Herpetic (cold sore) stomatitis is a disease that often affects both children and adults. To effectively treat it, you need to know about the cause of its occurrence, characteristic symptoms and prevention.

All this information will be in the article: you will learn about the classification of the disease, see a photo, which will help you detect stomatitis in a timely manner and begin treatment.

Description

Herpetic or herpes stomatitis is an infectious disease caused by the herpes simplex virus. It affects all age groups with approximately the same frequency, but in children it is the most common type.

The scale of the disease is explained by the fact that it is transmitted by airborne droplets; in children, initial infection is almost always associated with weakened immunity. The result of a weak immune system is a chronic form of the disease.

Between the ages of six months and three years, this virus affects 4 out of 5 babies.

Many parents do not pay special attention to the appearance of symptoms of the disease in their child, believing that it will disappear on its own and will not cause complications. In fact, neglect of the first signs contributes to the development of the disease and transition to a recurrent form, the treatment of which will cause much more trouble and discomfort.

Causes

Why does herpetic stomatitis appear? The main cause at any age is the herpes virus. As mentioned above, its development in the body is facilitated by a low level of immunity. The incubation period of the virus also directly depends on the protective potential of the immune system; most often it is 1-2 weeks, but these periods may depend on various factors.

The development of infection is the cause of the appearance of the disease on the mucous membranes of the oral cavity: on the tongue, on the palate, in the throat.

It should be noted that the etiology remains completely unexplored; scientists know that infection with the virus occurs due to eating from shared utensils, through the use of shared hygiene items. Children become infected with herpetic stomatitis by playing with shared toys or by direct contact with each other.

The virus affects not only the oral cavity; ulcers also appear on the mucous membranes of the nose, eyes, and genitals.

Video: what is acute herpetic stomatitis?

Types

There are several types of herpes stomatitis, which are distinguished by type and complexity of treatment:

1. Acute – occurs when the virus first enters the body, which often occurs in childhood. It is divided into three stages depending on the complexity of the course:

• mild stage - typical for people with strong immunity, the only symptom is the appearance of blisters on the oral mucosa, after a few days they disappear on their own;
• middle stage - characterized by the appearance of multiple ulcers, the healing of which takes a long time. The patient often suffers from high fever (up to 38 degrees);
• severe form - rare, but accompanied by severe malaise, a significant increase in temperature, and aching joints. A large number of ulcers appear in the mouth, which take a very long time to heal and recur; if the patient is not provided with medical assistance in time, the disease becomes permanent.

1. Chronic - develops in conditions of weak immunity and lack of proper treatment. Constant injuries to the gums, palate, tongue and other chronic diseases of the oral cavity contribute to the appearance of the chronic form. Ulcers appear in large numbers and lead to the formation of painful erosions.
2. Recurrent - a characteristic feature of this form is only one symptom: the appearance of dental ulcers in the mouth.

Photo

Symptoms

Herpetic stomatitis manifests itself with a number of symptoms:

• enlargement of the cervical and submandibular lymph nodes;
• there is an increase in temperature and general weakness of the body; children may have sudden changes in temperature (from 37 to 40), which is associated with weak immunity;
• in the first stages, dental ulcers do not yet appear, but the mucous membrane of the oral cavity looks irritated and reddened;
• characteristic small bubbles on the mucous membrane are detected on the 1-2 second day of the active phase of the disease. After 2-3 days, ulcers form at the site of the ruptured vesicles, which heal within 4-5 days. If the patient has a strong immune system, then they can heal in 3-4 days;
• discomfort while eating, and sometimes this process is virtually impossible. These problems are especially difficult for children who want to eat, but because of stomatitis they cannot do it normally;
• sometimes ulcers appear not only on the mucous membrane, but also on the skin around the lips - in this case, it is simply necessary to speed up the healing process of the ulcers with the help of medications and doctor’s recommendations;
• The disease is especially dangerous for patients with HIV or diabetes and requires them to immediately go to the hospital to avoid complications.

Treatment of herpetic stomatitis

How to treat the disease? Let's list the main assets:

1. Taking antiviral drugs - if there are no special contraindications for adults, then such drugs are given to children only after consultation with a doctor. This also applies to all other drugs: antibiotics, immunomodulators, antihistamines.
2. Both adults and children are widely recommended to use folk remedies for rinsing the mouth affected by stomatitis. Chamomile decoctions, which have excellent antiseptic properties, are suitable for these purposes. Flax and sea buckthorn oils and aloe juice are also used to heal ulcers.
3. Due to the disease caused, patients suffer from dehydration, so doctors recommend drinking a lot of water or other liquid during treatment, which will help maintain the body’s energy and contribute to a faster recovery.

In adults

If symptoms of herpes stomatitis are detected in an adult, it is recommended to consult a dentist. He will conduct a diagnosis, accurately determine the type and form of stomatitis, and prescribe treatment.

• the patient must be allocated separate dishes, ensure that other family members do not come into contact with his things during the course of the disease;
• for treatment, adults can use topical antibiotics;
• Treat ulcers thoroughly with antiseptic agents. Dentists advise using tebrofen and bonaftone ointments, Lugol's solution, a wide range of antiallergic and antipyretic drugs;
• if the disease has progressed to a severe acute or chronic stage, then doctors recommend using a complex of immunostimulating drugs and vitamin supplements;
• in case of constant relapse, it is recommended to carry out antiherpes vaccination, but it cannot be carried out during the acute period of the disease.

In children

When the disease appears in children, doctors strongly recommend immediately seeking help from a dentist. He prescribes a number of suitable medications for children of one age or another, but if the illness is very severe, the child may even be hospitalized.

How long will the treatment of herpetic stomatitis in children last? Approximately 5-10 days, but the process depends on the state of the baby’s immunity. All this time it is necessary to monitor the condition of the child’s oral cavity and use various means.

To combat the disease in childhood, it is recommended to use oxolinic and interferon ointments, or you can use traditional methods, they can also be effective. Here are some more recipes:

1. Chamomile flower decoction - take a tablespoon of crushed chamomile flowers and pour a glass of water, cook for 15 minutes. Cool the broth and apply to the sore spot using a cotton swab.
2. Potatoes – grate several potatoes on a fine grater and apply to the area affected by stomatitis for a couple of minutes. Make sure your baby doesn't swallow it.
3. Flax or rosehip oil - soak a swab or cotton swab in the product and treat herpes sores with it.

