Catarrhal stomatitis: everything is not as simple as it seems

Although the oral cavity of a person, according to the Latin terminology accepted in medicine, is called cavitas oris, but such a common disease as catarrhal stomatitis is of Greek origin: katarrhoos - drainage (or inflammation) and stomatos - mouth. That is, catarrhal stomatitis is a pathological condition of the oral mucosa, which is expressed in its inflammation.

Pathologies of the oral mucosa (stomatitis) have a different origin (etiology) and a variety of various clinical symptoms (manifestations). The clinical classification divides these diseases into catarrhal stomatitis, ulcerative stomatitis and aphthous stomatitis. From the point of view of clinical diagnosis, catarrhal stomatitis is recognized as the most common variant.

[1], [2]

Causes of catarrhal stomatitis

Classification, based on the causes of stomatitis, divides them into these types:

Traumatic (mechanical, thermal or chemical damage to the mucosa, including as a result of professional activity);

Infectious (defeat mucous pathogenic microbes, including those associated with such infections as influenza, parainfluenza, adenosirus, herpes, chicken pox, measles);

Specific (mucosal damage, characteristic of certain diseases, for example, for tuberculosis, syphilis and leprosy);

Symptomatic (when the damage to the oral mucosa is one of the manifestations of the pathology of the hematopoietic, digestive, cardiovascular, endocrine or nervous systems of the body, as well as a symptom of systemic diseases - pemphigus, streptoderma, red flat lichen, immunodeficiency).

Recognized by all dentists, the main cause of catarrhal stomatitis lies in a purely local factor - insufficient quality oral hygiene. At the same time, the pathological condition of its mucous membrane is promoted by dental diseases, the presence of deposits (tartar) on them, as well as the imbalance of microflora in the mouth (dysbacteriosis). In addition, the cause of catarrhal stomatitis can be any manipulation of dentists, or rather their violation, for example, microtrauma in the treatment of teeth or poorly fitted dental prosthetics.

However, everything is not as simple as it seems. Because the list of purely dental causes of catarrhal stomatitis is supplemented by such common negative factors as: iron deficiency anemia; deficiency of vitamins (A, B, B9, C); insufficient salivation (xerostomia); tobacco smoking; dehydration of the body (with vomiting, diarrhea, polyuria or significant blood loss); helminthic invasion; some oncological diseases and side effects of chemotherapy; changes in the hormonal background of various etiologies. And even the notorious sodium lauryl sulfate is a surfactant used to form foam in the production of most toothpastes (as well as shampoos for hair and shower gels). This substance causes persistent dryness of the mucous membranes and skin ...

Moreover, recently doctors are inclined to the version according to which the cause of catarrhal stomatitis is immune. This disease is the response of our immune system to the antigenic peptides of foreign cells unidentified by T-lymphocytes. Not without reason, most often catarrhal stomatitis occurs in young children and in elderly people, when immunity is reduced due to age-related features of the body. For the same reason (that is, reducing protective functions) catarrhal stomatitis is a common complaint of patients with pathologies of the gastrointestinal tract.

[3], [4], [5]

Symptoms of catarrhal stomatitis

A distinctive feature of catarrhal stomatitis is inflammation of the upper epithelial layer of the oral mucosa in the absence of lesion of its deeper layers.

The main symptoms of catarrhal stomatitis are manifested in the form of swelling, redness and soreness of the mucosa in the mouth. At the same time because of the swelling on the mucous cheeks - along the line of closing the teeth, and on the sides of the tongue - there are "prints" of teeth. The mucous coat is covered with a white or yellowish coating, the salivary secretion increases (hypersalivation), an unpleasant odor from the mouth (halitosis) is noted. Swelling of the gingival papilla between teeth is injured and bleeds. Disturb pain when chewing food. But there are no obvious defects (ulcers or papules) on the mucosa.

These symptoms suggest that this inflammatory disease of the oral mucosa - acute catarrhal stomatitis.

But if the disease is not treated, then the clinical picture changes, and the pathological process takes on a chronic form. It is her specialists who are often called ulcerative stomatitis, which in most cases is actually the next stage of acute catarrhal stomatitis.

At this stage of the development of the disease, the deepest layers of the oral mucosa are affected, and erosions and sores are attached to the plaque. Destruction of tissues leads to the appearance of serous plaque along the edge of the gum, after removal of which remains painful, bleeding erosion.

The general condition of the body worsens with an increase in body temperature to + 37.5-38 ° C, weakness and headache. The intake of food and the process of articulation become painfully painful, the submandibular lymph nodes increase and cause pain when palpating.

Catarrhal stomatitis in children

Inflammation of the oral mucosa often occurs in the youngest children - from birth to three years. Catarrhal stomatitis in infants pediatricians is diagnosed as a thrush called candidiasis, because it is caused by yeast-like fungi of the genus Candida. With this catarrhal stomatitis, the mucous in the child's mouth swells, turns red and becomes covered with a white coating, similar in appearance to the coagulated milk. Often on the mucous there are bubbles, and after their opening - the sores. At the same time, skin rashes (hives), dyspepsia and muscle pain can be observed.

Catarrhal stomatitis in children can accompany such infectious diseases as measles, chicken pox, diphtheria. The cause of catarrhal stomatitis at an early age is often mechanical damage to the oral mucosa, as well as allergy after treatment with antibiotics or sulfonamides.

[6], [7]

Diagnosis of catarrhal stomatitis

Diagnosis of catarrhal stomatitis is performed by a doctor during examination of the oral cavity of the patient - taking into account anamnesis and data on the presence of other diseases, primarily, gastric and intestinal.

