How to cure stomatitis

A common disorder that can ruin the time of the meal: here’s how to treat it in a few simple steps.

Aphthous stomatitis is one of the most common disorders of the oral cavity.

It affects between 5 and 25% of the population, both children and adults, and is even more common in people aged between 10 and 40 years. Women are the most affected.

It is undoubtedly a painful disease, which can make meal time a real problem, especially during the consumption of certain foods, first of all those with a high degree of acidity.

What is stomatitis?

It is an inflammation that manifests itself with the appearance of canker sores, or small painful ulcers that, in most cases, are located mostly at the level of the mucous membrane of the mouth.

In particular, these lesions can form:

• on the inside of the cheeks,
• at the base of the gums,
• on the palate,
• on the language,
• on the lips (sometimes).

They are divided into minor, major and herpetiform according to their size, but to characterize them is also the diffusion: in fact, if the first type is very frequent (so much so that it is estimated to be the most widespread condition in the world), the remaining two, which cause discomfort and intense pain, are less widespread.

To the eye, the minor canker sores appear as small abrasions of a few millimeters, round or oval. The whitish color, sometimes surrounded by an erythematous halo of red color, allows them to be easily identified with the naked eye. They can occur singly or grouped in small clusters and tend to heal within 10 days.

The appearance of the actual lesion is often anticipated, in the previous days, by a feeling of discomfort or burning.

Pain during meals: the symptoms of stomatitis

The main manifestation of this disease is represented precisely by the appearance of canker sores, which can provoke a number of symptoms:

• pain, sometimes very strong, which becomes intense, making it difficult to eat (especially when ingesting very acidic foods, including for example tomato) and in some cases even talk,
• reddening
• burning
• fever, in case of very large canker sores, e.g. with a diameter of more than 1 cm,
• swelling of the lymph nodes below the jaw.

How to detect stomatitis: diagnosis

To make a diagnosis of stomatitis, physical examination, i.e. observation of canker sores during the medical examination, is sufficient.

However, some specialists may order blood tests and, in the case of major canker sores, even a biopsy that allows a sample to be examined in the laboratory to rule out other pathologies. Some forms of vitamin deficiency, in fact, can manifest themselves with symptoms similar to those of aphthous stomatitis.

In addition, as we will see below, there are several pathologies that can cause the formation of these typical ulcers.

The causes of stomatitis

To date, it is still not entirely clear what triggers stomatitis. Experts suspect that this is a combination of factors that contribute to the formation of canker sores.

Probably, there is a genetic predisposition, since often those who suffer from this discomfort have a family history behind them.

As with many diseases, however, it is the environment and personal habits that largely influence our body, and therefore sometimes the weakening of the immune system (perhaps due to a bad flu, a period of stress, or the intake of antibiotics) is sufficient to favor the onset of this annoying disorder.

But that’s not all. Among the elements that can stimulate the appearance of these ulcers, there are:

– trauma and small wounds due to excessive brushing when brushing your teeth or an accidental bite;

– intolerances or allergies to certain foods, such as chocolate, coffee, strawberries, eggs, nuts, cheese and acidic or spicy foods;

– tobacco and chemical irritants;

– diet deficient in vitamin B12, zinc, folate or iron;

– viral infections (and in particular Helicobacter pylori infection);

– infectious agents such as bacteria and fungi (among which we remember the Candida albicans);

– drop in certain hormones during the menstrual cycle or pregnancy;

– emotional stress;

– chronic inflammatory bowel diseases (for example, Crohn’s disease, ulcerative colitis);

– immunodeficiency and immunosuppressive drugs;

– systemic diseases such as diabetes and celiac disease.

Finally, the occurrence of ulcerations similar to severe canker sores, but wider and deeper, is the first symptom of Behcet’s disease, an inflammation of blood vessels of genetic origin and chronic course, while the appearance of bubble-like lesions on the oral mucosa is – along with pharyngitis, periodic fever and adenitis – one of the manifestations of Sweet’s syndrome, an acute dermatosis with causes not yet known.