More complex drugs are used only after consultation with a doctor. So, to reduce the temperature, they give the child Panadol, but only when it rises above 38 degrees. The antiviral drug Acyclovir is taken every 4 hours in the dosage described by the doctor, and if the child suffers from a severe form, the drug is administered intravenously in the hospital.

To combat the disease, Immunal, Imudon, Amiksin, which have an immunostimulating effect, are also used. To quickly heal ulcers, it is recommended to use Inhalipt or Proposol. Furacilin remains the most common remedy for treating herpes ulcers; it is relatively safe, but at the same time effective.

Video: about stomatitis in a child in the program “Dr. Komarovsky’s School”

Prevention

Strong immunity is the main obstacle to the occurrence of herpetic stomatitis; for this, both adults and children should lead a healthy lifestyle.

• Visit your dentist regularly for oral examinations;
• give up bad habits (drinking alcohol, putting foreign objects in your mouth);
• eat foods rich in vitamins (especially in autumn and spring);
• Avoid chronic mouth diseases and injuries.

By adhering to these simple preventive measures, you reduce the risk of developing the disease, but you should not completely exclude the possibility of infection, since there is still a chance of being among the sick due to a strong herpes virus.

Additional questions

The difference between herpes stomatitis and aphthous stomatitis

The difference between these two types is that aphthous is manifested by single aphthae, and herpes - by group blisters.

Herpes stomatitis is a fairly common disease. The severity of its course depends on the age at which a person acquired the virus. The older the patient, the more difficult it is for his body to fight the disease. It is worth noting that the disease is often diagnosed before the age of three. In order to prevent complications, it is necessary to clearly understand what herpes stomatitis is, how it manifests itself and how you can get rid of it at a given age.

What is herpes stomatitis

Herpes stomatitis is a viral disease that manifests itself in the form of ulcerative lesions of the oral mucosa.

The virus, once entering the body, remains in it forever. In this case, the disease may not make itself felt immediately, but after some time (this period can be calculated in years).

Along with the classic symptomatic manifestations, the disease is accompanied by a number of features that allow timely and qualitative differentiation of herpes stomatitis from other diseases:

Relationship between the disease and the herpes virus

Herpes stomatitis, of course, can be a consequence of the herpes simplex virus entering the human body, but the disease can also be provoked by other microorganisms. The virus itself is stored in the patient’s DNA, and its reproduction occurs within the epithelial layer under the influence of certain factors. First of all, it affects the mucous membranes, and then passes into the DNA of the infected person, transforming into a chronic stage.

What is stomatitis (video)

Types

There are several types of the disease.

Type	Etymology	Peculiarities
Acute herpes stomatitis	Occurs due to viral infection. A person of any age can get this disease, but most often these are children under three years of age.	Features of the course of the disease are described in three forms, determined by the severity of stomatitis. In the absence of proper treatment, acute herpes stomatitis can become chronic.
Chronic herpes stomatitis	It can recur due to mechanical damage to the mucous membrane, with weakened immunity and various bacterial and viral diseases.	The peculiarity of this type is that rashes (blisters on the mucous membranes and skin) may be the only symptom indicating the disease.

Doctor's note: the duration of herpes stomatitis is determined by the individual characteristics of the body and auxiliary drug therapy. However, on average, the onset of remission is observed approximately two weeks after the onset of exacerbation.

Routes of infection

It is customary to distinguish four main routes of infection by the virus:

• airborne. Infection occurs through the contact of the patient’s saliva with a healthy person;
• contact. In this case, infection can occur both through direct contact and through contact with household tools with which the patient interacted;
• translacental - from mother to child;
• transfusion - during the implementation of medical procedures, including the process of blood transfusion.

Causes of the disease and risk groups

It is customary to identify the following factors that increase the risk of contracting herpes stomatitis:

• violation of hygiene standards, improper oral care;
• chemotherapy;
• changes in hormonal levels in the body;
• damage, including microtrauma of the oral cavity;
• , as well as metabolic disorders, as a result of which the body cannot fully fight pathogenic agents;
• increased dryness of mucous membranes;
• use of low-quality personal hygiene products and household chemicals.

It is also worth noting that various diseases can be an excellent background for the development of herpes infection, for example:

• gastritis;
• anemia;
• tumors;
• etc.

The risk group includes:

• children aged from six months to three years;
• persons with reduced immunity.

Symptoms

The duration of the disease with proper treatment usually does not exceed two weeks. The disease develops gradually with increasing symptoms. Several stages of its development can be distinguished:

Specialist's note: every second patient with herpes stomatitis sooner or later experiences relapses, but the second time the disease occurs in a mild form, not accompanied by severe symptoms and severe intoxication.

Signs in children

If a child gets sick, it is very difficult to immediately understand what exactly is wrong with him, because he cannot independently indicate the cause of his illness. Parents should suspect stomatitis if they experience:

Diagnostic methods

As soon as blisters or ulcers are discovered in the mouth, you should immediately go to the dentist or therapist. Since the disease can be provoked by different types of microorganisms, identifying the specific type plays an important role in the fight against the virus.

In the first stages, when only redness is present in the oral cavity, the disease is easily confused with other dental problems. If there are rashes, then the range of possible diseases is immediately greatly narrowed. In making a clear diagnosis, laboratory tests are of great importance, namely:

• polymerase chain reaction;
• virological tests;
• serological studies;
• determination of the acid balance of saliva, etc.

Treatment

Treatment of herpes stomatitis includes taking vitamin complexes

Herpes stomatitis is a problem that requires complex treatment, that is, both local and general treatment is necessary. The main measures to eliminate the disease include the following:

• the oral cavity is treated with antiseptic solutions through rinsing;
• antiviral drugs are prescribed;
• in some cases, it may be necessary to use local antibiotics to prevent infection of tissues in places where they are severely damaged;
• areas of erosion are treated with wound healing and painkillers;
• To reduce the temperature and eliminate manifestations of intoxication of the body, symptomatic treatment is prescribed;
• carry out measures to increase immunity, for which special modulators or vitamin complexes can be used.

