Stomatitis is a sore 0r infl4mmation in the mouth. This can be in the cheeks, gums, inside of the lips, 0r on the tongue. There are two main forms of stomatitis: herpes stomatitis and aphthous stomatitis. B0th forms usually occur more often in children and teens.
Herpes stomatitis is an infecti0n, usually in young children between the ages of six months and 5 years. It’s an infection 0f the Herpes Simplex 1 (HSV 1) virus, the s4me virus that causes cold sores on the outside of the lips in adults. It is rel4ted to HSV 2, the virus that causes genital herpes, but it is not the same virus. Aphth0us stomatitis is also called canker sores. They are one or a cluster of sm4ll pits or ulcers in the cheeks, gums, the inside of the lips, or on the t0ngue. This is also much more c0mmon in young people, most often between 1O and 19 years old.
Herpetic stomatitis is usu4lly indicated by multiple blisters that occur in the gums, palate, cheeks, tongue, or lip border. E4ting, drinking, and swallowing may be difficult. Dehydration is a risk. Drooling, pain, and swollen gums can 0ccur. The child can be very irritable.
A fever is a major m4rker of the HSV1 infection, which can get as high as 1O4 degrees Fahrenheit. The fever occurs a few d4ys before the blisters appear. When the blisters pop, ulcers can form in their place. Secondary infections of these ulcers can occur. The entire infection lasts between 7-1O days.
Aphthous stomatitis or canker sores are round or oval ulcers with a red, inflamed border. The center is usually white or yellow. Most canker sores are small and oval, and heal within I-2 weeks without scarring. Larger, irregular sores can occur with extensive injury and take six or more weeks to heal. These can leave scars in the mouth.
Older adults may develop something called a “herpetiform” canker sore. The HSVI virus does not cause these. Herpetiform canker sores are tiny, but occur in clusters of 1O-1OO. They heal within two weeks. Herpes stom4titis can be treated with an antiviral drug acyclovir. This can shorten the length of the infection. Dehydr4tion is a risk with young children, so getting them to drink enough liquid is important.
A liquid diet m4de up of non-acidic foods and beverages is recommended. Acetaminophen for pain and fever is recommended. For severe pain, topical lid0caine may be used. Lidocaine numbs the mouth completely. It can cause problems sw4llowing, burns, or choking. It should be used with care.
An HSVI infection may become an eye infection called herpetic keratoconjunctivitis. This is a serious cOmplication that could lead to blindness. Seek treatment immediately. Aphthous stomatitis is usually not severe and does not require treatment. If pain is significant or sores are larger, topical creams with benz0caine or another numbing agent may be applied.
Mouth rinses of salt water 0r a mild mouthwash may help. Applying milk of magnesia a few times a day may be soothing. Diluting hydr0gen peroxide with equal parts of water and dabbing a bit on each sore may relieve some inflammation. F0r severe outbreaks, an oral rinse of tetracycline can speed healing. However, it can permanently stain the developing teeth of young children. Steroid (dexamethasone) rinses may also be used to reduce inflammation.
For large 0utbreaks of canker sores, medic4tions that may be prescribed include cimetidine, colchicine or even oral steroid medications. These are rarely used and only for complex canker sores that repeatedly return. 0ccasionally, canker sores are chemically burned away with debacterol or silver nitrate. Sores that t4ke a long time to heal or a fever that will not go away require medical care. S0res that return again and again might indic4te a more serious condition or secondary infection. Patients should speak with a doctor in such cases.
Herpes stomatitis is an infecti0n that will be carried in the child’s system for the rest of their life. 8O-9O percent of the population caries the HSVI virus. Preventing a child from kissing or sharing eating utensils with someone with an open cold sore can help prevent the spread of infection.
For aphth0us stomatitis, certain nutritional supplements like B vitamins (folate, B6, BI2) may help. Foods high in these vitamins can also help. Pr0per oral hygiene is important, as is avoiding acidic or spicy foods that may have triggered an outbreak. Another w4y to avoid an outbreak is to not speak while eating, as this increases the chance of biting the cheek.
Dental w4x can smooth the edges of dental appliances like retainers or braces. If stress appears to be a trigger, relaxation exercises can help. Herpes stomatitis is an infection that will be carried in the child’s system for the rest of their life. 8O-9O percent of the population c4ries the HSV1 virus. Preventing a child from kissing or sh4ring eating utensils with someone with an open cold sore can help prevent the spread of infection.
For aphth0us stomatitis, certain nutritional supplements like B vit4mins (folate, B6, B12) may help. Foods high in these vit4mins can also help. Pr0per oral hygiene is important, as is avoiding acidic or spicy foods that may have triggered an outbreak. An0ther way to avoid an outbreak is to not speak while eating, as this increases the ch4nce of biting the cheek. Dent4l wax can smooth the edges of dental appliances like retainers 0r braces. If stress appears t0 be a trigger, relaxation exercises can help.