diagnosis is based on the history, clinical picture, as well as (if necessary) the results of special allergological studies conducted in specialized institutions. Treatment involves eliminating the allergenic factor, the appointment of desensitizing agents. In severe cases, patients are hospitalized. In a hospital prescribe a drip infusion of hemodesy, polyglucin, isotonic sodium chloride solution, as well as corticosteroid preparations. The prognosis with adequate treatment is favorable.

Infectious-allergic nature has aphthous stomatitis , characterized by the appearance on the mucous membrane of the oral cavity of single painful aft - small round formations, emerging from the bubbles and turning into erosion or sores, covered with a fibrinous film and surrounded by a red rim. Aphids are located more often on the lateral surfaces and tip of the tongue, the mucous membrane of the lips, cheeks, bottom of the mouth, hard palate. Their appearance is accompanied by sharp painfulness, a violation of salivation, an increase in regional lymph nodes, and sometimes an increase in body temperature. On average, the development of aphthae occurs within 7-10 days, the healed aphtha traces do not leave. The disease can have a recurring course. Relapses are observed mainly in spring and autumn. The severity of recurrent aphthous stomatitis increases with time, the number of emerging aphthas increases, the healing period extends to 2-4 weeks, relapses increase (sometimes there are no remissions at all), ulcers that do not heal 2-3 months may appear on the site of aft. Aphthous stomatitis often accompanies diseases of the gastrointestinal tract, it can be a manifestation of generalized aphthosis, or Behcet's disease, in which the conjunctiva, the mucous membrane of the genital organs, etc., are also affected. Diagnosis is based on a characteristic clinical picture. Treatment of aphthous stomatitis is complex and strictly individual. In the detection of hypersensitivity to any allergen, specific and non-specific hyposensitizing therapy is prescribed. The sanation of the oral cavity is carried out, local anesthetics and proteolytic enzymes, dog-rose or sea-buckthorn oil are applied locally. The prognosis is favorable. Prevention is to eliminate allergic factors.

Stomatitis with intoxication with salts of heavy metals. With mild intoxication with salts of lead, bismuth, mercury, catarrhal stomatitis usually occurs with areas of pigmentation on the mucous membrane of the oral cavity (primarily the gingival margin). In severe cases, ulcers develop, characterized by persistent flow. In addition to soreness, the violation of salivation and a sense of metallic taste in the mouth of patients are concerned about weakness, digestive disorders and other signs of intoxication. Treatment is the same as with traumatic stomatitis, but it is carried out against the background of detoxification therapy.