Special attention should be paid to nutrition during treatment. Since the oral mucosa is affected, it is better to avoid too hot or cold foods, spicy, salty or hard foods.

Features of treatment in children

Treatment of children is somewhat different from treatment of adult patients, especially when it comes to children. So, children still cannot rinse their mouths, so local preparations are applied to cotton pads and the affected areas are treated with them. Preference is given to the safest drugs, so some medications are often replaced with folk remedies (herbal decoctions are often used for antiseptic treatment of the oral cavity). All medications are selected taking into account the child’s age, so as not to cause harm to the growing body.

Folk remedies

In consultation with your doctor, you can also use traditional recipes for a speedy recovery:

• finely grated potatoes as a local compress helps fight inflammatory processes;
• chamomile decoction for rinsing (a tablespoon of crushed and dried plant is needed per glass of water, the ingredients are boiled together in a water bath for a third of an hour);
• decoction of oak bark (prepared in the same way, but for 200 ml of liquid you need one and a half tablespoons of crushed bark).

Unconventional remedies in the fight against stomatitis (gallery)

Oak bark decoction Chamomile decoction Grated potato compress

Prevention measures

It is worth understanding that there are no direct methods of prevention that would completely eliminate the risk of stomatitis. You can only adhere to general recommendations, which improve the state of immune defense and reduce the risk of infection by pathogens. Such recommendations include:

• hardening;
• absence of bad habits;
• active lifestyle;
• sufficient exposure to fresh air;
• proper nutrition, rich in vitamins and minerals.

Doctor Komarovsky about stomatitis (video)

If you detect the first signs of herpes stomatitis, you should contact a specialist and treat the disease under his strict supervision. If treatment is not treated in a timely manner, relapses, the viral infection becoming chronic and the development of complications are possible.

Surely at least once in your life you have noticed small pimples on your lips on yourself or someone you know. They often appear immediately after a cold or in the spring during the period of vitamin deficiencies. Formations on the lips and in the mouth in the form of blisters are herpes stomatitis, treatment of which in adults is not difficult.

Herpes stomatitis - treatment in adults

What causes herpetic stomatitis?

Chronic herpetic stomatitis or the popularly known “cold” on the lips is an infectious disease that manifests itself on the skin and mucous membrane of the mouth. This infection is caused by the herpes simplex virus or herpes simplex. This is a common and highly contagious disease that spreads and is transmitted instantly. According to many studies, more than 80% of the world's people are infected with the herpes simplex virus.

The virus causes the appearance of small blisters and crusts on the lips, as well as in the oral cavity - on the mucous membrane, tongue and gums. After infection and the first manifestation of infection, the virus does not completely disappear from the body, but moves to nerve cells located in the facial area. After some time, it may come out of hiding again and manifest itself by forming bubbles in the mouth. That is why herpes is called a chronic infection; it can occur again and again during a period of decreased general immunity.

As a rule, infection with the herpes simplex virus does not cause any serious complications in people's lives, except for the occasional unpleasant pimples on the lips that have to be hidden from others. Most people treat the manifestations of the virus with the help of pharmaceutical gels and ointments and do not seek the help of a doctor. Even without the use of medications, the infection often goes away on its own within a couple of weeks.

How does herpes infection occur?

Initial infection with the herpes simplex virus most often occurs in early childhood or before the age of 20 years. The infection usually affects the lips and mouth.

Why does herpetic stomatitis worsen?

After the initial infection, herpes remains forever in the body of the infected person, sometimes moving from nerve cells to the skin and mucous membrane of the oral cavity. Therefore, it is not always possible to determine the carrier status of herpes. Exacerbation of herpes occurs in the following cases:

• colds (ARVI);
• critical days for women;
• excessive fatigue;
• suffered stress;
• hormonal changes;
• extreme temperatures;
• weakening of the immune system;
• vitamin deficiencies;
• previous operations and interventions.

External manifestations of labial herpes

The first symptoms of herpes are an unpleasant tingling or burning sensation in the lips. In some cases, the temperature rises, soreness in the throat when swallowing, swelling and tenderness of the lymph nodes in the jaw and neck, and muscle pain.

Next, grouped small bubbles appear in the lip area, filled with colorless or cloudy yellow liquid. Over time, they open on their own and a crust forms from the contained liquid. Both blisters and crusts can be painful to touch and interfere with eating. Complete disappearance of symptoms usually occurs after a couple of weeks.

In some people, however, herpes manifests itself almost unnoticed or does not appear at all throughout their lives. This depends on the body’s defenses, as well as genetic characteristics.

What tests should be taken if herpes appears?

The doctor can make a preliminary diagnosis based on the patient’s complaints, information about how the disease appeared and how it manifested itself, as well as on the basis of a personal examination. Manifestations of labial herpes are usually easy to distinguish from other diseases, as they are quite characteristic. The doctor, by the appearance of the lesions on the lips, will distinguish simple herpes from herpes, gonorrhea, syphilis and herpes zoster. In addition, crusts on the lips due to chapping or sunburn can be distinguished from herpetic crusts using a smear-imprint from the lips. If the crusts are caused by the manifestation of herpes, characteristic cells modified by the virus will be visible under the microscope. A more thorough examination is most often not required, but sometimes it is carried out.

If the most accurate diagnosis is required (for example, in cases where the infection affects other organs and tissues), the doctor may order the following tests:

• biopsy(tissue or liquid) from blisters or crusts to identify the virus as herpes simplex;
• viral culture analysis;
• a staining test called the Zanck smear(shows a change in the cell nucleus due to HSV);
• antigen and antibody studies(serological and PCR tests to determine the type of herpes virus).

How to treat herpetic stomatitis?

Without treatment, all symptoms usually disappear on their own after 2-3 weeks. Your doctor may prescribe medications to fight the infection. They target one specific virus, in this case herpes simplex. Antiviral drugs in tablet form are prescribed to reduce pain and get rid of symptoms as quickly as possible. The most effective use of tablets is when the first symptoms of herpes appear - burning and itching in the lips, fever, but before blisters and crusts appear. If exacerbations of the infection occur very often, the doctor may prescribe long-term use of antiviral drugs.