Risk factors: the role of stress

Although there are many causes and risk factors that can play a role in the onset of this disease, the most accredited hypothesis is that stress is the master.

It is easy to notice that canker sores are more frequent during particularly strenuous periods, from a physical or emotional point of view, such as university exam sessions or situations of intense pressure at work.

This is a characteristic that stomatitis has in common with Herpes simplex virus type 1 (HSV-1) infections: even in this case, in fact, stress seems to be one of the triggering factors in particular of cold sores, commonly known as “lip fever”.

Unlike the latter case, stomatitis lesions are not contagious.

Is there a cure?

Under normal conditions, canker sores heal spontaneously within a couple of weeks. However, there are many cases in which these lesions occur in recurrent episodes, causing extreme discomfort and jeopardizing the patient’s well-being.

In case the stomatitis does not heal or if the pain is too strong, it is always a good rule to consult your doctor, who will suggest the most appropriate treatment. Below, here are some remedies.

Mouthwashes and oral hygiene

Although it is not clear whether canker sores are caused by poor oral hygiene, it is always a good idea to take care of the health of your mouth.

Brushing your teeth regularly, about half an hour after meals, and flossing at least once a day are good tips to keep in mind.

In case of persistent stomatitis, your doctor may recommend the use of mouthwashes. The purpose of these products is to form a protective film over canker sores, to prevent pain from contact with food.

Some mouthwashes also contain ingredients that have the specific function of reducing pain and inflammation, such as:

• Corticosteroids
• lidocaine.

When using these products, it is important to keep in mind that they must be kept in the mouth, in contact with the damaged mucosa, for the time indicated on the package or by the doctor, but never swallowing them.

Gels and creams against aphthous stomatitis

These are remedies that act locally and must be applied directly to the lesion, using brushes or spatulas. They can be based on:

Active ingredient	Function
Retinoic acid	Promotes faster healing
Aluminium chloride	Contained in astringent gels that stimulate the mucosa to form new epithelium, fighting the damage caused by canker sores
Corticosteroids	Reduce pain and inflammation, especially in severe cases where the patient struggles to eat and speak

The purpose of these therapies is to act on the mouth ulcer, favoring the healing and healing of the single lesion, also reducing pain and inflammation.

After applying these substances to the ulcer, it is very important that they remain in close contact with the damaged mucosa for as long as possible. It is therefore necessary to avoid drinking or eating for at least 20 minutes after applying the ointment or gel.

Vitamins

These substances are essential for the well-being of our body, since they are involved in different metabolic processes.

The deficiency of one or more vitamins is one of the factors that could contribute to the onset of canker sores.

Since our body is not able to produce them on its own, it is essential to take an adequate amount with food. In case of stomatitis, the doctor may advise you to increase the consumption of foods rich in folic acid, vitamin C, B6 and B12 and zinc, or to take supplements that ensure the right intake.

According to some studies, in fact, a treatment that also includes supplements based on vitamin C or B12 can have positive effects, reducing the frequency and intensity of episodes of stomatitis.

Antibiotics? Yes, but only on the advice of the doctor

Since canker sores can be aggravated by the presence of bacteria in the oral cavity, it is possible that the doctor decides to prescribe antiseptics or antibiotics, to be taken strictly following the doctor’s instructions regarding the dosage and duration of treatment.

Most of the antiseptics or antibiotics that are prescribed are products to be applied topically, but in some specific cases it is possible that the doctor suggests a product with systemic action, to be taken by mouth.

The importance of prevention

Preventing stomatitis is not always easy, since the causes of this ailment are not yet fully understood.

However, there are some simple rules that can help reduce the risk of developing the typical lesions of this disease, including:

– constant oral hygiene, using soft bristle toothbrush and toothpaste after each meal;

– avoid acidic or spicy foods, such as nuts, chips, pineapple, grapefruit, oranges and some spices;

– eat plenty of fruits, vegetables and whole grains;

– drink abundantly;

– try to reduce stress.

Speaking of oral hygiene, it is essential to pay special attention to this aspect if you wear dentures or dental appliances. In this case, it is a good idea to always inform the dentist you are treating of any discomfort or injury.