Stomatitis is a general term used for a mouth that is sore and inflamed. In fact, it can occur on any part of the mouth: the gums, cheeks, lips, tongue, and palate. It can impact your ability to talk, eat, and sleep.

Today, we're going to discuss what causes stomatitis, what symptoms may form, and how to treat it.

Main forms of stomatitis

Stomatitis can take on several forms and some are more common than others. For example, one type of stomatitis is denture stomatitis, which is a fungal infection or yeast infection and is, of course, limited to those with dentures.

However, there are two main forms of stomatitis that most of the world's population will have at some point in their lives.

Canker sore

Canker sores are also called aphthous ulcers or aphthous stomatitis and present as a single or cluster of yellow or pale ulcers with red outer rings. They usually occur on the tongue, cheeks, or inside of the lips. Canker sores can be:

  • mild,

  • major, or

  • take on the form of herpetic stomatitis.

Minor sores might show up a few times each year, most often in people who are between the ages of ten and 20. The ulcers are very small - typically less than a centimeter in diameter - and heal in a week.

Major canker sores are not as common. They are larger than minor ones and can last for two weeks or more. Once healed, they often leave scarring.

Herpetic stomatitis is rare. They present as a cluster of very small ulcers and usually heal within one week.

Cold sore

People often get the terms "canker sore" and "cold sore" confused, but if you've ever had one, you'll surely remember the difference. Cold sores are also referred to as fever blisters, which is a more accurate description of their symptoms.

A cold sore is fluid-filled and shows up on or around your lips. They can occur on the gums and roof of your mouth, but that is rare. The sores will crust over like a scab and are very tender. They also cause a burning and tingling sensation, which actually happens before the sore appears.

Stomatitis symptoms

Now that you know more about the two common types of stomatitis, you also know their symptoms. You may not have all of these systems with every outbreak.

  • Canker sore symptoms

  • Sometimes painful sores

  • Last five to ten days

  • Usually reoccur

  • Not typically associated with a fever

  • Cold sore symptoms

  • Tingling or burning may occur before the sore

  • Usually painful

  • Last seven to ten days

  • Sometimes present with cold or flu symptoms

In most cases, your dentist or medical doctor can diagnose stomatitis - whether in the form of a canker or cold sore or some other form - with just a physical examination. However, in more complicated cases, a biopsy of the lesion may be needed to determine the cause of your stomatitis.

Stomatitis causes

The cause of stomatitis largely depends on which kind you have.

We mentioned denture sore earlier. That is caused by wearing dentures too long without a break, usually overnight while sleeping. As for the more common types of stomatitis, their causes vary.

No one is completely sure what causes canker sores, but there are many things that contribute to their development:

  • certain medications,

  • poor nutrition,

  • mouth trauma (like biting the inside of your cheek),

  • lack of sleep,

  • stress,

  • bacteria or viruses,

  • sudden weight loss, and

  • some foods like citrus fruits, chocolate, potatoes, cheese, nuts, and coffee can also cause the development of a canker sore.

They might also occur as a result of a weakened immune system, hormonal changes, or low levels of folate or vitamin B12.

You may even have a genetic predisposition to canker sores. They've actually been deemed an autoimmune disease. Canker sores are not contagious and about 20% of the population will experience one within their lifetime (men less often than women).

The cause of cold sores is better explained. They are caused by the herpes simplex type 1 virus. Upon the initial infection, usually in younger children, the virus presents as the cold or flu. Once infected, the virus is always present in the body and becomes activated by certain conditions like:

  • fever,

  • stress,

  • trauma,

  • exposure to sunlight, and

  • hormonal changes.

Cold sores tend to reoccur in the same location. From the time the blister ruptures until it is healed, the virus is contagious and can spread to both other people and/or other parts of the body.

How to treat stomatitis?

Tablet on the tongue

Picture by Authority Dental under CC 2.0 license

Left untreated, mouth sores don't usually last longer than two weeks. If you can identify the cause of the sore, you or your physician might be able to treat it so that it heals faster. If the cause is unknown, it's best to only treat the symptoms to provide relief until it heals on its own.

To treat the inflammation and pain that come with any mouth sore, you can use an over-the-counter pain medication like ibuprofen or acetaminophen. You can also gargle with cool water or suck on ice to relieve the burning. You should avoid hot food and beverages, as well as spicy and salty food and citrus fruits.

If you have a canker sore, you can also do salt water mouth rinses or apply one of the following treatments:

  • topical anesthetics like xylocaine or lidocaine (not recommended for children),

  • topical corticosteriods like triamcinolone paste,

  • Campho-Phenique or Blistex, which work best if applied when the sore first appears.

More severe sores might require additional treatment like with anti-inflammatory pastes, Peridex mouthwash, or Lidex gel.

To help avoid aphthous stomatitis, you should practice good oral hygiene and make sure you are eating a proper diet and getting adequate hydration. If you get canker sores frequently, you should discuss your medical history with your doctor and talk about the possibility of a vitamin B12 deficiency.

If you notice a cold sore before it appears (by feeling the burning or tingling sensation), you can take valacyclovir which will prevent or at least minimize the lesion. Once it has formed, you can place a protective ointment and ice to minimize symptoms and speed up recovery.

FAQ

Who is at risk of stomatitis?

Nearly everyone is at risk for oral stomatitis. However, people who smoke, have a nutritional deficiency, drink alcohol, experience high levels of stress, or are immunocompromised are at greater risk of stomatitis.

How long does stomatitis take to go away?

Depending on the form and severity, most cases of stomatitis are healed in five to ten days.

What are popular home remedies for stomatitis?

Home remedies for stomatitis include gargling with salt water or using natural foods like honey, mulethi powder, mishri and camphor, and aloe vera.

References

  1. Treatment of recurrent aphthous stomatitis. A literature review - NCBI
  2. Vitamin B12 for the treatment of recurrent aphthous stomatitis - NCBI
  3. Herpes simplex virus - WHO
  4. Assessment of Oxidant-Antioxidant Status and Stress Factor in Recurrent Aphthous Stomatitis Patients: Case Control Study - NCBI