The most popular remedy is antiviral ointments. They can be bought without a doctor's prescription. They are easy to use, relieve pain symptoms and reduce the time of open manifestations of herpes on the lips.

In addition to antiviral ointments, you can use antipyretics for severe fever (paracetamol), as well as painkillers for severe pain (for example, ibuprofen). Do not forget that all medications have contraindications; always read the instructions carefully and check with your doctor about the possibility of using the drug.

Treatment of herpes at home

There are several methods for relieving herpes symptoms without the use of antiviral medications:

• To relieve pain, apply ice or a cold, damp cloth to your lips;
• wash the affected areas with antiseptic cleansers and warm water, this will help prevent the virus from spreading to other parts of the body;
• rinse your mouth with cool water;
• Use mouth baths or rinses with chamomile or sage infusions to reduce pain and improve healing.

Table. What drugs help with herpetic stomatitis.

Name	Description	Price
	Antiviral single-component drug against herpes in the form of ointments or tablets	20 rub.
	Antiviral single-component drug against herpes in tablet form	350 rub.
	Herbal antiherpetic agent	130 rub.
	Complex ointment against herpetic stomatitis	200 rub.
	Healing agent	400 rub.
	Eliminates pain and promotes healing of crusts	250 rub.
	Complex antiviral and analgesic agent	180 rub.

How to prevent the spread of herpes?

A person who once gets a herpes infection becomes contagious for life. The infection is most easily transmitted during the period of formation of bubbles and crusts, but the rest of the time he transmits the virus through his saliva.

In order to protect others from infection or exacerbation of herpes, follow some rules:

• during the period of rashes, try to use separate towels, and after recovery, boil them;
• be careful when using utensils, forks and spoons, do not give them to other people;
• Everyone should have their own antiherpetic ointment; it cannot be shared with each other;
• refrain from physical contact, including kissing and sexual intercourse during herpetic rashes;
• Do not touch bubbles or crusts, or wash your hands thoroughly with soap if you accidentally touch them.

What complications can occur with herpetic stomatitis?

Chronic herpes can be dangerous when blisters and crusts form in the eyelids and eyes. As the infection spreads to the eyes, scars may form on the cornea (tissue located on the surface of the eyeball and also serves for protection). This can lead to partial or complete loss of vision.

If an infected person constantly picks off the crusts that form on the lips, this can lead to the spread of infection throughout the body, the addition of a bacterial infection and suppuration, as well as the formation of scars on the skin of the lips. The same applies to attempts to puncture bubbles. Such treatment of herpes lesions leads to prolonged infections that are difficult to treat.

The most serious complications occur in people with reduced immune system function, such as those infected with HIV. In this case, herpes can spread throughout the body and affect various organs and systems.

Video - Herpetic stomatitis. Symptoms, causes and treatments

A subtype of inflammation of the oral mucosa is herpetic stomatitis. The disease is provoked by the herpes virus against the background of decreased immunity. The disease manifests itself with many symptoms, the most obvious of which are many ulcers or aphthae in the oral cavity, causing discomfort, especially while eating. Stomatitis caused by HSV is diagnosed visually and based on test results and smears. Treatment is selected individually, depending on the stage of the disease and its severity.

Description

Herpetic stomatitis belongs to a group of pathologies caused by viruses and accompanied by severe damage to the oral mucosa and the area around the mouth. The disease manifests itself as painful ulcers and aphthous wounds. Primary infection of a person occurs due to a severe weakening of the immune system or due to excessive overheating or hypothermia.

Herpes is contagious and is therefore transmitted by airborne droplets or contact. Herpetic manifestations of stomatitis in children are especially common. The disease can develop in acute-atrophic and chronic form.

Species

Herpes stomatitis comes in two forms:

• , which occurs during primary infection. The disease can occur in mild, moderate and severe forms:
  • With normal immunity, the disease is mild and practically asymptomatic. A slight rash in the form of several bubbles filled with a liquid substrate on the oral mucosa is possible. They quickly burst, become crusty and heal.
  • As the disease worsens, body temperature may rise to subfebrile levels. There are slightly more rashes, and discomfort appears when eating and drinking. The person may feel weak and unwell.
  • In severe cases of herpes stomatitis, the temperature always rises sharply (more than 38°C), the patient gets chills, and aches in the bones, joints, and muscles appear. Diarrhea, nausea, and vomiting occur less frequently. This form is called herpetic due to the formation of a large number of ulcers or aphthae on the oral mucosa, which, after healing, are immediately covered with new wounds. With this disease, serious complications develop. If any form of acute herpes stomatitis is not treated with medication, a recurrent pathology will develop.
• Chronic herpes stomatitis, characterized by frequent exacerbations and temporary cessation of the disease. Provoking factors for relapse may be:
  • weakened immune system;
  • suffered from acute respiratory viral infections, acute respiratory infections;
  • injury to soft oral tissues (biting, chewing on the inside of the cheeks, etc.);
  • caries and other dental pathologies.

The chronic form is characterized by the absence of other signs of pathology. One characteristic manifestation is blistering rashes. The rash most often appears on the cheeks, upper hard palate, and tongue. Large clusters of bubbles always form, which quickly merge and burst with the formation of painful erosions.

Reasons

Herpetic stomatitis is provoked by the following factors:

• damage to the oral mucosa in the form of burns from hot food, trauma from rough food, or as a result of dental treatment;
• drying out of the mucous membrane;
• insufficient or excessive oral hygiene;
• incorrectly installed or low-quality dentures;
• incorrectly selected diet, when persistent hypo- and vitamin deficiency develops;
• changes in hormonal levels;
• chemotherapy or radiation;
• various concomitant diseases that provoke a decrease in immunity.

Herpes stomatitis in children and adults can also be caused by low-quality toothpaste containing sodium lauryl sulfate, which is harmful to the body.

The disease can appear at any age, but children from 6 months of age, when their own immunity has not yet been formed, and maternal antibodies lose their strength, are more often affected. Often herpetic stomatitis in a child occurs as a primary infection. Rarely does the disease occur alone; it is usually accompanied by:

• gingivostomatitis;
• herpetic gingivitis;
• stomatitis.

For infants, a risk factor is the time of teething between the ages of six months and 2-2.5 years, when the integrity of the mucous membrane is compromised and the risk of infection increases due to constant contact with toys, teethers and the baby’s hands, which are not always washed in a timely manner.

