Stomatitis: Symptoms, Causes, Types & Treatment

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, a fungal or yeast infection that 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, also called aphthous ulcers or aphthous stomatitis, present as single or clustered 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 have ever had one, you will 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 a fluid-filled lesion that appears on or around your lips. They can occur on the gums and the 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.

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 depends on the type 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.

In addition to proper brushing, flossing, and regular dental care, some individuals explore daily oral health supplements designed to support a balanced oral microbiome. Oral probiotics are formulated to support balanced oral bacterial communities, which may contribute to overall oral comfort and help maintain a balanced oral environment when used alongside good oral hygiene practices. These supplements are not a treatment for stomatitis or a replacement for professional dental care, and they should be used as part of a comprehensive oral hygiene routine.

No one is completely sure what causes canker sores, but many things 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, such as citrus fruits, chocolate, potatoes, cheese, nuts, and coffee, can also cause canker sores.

They might also occur due to 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 have 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 virus type 1. Upon initial infection, usually in younger children, the virus presents as a cold or the flu. Once infected, the virus is always present in the body and becomes activated by certain conditions, such as:

• fever,

• stress,

• trauma,

• exposure to sunlight, and

• hormonal changes.

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

How to treat stomatitis?

Picture by Authority Dental under CC 2.0 license

Left untreated, mouth sores usually do not last longer than 2 weeks. If you can identify the cause of the sore, you or your physician can treat it to help it heal faster. If the cause is unknown, it is best only to treat the symptoms to provide relief until it heals on its own.

To treat the inflammation and pain associated with a mouth sore, you can use an over-the-counter pain medication such as 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 corticosteroids like triamcinolone paste,

• Campho-Phenique or Blistex works best if applied when the sore first appears.

More severe sores might require additional treatment, such as 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.