However, experts argue that the proper diagnosis of catarrhal stomatitis is not an easy task, since a visual assessment of the situation in a sufficiently large number of clinical cases does not reveal the true cause of the disease, and there is no specific diagnostic technique for stomatitis yet.

Therefore, a good doctor will not only examine the patient's oral cavity, but also take a scraping of the mucous membrane, and also give direction to a general blood test.

[8], [9]

Treatment of catarrhal stomatitis in adults and children

Treatment of catarrhal stomatitis is predominantly local, aimed at eliminating inflammation and accompanying external symptoms.

In acute catarrhal stomatitis, frequent rinsing of the mouth with antiseptic solutions and decoctions of medicinal plants is recommended. To this end, a solution of hydrogen peroxide (per 100 ml of boiled water - a tablespoon of 3% hydrogen peroxide) is used; 2% solution of drinking soda (teaspoon per 0.5 liters of water). Antimicrobial drug Chlorhexidine (Gibitane, Sebidin): 0.05-0.1% solution rinse the mouth 2-3 times a day.

Both adults and children need every 2-3 hours to rinse the oral cavity with broths of chamomile, sage, calendula, oak bark, leaves of walnut, plantain, yarrow, lapchatka, arnica. To prepare the broth, take two tablespoons of dry herbs on a glass of boiling water, cook for 5-7 minutes, allow to stand for half an hour. For the rapid preparation of rinse aid, you can use ready-made alcohol tinctures of calendula, St. John's wort, eucalyptus, adding 30 drops of tincture to 100 ml of boiled water. Very effective in the treatment of catarrhal stomatitis, alcoholic tincture of propolis: several times a day, rinse the mouth with a solution prepared from 100 ml of warm water with the addition of a teaspoon of this tincture.

To remove the swelling of the mucous the doctors recommend taking a 5% solution of calcium chloride (calcium chloride) inside: the drug is taken twice a day after meals, a single dose for adults - a dessert or table spoon, for children - a teaspoon. Calcium chloride is contraindicated with a tendency to thrombosis and severe forms of atherosclerosis.

In local therapy of catarrhal stomatitis, antibacterial agents such as Tantum Verde and Hexoral are also used. Nonsteroidal anti-inflammatory drug Tantum Verde in the form of tablets for resorption is prescribed on a tablet 3-4 times a day. In the form of an anesthetic and anti-inflammatory solution for mouthwashes, this drug is prescribed for 1 tablespoon every 2-3 hours. Children under 12 years of age, the solution for topical application is contraindicated.

Tantum-Verde spray is used three times a day for 4-8 doses (that is, 4-8 clicks on the nebulizer). When catarrhal stomatitis in children, the spray is used as follows: children 6-12 years old - 4 doses, children under 6 years - at a rate of 1 dose for every 4 kg of body weight. Side effects of this drug manifest in the form of feelings of numbness, burning or dryness in the mouth; skin rash and insomnia are possible.

The drug Geksoral has antiseptic, antimicrobial, analgesic, enveloping and deodorizing properties. The solution of Geksoral should be applied in undiluted form for rinsing or rinsing the oral cavity, or applied to affected areas of the mucosa. The dose for one procedure is 10-15 ml, the duration of the procedure is 30 seconds. Hexoral sprays after meals are sprayed on the affected areas of the oral mucosa for 2 seconds twice a day. Side effect of this drug is a violation of taste sensations, it is contraindicated to use in catarrhal stomatitis in children under the age of three.

The appointment of oral medications for the treatment of catarrhal stomatitis depends on the etiology of inflammation. Thus, in infectious catarrhal stomatitis in adults and in catarrhal stomatitis in children in the form of thrush (candidiasis) - doctors are most often prescribed an antifungal combination antibiotic Nystatin (in tablets of 500 000 units). Dosage of this drug for adults - one tablet 3-4 times a day or 0.5 tablets 6 times a day. The average duration of treatment is 10 days.

Dosage of Nystatin to children under 1 year of age: a tablet (125,000 units), one to three years - half a tablet (250,000 units) 3-4 times a day, and older children - 2 to 3 tablets per day in 4 admission. Tablets are swallowed without chewing, but with significant lesions of the oral mucosa, the tablets are placed after the meal on the cheek, where they are kept until complete resorption.

In the treatment of catarrhal stomatitis in children - milkmaids in infants - apply drops with Nystatin, which are prepared at home as follows: grind one Nystatin tablet to a powder and mix with the contents of one ampoule of vitamin B12 (can be boiled water). With the help of a tampon or a cotton swab, the oral cavity is treated with the oral cavity 2-3 times a day.

Side effects Nystatin usually does not cause, but with increased sensitivity to antibiotics, nausea, vomiting, diarrhea, fever, chills are possible. Among the contraindications of this drug: liver failure, pancreatitis, peptic ulcer of the stomach and duodenum, pregnancy, hypersensitivity to the drug.

For successful treatment of catarrhal stomatitis, hot, cold, spicy, sour and rough food should be discarded. It is necessary to drink an infusion of dog rose and take vitamin preparations containing vitamins A, B and C.

Prevention of catarrhal stomatitis

In order to prevent catarrhal stomatitis, it is necessary to remove tartar, timely to treat carious teeth, regularly and thoroughly brush your teeth and rinse your mouth after eating. If a history of GIT disease and pathology of the endocrine system should be addressed by their treatment.

Full nutrition, the use of vitamin-rich foods, especially fruits and vegetables, the reception of good multivitamin complexes in the winter, the cessation of smoking ... In general, anything that can contribute to increasing the protective functions of the immune system will contribute not only to prevention catarrhal stomatitis, but also many other diseases.