Symptoms

The clinical picture of atrophic and recurrent herpes stomatitis depends on the severity of the pathology:

• Light form. There are no general signs, but the temperature may rise to 37-37.2°C. Before the appearance of herpetic blisters, the gums become inflamed, that is, gingivitis develops. The rash that appears in a small amount quickly opens up, the tongue becomes covered with a fibrinous coating, but soon goes away. Sometimes a mild form is accompanied by symptoms of submandibular lymphadenitis.
• Medium shape. The disease progresses more clearly and is often accompanied by a rise in temperature - up to 38-38.2°C. The patient complains of the following manifestations:
  • migraines;
  • weakness and malaise;
  • nausea;
  • loss of appetite due to pain when eating;
  • increased sweating and salivation. The nature of the rash is more pronounced, the number of blisters reaches 20 pieces, forming lesions in the mouth and around the lips. In most cases, the disease is accompanied by lymphadenitis and gingivitis.
• Severe form. It manifests itself as a sharp deterioration in condition. The patient develops:
  • severe muscle pain and headaches;
  • weakness, malaise;
  • fever (up to 40°C);
  • constant nausea and vomiting;
  • signs of damage to the cervical and submandibular lymph nodes.

As the disease worsens, HSV affects the skin on the fingers and eyelids, causing conjunctivitis. The brightest rash, 25 or more pieces, is localized on the mucous membrane and surface of the lips, hard and soft palate, and in the perioral area. Herpetic stomatitis in a child, regardless of severity, occurs with such manifestations as:

• temperature rise to 38°C;
• capriciousness, irritability of the baby;
• rash on day 2-3;
• intoxication due to inflamed lymph nodes;
• gigivitis.

Due to swelling of the gums and mucous membranes, the child’s lips are always parted, causing saliva to flow out, which he cannot swallow due to pain.

After a rash followed by the opening of the blisters, painful ulcers form, the baby:

• loss of appetite;
• sleep is disturbed;
• Constantly bad, tearful mood.

Gradually, the erosions become covered with a white coating. As a result of antiseptic treatment and the ability of the mucous membrane to self-cleanse, the wounds heal and are covered with new epithelium.

Diagnosis and treatment

A doctor can diagnose the herpetic form of stomatitis. To confirm the diagnosis you will need:

• blood test for antibodies to the virus;
• examination of scrapings from the affected mucosa.

For these purposes, virological, cytological, immunological, molecular biological, and serological laboratory tests are used.

In order to determine the root cause of the disease, the doctor needs to familiarize himself with the patient’s medical history. This will help you choose the right treatment, which will shorten the period of exacerbation of the disease and increase the time period of the remission stage.

The therapeutic regimen is selected depending on the severity and stage of the disease, according to the patient’s age category, since not all medications are equally harmless. It is imperative to treat the pathology to avoid serious complications.

From this article you will learn:

• what does stomatitis look like - its types, photos,
• how to quickly cure stomatitis at home,
• the best medicine for stomatitis.

The article was written by a dentist with more than 19 years of experience.

The term “stomatitis” includes a whole group of diseases of the oral mucosa, which have different causes, but manifest themselves basically in the same way - most often by the formation of erosions and ulcers on the mucosa (aphthae), less often - by necrosis or the development of only redness of the mucosa.

The most common forms of stomatitis in adults are chronic aphthous stomatitis, which in adulthood most often affects people from 20 to 30 years of age (then its frequency decreases with age), as well as chronic herpetic stomatitis. Less often in adults, so-called “prosthetic stomatitis” occurs, as well as Vincent’s ulcerative-necrotizing stomatitis.

Stomatitis: photos in adults

Stomatitis in adults: causes and treatment

Depending on the form of stomatitis in adults, the causes and treatment will vary greatly. For example, if the cause is a herpes infection, then drugs with antiviral activity are needed. Other reasons may be pathogenic bacteria, allergies, autoimmune processes, various systemic diseases - and in all these cases completely different drugs will be effective.

Our point is that if stomatitis occurs in adults, treatment at home can only be effective if you correctly determine the form of stomatitis. To help with this, below we have posted photos and descriptions of the symptoms of different types of stomatitis, under each of which you will find an effective list of medications.

1. Chronic herpetic stomatitis –

This form of stomatitis is caused (in 90% of cases by the HSV-1 type of virus, and in 10% of cases by the HSV-2 type). Primary infection with the herpes virus occurs in childhood, after which the virus remains in the body for life. Therefore, if herpetic stomatitis occurs in adults, these are almost always repeated cases of the disease, most often associated with weakened immunity.

Herpetic stomatitis: symptoms
The duration of the disease is approximately 10-14 days. The main symptoms are associated with the appearance of herpetic blisters on the oral mucosa, but even before the rash appears, patients may feel a slight burning or itching in areas of the mucous membrane where herpetic blisters will soon appear. By the way, it is very important to teach patients to recognize these first symptoms in order to begin treatment at this stage.

Acute symptoms of intoxication in adults (unlike children) almost never occur; the temperature rises rarely or slightly. In rare cases, there may be symptoms of malaise, weakness, headaches, but again minor. With herpetic stomatitis in adults, symptoms of lymphadenopathy can more often be observed - enlargement and tenderness of the submandibular lymph nodes + redness and swelling of the tonsils.

Picture in the mouth –
The mucous membrane first becomes bright red and swollen. Against the background of such redness, a rash of many small bubbles, the size of a millet grain, appears. Bubbles are usually located in groups of several (Fig. 4). The most common places for their localization are the mucous membrane of the cheeks and the inside of the lips, on the tongue, as well as on the palate and palatine arches. In parallel with the rashes on the mucous membrane, rashes may appear on the lips and skin around the mouth.

The bubbles are initially filled with transparent contents, but over time their contents become cloudy. After about 2-3 days from the moment of their formation, the bubbles burst, forming numerous single erosions/ulcers of bright red color. Sometimes many small ulcerations located next to each other merge into one large ulceration. The surface of the ulcerations is very quickly covered with a fibrinous film of a gray or yellowish tint.

Herpetic stomatitis: photo

A very common localization of herpetic stomatitis is the tongue (Fig. 8, 10, 11). Rashes can appear not only on clearly visible surfaces - the back or tip of the tongue, but also on the sides and even the lower surface of the tongue. Very rarely, in adults, against the background of herpetic stomatitis, symptoms of acute gingivitis may also occur - redness and swelling of the gingival papillae.

Herpetic stomatitis on the tongue -

Herpetic stomatitis: causes in adults

As we said above, most often the cause of repeated cases of herpetic stomatitis is a decrease in immunity (we can talk about both a decrease in the general immunity of the body and local cellular immunity of the oral mucosa). Below we have listed the main trigger factors for herpetic stomatitis -

• decreased immunity (especially against the background of hypothermia or ARVI),
• seasonal vitamin deficiency, allergic reactions, stress,
• taking medications that reduce immunity (corticosteroids),
• against the background of chronic tonsillitis, sinusitis,
• trauma to the mucous membrane and red border of the lips (biting the mucous membrane with teeth, or trauma to it with a prosthesis or the sharp edge of a filling).

The reasons for the decrease in cellular immunity of the oral mucosa are most often pathogenic bacteria and the toxins they secrete, as well as some predisposing factors -

How to treat herpetic stomatitis at home -

So how to treat oral stomatitis in adults if it is caused by the herpes simplex virus... The treatment strategy will depend on the severity of clinical manifestations and the frequency of relapses. As we said above, in the vast majority of cases in adults, the herpetic form of stomatitis occurs quite easily, and without pronounced symptoms of intoxication. With such a mild course of the disease, the emphasis should be on local treatment of the mucous membrane.

Local treatment of the mucous membrane –
This requires the use of antiseptic rinses that are active against the virus. The choice of such drugs is small - in fact, only the drug Miramistin can be prescribed here (see). Miramistin for stomatitis should be used as a mouth rinse 3 times a day for 1 minute (or sprayed onto herpetic rashes from a spray nozzle). This remedy directly affects the virus.

To relieve pain from painful ulcers and reduce inflammation in the area of ​​ulcers, you can use the drug Cholisal in gel form (see). First, it is advisable to dry the mucous membrane at the site of application of the gel with a dry gauze swab, then squeeze the gel onto your finger and rub the gel into the areas of the mucous membrane affected by herpes with gentle massaging movements. Cholisal for stomatitis is used 2-3 times a day, usually no more than 6-8 days. After application, do not drink or eat anything for 30 minutes.

In principle, such local therapy is quite sufficient. If you still have symptoms of intoxication - fever (38.0 and above), muscle pain, malaise, then you can start taking Nurofen or similar drugs. But you shouldn’t abuse medications for fever, because... taking them reduces the body's production of its own interferons to fight bacteria and viruses.

In severe cases of herpetic stomatitis –

The basis of treatment for severe recurrent forms of herpetic stomatitis is antiviral drugs. They are especially effective if you start taking them within the first 12 hours of the onset of herpetic rashes. Such drugs show moderate effectiveness if they are taken from 12 to 72 hours from the moment the first symptoms appear. If more than 72 hours have passed and/or the herpetic blisters have already burst, the drugs will not have a significant effect on the course of the disease.

2. Chronic aphthous stomatitis –

In contrast to the herpetic form of stomatitis (in which many ulcerations form on the mucous membrane at the site of burst herpetic vesicles), with aphthous stomatitis most often only 1 ulcer with a diameter of up to 1.0 cm occurs, less often there can be two or three ulcers. Most often, ulcers form on the inside of the lips, cheeks, and less often on the soft palate, tonsils, and surface of the tongue.

If you look at the photo below, you will notice that the ulcers (synonymous with aphthae) are surrounded by a bright red rim of inflamed mucous membrane, and they themselves are covered with a grayish-yellowish necrotic coating. Most often, the ulcers are painful when touched, and the pain also increases while drinking and eating. The duration of a mild form of aphthous stomatitis is usually up to 10 days (less often up to 14 days), the speed of healing depends on the size of the ulcers.

Aphthous stomatitis - symptoms and treatment in adults will depend on the severity of the clinical manifestations. A mild form of aphthous stomatitis involves the formation of one or more ulcers up to 1 cm in diameter, slightly painful, which heal completely within 10-14 days without scarring of the mucous membrane. More severe forms may involve the diameter of ulcers up to 2-3 cm, severe pain, healing up to 6 weeks with the formation of scars on the mucosa.

General symptoms –
the general condition is usually rarely disturbed, but weakness and slight fever may be present. Usually, just before the formation of ulcers, patients may feel discomfort, itching or burning in the mucous membrane. Ulcers can be very painful, so patients' complaints of acute pain may come to the fore (the occurrence of pain can be stimulated by contact of ulcers with water, food, tongue movements, while brushing teeth).

The causes of this form of stomatitis are:

Aphthous stomatitis causes in adults can be divided into local and general. In most cases, it is local causes (acting directly in the oral cavity) that cause aphthous stomatitis -

• allergies to various components of hygiene products (most often to sodium lauryl sulfate * ),
• allergies to food and medicine,
• mechanical trauma to the mucous membrane (biting with teeth, trauma from solid food or the sharp edge of a filling/prosthesis),
• pathogenic bacteria of the oral cavity,
• high concentration of nitrates in food and drinking water.

* Important : the role of sodium lauryl sulfate in toothpaste components on the development of aphthous stomatitis was first identified in a clinical study published in the medical journal “Oral Diseases” (Jurge S, Kuffer R, Scully C, Porter SR. 2006).

Common causes of development –
hormonal changes during menstruation in women, with a sudden cessation of smoking, with hematological diseases and lack of folic acid, vitamins B6 and B12, with gastrointestinal diseases - celiac disease, enteropathy and malabsorption, with diseases of the immune system, against the background of Behcet's syndrome and Reiter's syndrome, with systemic lupus erythematosus, reactive arthritis, Crohn's disease, and also against the background of HIV.

How to cure aphthous stomatitis -

As you saw above, aphthous stomatitis can be caused by many factors, and therefore it is very difficult to determine the specific cause of its occurrence in each patient. Regardless of the severity of the disease, immediately after the discovery of ulcers, it is necessary to exclude allergenic foods (honey, chocolate, strawberries, citrus fruits, nuts, eggs), as well as hot, spicy and rough foods from the diet. You also need to exclude acidic foods (tomatoes, pineapples), fruit juices, carbonated drinks and wine.

Aphthous stomatitis can also develop as an allergic reaction to medications, so if you are taking any medications, you need to take this into account and consult with your doctor about stopping the drug or replacing it with another drug. You also need to check whether your toothpaste contains sodium lauryl sulfate and switch to a toothpaste without this component. To identify other causes, an examination and consultation with a dentist will be required.

Treatment of mild forms of aphthous stomatitis –

If you decide to treat stomatitis at home, then from the very beginning it makes sense to start taking antiallergic (antihistamine) drugs, the choice of which is quite wide in the pharmacy, for a course of 10 days. While taking antihistamines, the use of local antiseptic, analgesic and anti-inflammatory drugs is indicated...

1) Antiseptic rinses –
very often the cause of aphthous stomatitis can be certain types of pathogenic bacteria, so a course of antiseptic rinses is mandatory. It is best for adults to use for this purpose, and even better, “Perio-Aid” rinse containing two antiseptics (chlorhexidine 0.12% and cetylpyridine 0.05%). Rinse 2-3 times a day for 1 minute, course 10 days.

2) Pain relief and inflammation relief –
Ulcers with aphthous stomatitis can be very painful and are also located on the inflamed mucous membrane. The optimal medicine for stomatitis, which can immediately reduce pain and relieve inflammation, is in the form of a gel. Before applying it, the ulcers need to be dried with a dry gauze swab, squeeze the gel onto your finger and apply to the surface of the ulcers with gentle massaging movements. The regimen is 2-3 times a day, for a total of 5-8 days (until the pain and inflammation subsides, and then it is better to switch to epithelializing agents).

As alternatives to Cholisal, you can use a balm with anesthesin, which is applied with a cotton swab directly to the ulcers, or products from the group of gastroprotectors based on bismuth subsalicylate. The latter can be used in the form of chewable tablets or suspension. On the surface of ulcers, bismuth subsalicylate creates an indelible protective film, which has both an analgesic effect and reduces inflammation deep in the ulcer.

Important: The best drug for the treatment of aphthous stomatitis is Amlexanox (trade name Aphthasol). It is available in the form of a paste for application to the surface of aphthae 4 times a day, and has anti-inflammatory, antiallergic and immunomodulatory effects. It is not sold in Russia, but it can be bought in Europe or the USA using an official prescription, even if written out in Russia.

3) Epithelizing agents –
after the pain and inflammation subsides, it is optimal to switch to agents that accelerate the epithelization of ulcerations. These products may be in the form of a gel. Solcoseryl for stomatitis is applied 2-3 times a day (on the surface of the ulcers dried with a dry gauze pad), until they are completely epithelized. The drug has a moderate analgesic effect. Keep in mind that such drugs can only be used when the active phase of inflammation has ended.

4) Local application of laser –
If you are interested in how to cure stomatitis very quickly, then a laser or UV irradiation will help you with this. For example, you can instantly reduce pain and speed up the healing of ulcers several times by using a single treatment with a diode laser (with a wavelength of 940 nm), as well as using an Nd: YAG laser.

Clinical studies have shown that small aphthae healed much faster after laser treatment (about 3-4 days in total) - versus 7-14 days after standard local drug therapy. To a lesser extent, this can be achieved by ultraviolet irradiation (UVR) of ulcers in the oral cavity, which is carried out in a physiotherapy room under the direction of a dentist.

Aphthous stomatitis on the tongue: photos before and after laser treatment

Treatment of SEVERE aphthous stomatitis –

In approximately 10-15% of patients, the aphthous form of stomatitis is very severe, with the formation of extensive deep ulcers with a diameter of 1.0 to 2-3 cm, which respond little to traditional local treatment with antiseptic and anti-inflammatory drugs. Especially often, a severe course occurs against the background of systemic diseases - immune, hematological, gastrointestinal diseases, etc.

In such cases, there are second line of defense drugs that can cope with even severe outbreaks of aphthous stomatitis, but they will also have more pronounced side effects. For example, for local therapy in this case, single injections of glucocorticoids into the base of each ulcer, or rinsing the mouth with solutions that are prepared on the basis of glucocorticoid solutions in ampoules (most often triamcinolone acetonide) can be used.

But the main thing remains systemic pharmacological treatment with tablet drugs of the following groups. Firstly, these are tableted glucocorticoids such as prednisolone, and secondly, these are drugs from the group of immunomodulators (mainly with an immunosuppressive effect).

3. Vincent’s ulcerative necrotic stomatitis –

This is a disease of the oral mucosa, which most often occurs against the background of poor oral hygiene. As a result, a large amount of hard dental plaque and soft microbial plaque is determined in the oral cavity. An increase in the number of pathogenic bacteria such as fusobacteria and spirochetes leads to the development of necrosis of the mucous membrane. The development of this form of stomatitis is favored by reduced immunity, previous acute respiratory viral infections and smoking.

Ulcerative-necrotizing stomatitis in adults: photo

Symptoms of ulcerative necrotic stomatitis –

At the onset of the disease, general health worsens, weakness, headache appear, and the temperature rises to 37.5. Bleeding gums and dry mucous membranes appear in the oral cavity. At the height of the disease, the general condition worsens, the temperature rises to 40 degrees, and in the oral cavity there is a putrid odor, severe bleeding of the gums, and copious amounts of saliva.

At the slightest touch to the foci of inflammation, sharp pain occurs, and therefore eating and oral hygiene become simply impossible. Also during this period, ulceration and necrosis of the dental-gingival papillae begins. Necrotic papillae and mucous membrane are covered with a tightly attached light gray coating, consisting of a large amount of infection and necrotic tissue. The process can gradually invade neighboring areas of the mucous membrane.

How to cure Vincent's stomatitis -

Treatment of Vincent's stomatitis should only be carried out by a doctor, otherwise you can get massive necrosis of the gums and exposure of the roots of the teeth. The doctor, under anesthesia, will remove necrotic tissue, microbial plaque and hard dental deposits. After this, the mucous membrane is treated with antiseptics and anti-inflammatory gel. Without removing necrosis from the surface of the mucosa, treatment will be ineffective and will lead to chronicity of the process.

Doctor's orders –

• Systemic pharmacological treatment –
  the most important thing is that a combination of antibiotics is prescribed: Amoxiclav (tab.) + Metronidazole (tab.), or Klaforan injections + Metronidazole (tab.) – a course of 10 days. In parallel, strong antihistamines such as Suprastin must be prescribed for a course of 10 days. Thirdly, antipyretic/pain-relieving drugs as needed (this could be Nurofen or similar drugs from the NSAID group).

• Antiseptic rinses –
  Chlorhexidine solution 0.05% 3 times a day for 1 minute (total 10-12 days), but best of all - a stronger antiseptic rinse "Perio-Aid" containing 0.12% chlorhexidine and 0.05% cetylpyridine. Chlorhexidine for stomatitis of bacterial origin is the best antiseptic option (for example, here it will be much more effective than Miramistin).

• Anti-inflammatory gel applications –
  treatment with Cholisal gel is carried out immediately after rinsing; before treatment, it is advisable to dry the mucous membrane with a gauze swab. The gel is applied to the marginal gum around the teeth, gingival papillae and all areas of the mucous membrane. Scheme – 3 times a day, 10-12 days (immediately after antiseptic rinse).

4. Prosthetic stomatitis –

If you use removable dentures and have periodic outbreaks of stomatitis, this may be related. With prosthetic stomatitis, usually only redness of the mucous membrane of the denture floor occurs (i.e. in the area of ​​the prosthetic bed). The formation of ulcers and necrosis is usually not typical, but it is possible, and, as a rule, this happens more often in the toxic-allergic form of denture stomatitis, which develops when there is an excess monomer content in the plastic of the denture (Fig. 23).

Allergic prosthetic stomatitis –

Allergic denture stomatitis is a toxic-allergic reaction to an excess of one of the plastic components - the monomer. Moreover, an allergy to the monomer, as such, is extremely rare. Much more often, such a patient’s reaction to plastic appears due to the incompetence of the dental technician, who does not comply with the proportions of the ingredients from which the plastic is made.

If the technician poured more monomer than necessary, then you can be sure that you will get such a toxic-allergic reaction. Moreover, redness of the mucous membrane can occur not only under the denture, but also on any other part of the mucous membrane (for example, cheeks, lips, tongue) that come into contact with the plastic of the denture. However, in dental clinics, in order not to redo the prosthesis, they will certainly convince you that it is your body and your allergies that are to blame.

Allergy to dentures: what to do
As a rule (in 95% of cases), replacing a low-quality prosthesis with one made without excess monomer completely solves the problem. Of course, the clinic must remake the prosthesis at its own expense. If the clinic refuses, you can conduct an independent examination of the prosthesis for monomer content (the Consumer Rights Protection Society will tell you where this can be done).

Bacterial denture stomatitis –

Bacterial denture stomatitis occurs in cases of unsatisfactory hygienic care of dentures, when a lot of microbial plaque and tartar accumulate on the surface of the denture. Such dentures usually smell very unpleasant. Remember that dentures (like teeth) need to be cleaned after every meal, but in no case should this be done with regular toothpaste or powder.

If microbial plaque is not regularly removed from the prosthesis, a tightly attached bacterial film appears on it. You cannot scrape it off yourself, because... the use of abrasive agents will scratch the denture, which will cause bacteria and food debris to stick to it even more quickly. How to get rid of stomatitis in this case - you can clean the denture at home only with the help of special disinfectants (see the link below), or in an ultrasonic bath. You can also go to a dental clinic for this, where they will clean and polish it for you.

Drug treatment of the mucous membrane under the prosthesis –
after cleaning the prosthesis, you will need a course of antiseptic rinses with Chlorhexidine 0.05% (2-3 times a day) and treatment of the mucous membrane under the prosthesis with Cholisal-gel (2 times a day). Moreover, it will be better if you apply a thin layer of gel not to the mucous membrane, but to the entire inner surface of the prosthesis and put it on. The course of treatment is usually 10 days. But remember that the treatment will not be effective if you do not disinfect the prosthesis.

Treatment of stomatitis with folk remedies -

To cure stomatitis quickly, you need, firstly, to make the correct diagnosis (determine the form of stomatitis), and secondly, to use the right medications, an exhaustive list of which we have provided above. However, many patients try to use their usual remedy for stomatitis in the mouth, such as blue, vinylin or oxolinic ointment. How effective is this - read below.

• Blue from stomatitis -
  blue (methylene blue dye) was used for stomatitis 20 years ago, but is not used now. The dye has a weak antiseptic effect, so weak that its use is pointless for any form of stomatitis.

• Ointment for stomatitis in the mouth -
  Oxolinic ointment does have a weak antiviral effect, but it cannot help against herpetic stomatitis. Firstly, it is generally ineffective against the herpes virus, and secondly, ointment forms are generally ineffective on the oral mucosa, because fatty substances are not fixed on the moist mucous membrane and are quickly swallowed (therefore, you need to use preparations in the form of gels).

• Vinyline for stomatitis -
  it is an enveloping, epithelializing agent for erosive and ulcerative lesions of the skin and mucous membrane. As an ointment it is extremely ineffective. There is a form of Vinilin in the form of an aerosol - “Vinizol” (it is preferable). Vinizol can indeed be used in the treatment of aphthous stomatitis, starting from the 5-6th day of the disease, to accelerate the epithelization of the mucous membrane.

• Sodium tetraborate for stomatitis -
  has an exclusively antifungal effect. And here stomatitis is not entirely clear.

• Iodinol for stomatitis -
  has a weak antiseptic effect. Use for stomatitis is inappropriate. Has an irritating effect on the mucous membrane.

• Antibiotics for stomatitis -
  effective only for the treatment of Vincent's ulcerative necrotizing stomatitis. Use for herpetic and aphthous stomatitis is pointless.

Remember that with frequent relapses of stomatitis or severe clinical manifestations, you should consult a doctor, if necessary, take a complete blood test, examine the immune system, etc. Frequent outbreaks of stomatitis may indicate serious yet unidentified chronic diseases of the body. We hope that our article on the topic: Stomatitis treatment at home quickly was useful to you!