Aphthous stomatitis stage. Treatment of aphthous stomatitis in adults at home. Scientific research in this field

Aphthous stomatitis is a type of ordinary inflammation of the oral mucosa, accompanied by the appearance of aphthae, i.e. small white ulcers with a red border, which are in the shape of a circle or oval (may occur singly or appear in large numbers). The main symptoms of the disease are - unpleasant sensations in the form of pain and burning, aggravated during meals. Neoplasms heal in about ten days, leaving no traces behind, only some types of ailment can provoke scars.

Aphthous stomatitis in children and adults affects the upper palate, tongue, lips and cheeks from the inside, often rashes affect the tongue. The treatment of such an ailment depends on the age of the patient, the state of immunity, the form of the disease, the causes of occurrence and is selected individually for each patient.

It is possible to completely cure ordinary aphthous stomatitis, but not its chronic form - in this case, a long period of retreat and change in the intensity of symptoms will be considered a success in therapy. Treatment consists of a complex of remedies - from medicinal substances to folk remedies at home (but only adults can be treated with such methods, and children under three years old are prohibited). If treatment is not started on time, the disease can take the form of chronic recurrent aphthous stomatitis.

Infection with this disease is possible only when a healthy person uses the same household items as the patient.

Etiology

Doctors have not been able to fully study the nature of the occurrence of such a disease, but it turned out to be possible to accurately determine some of the factors contributing to this. So, the main causes of aphthous stomatitis in children and adults are:

• hereditary predisposition;
• various infectious processes occurring in the body;
• diseases of the gastrointestinal tract;
• poor nutrition, due to which a person does not receive enough vitamins and nutrients;
• exposure to allergens;
• prolonged exposure to stressful situations;
• smoking and drinking alcohol;
• eating unwashed fruits and vegetables;
• unintentional damage to the oral mucosa, for example, by a child while sleeping or eating;
• the consequences of the establishment of braces;
• burns of the oral cavity with burning food or chemicals;
• menstrual cycle;
• pregnancy;
• blood diseases;
• change in climatic conditions of residence;
• the entry of infectious agents into the child's body through dirty toys, objects or hands that babies love to put in their mouths.

Aphthous stomatitis in children is diagnosed much more often than in adults, who mostly have a chronic form of the disease. Adults between twenty and forty years of age are most susceptible to it.

Varieties

In addition to chronic aphthous stomatitis, the disease can be:

• fibrinous- neoplasms on the mucosa take on a gray tint. They go away on their own after a few weeks. In the chronic form, they appear up to three times a year, and without proper treatment they form on an ongoing basis;
• necrotic- the main cause of the appearance is inflammatory or infectious diseases. This type of disease is characterized by the death of cells of the oral mucosa. Aphthae do not cause discomfort to a person, but increase in size over time, which makes the healing process difficult, which can last several months;
• granular- in which the salivary glands are affected. Neoplasms are quite painful, and after therapy, the likelihood of relapse is high;
• scarring- manifested by aphthae, increasing in size (they can reach more than one centimeter), and after elimination they leave large, clearly visible scars on the mucous membrane. Healing is long, takes more than three months;
• deforming- one of the most severe forms of the disease. Ulcers are so large that they leave behind large scars that can change the structure of the oral mucosa. The healing process is slow and lengthy;
• herpetic- most often affects infants, they can be born with such an ailment, having become infected from a mother who does not have immunity to the virus. Aphthae appear in the form of small bubbles. Their number can reach thirty pieces. The mucosa acquires a red tint and is very inflamed. In a small child, the disease may be accompanied by fever and damage to the membranes of the eyes and skin;
• recurrent aphthous stomatitis- often occurs in adults, children get sick with it very rarely. Aphthas are characterized by merging with each other, which is why large ulcers are formed, covered with a white coating, outlined in a red outline (they disturb the patient when talking, laughing, eating food);
• sharp- occurs mainly in children under three years of age and often accompanies diseases characteristic of this age group -, etc. Accompanied by an increase in temperature and bad breath;
• mixed- The most common is chronic recurrent aphthous stomatitis. It is diagnosed in children older than four years and is accompanied by burning and intense pain in the mouth. Aphthae often recur, causing discomfort. The older the child becomes, the stronger the signs of the disease will be expressed, and the number of aphthae will increase, as a result of which healing will take longer each time.

Symptoms

As mentioned above, the symptoms of the disease completely depend on the form of aphthous stomatitis. Thus, for the acute form of the course of the disease, the following are characteristic:

• severe headaches;
• . When trying to probe them, the child feels severe pain;
• a sharp increase in body temperature;
• fetid odor from the mouth;
• replaced by diarrhea.

Symptoms of herpetic aphthous stomatitis are:

• high fever (typical for young children and infants);
• pain haunts the child even at night;
• appetite decreases or disappears completely, due to increased intensity of discomfort during meals or breastfeeding.

Chronic recurrent aphthous stomatitis will be expressed by the following symptoms:

• sleep disturbance;
• severe irritability and restlessness of the child;
• loss of appetite;
• inflammation of the lymph nodes;
• increased secretion of saliva;
• bouts of vomiting;
• the appearance of irritation in the corners of the mouth.

The older the child is, the stronger the symptoms will appear.

In addition, absolutely any type of disease is accompanied by general weakness and malaise, as well as signs of a concomitant illness. At the first symptoms of the disease, you should immediately consult a doctor and not use folk remedies at home.

Diagnostics

Diagnosis of aphthous stomatitis is carried out by a dentist, in case of a child’s illness, by a pediatric dentist. Making a final diagnosis will not be difficult for an experienced specialist, since the disease has its own external manifestations. To determine the cause of the disease, the doctor may prescribe and.

Treatment

Basically, the treatment of aphthous stomatitis is carried out in stationary conditions (both children and adult patients). Therapy of the disease consists of a whole range of remedies that are selected individually for each patient, and depends on the severity of the ongoing form and the intensity of the symptoms.

In most cases, stomatitis is treated with hydrogen peroxide, furacilin and chlorhexidine. In the presence of pain, a mixture of glycerin and lidocaine (or novocaine) is used. If there is an allergic factor, then anti-allergens are prescribed. In addition, the patient is prescribed a vitamin complex, with a high content of B and C vitamins.

An important role in the treatment is played by physiotherapy - electrophoresis and laser therapy. If you do not carry out treatment, aphthae in adults and children will pass on their own in a few weeks, only this entails the formation of chronic recurrent aphthous stomatitis.

In addition, it is possible to treat aphthous stomatitis independently at home. Such therapies include prescriptions from:

• chamomile - rinsing with a decoction will relieve pain and inflammation;
• burdock seeds, from which it is necessary to prepare an ointment;
• mint, chamomile, fennel. Such an infusion may well replace antibiotics;
• oak bark;
• mint, chamomile, paprika and alcohol make a solution that daily cauterize neoplasms on the oral mucosa;
• cabbage juice diluted with water;
• aloe and parsley leaves, chewing which prevents the spread of infection;
• carrot fresh, but do not take orally, but rinse.

It must be remembered that the treatment of stomatitis in adults and children should not consist only of home therapy, and before using such remedies, it is necessary to consult a doctor. In no case should you treat aphthous stomatitis in children under three years of age with folk methods.

Prevention

Preventive measures for aphthous stomatitis include:

• proper oral hygiene. Adults should help the child carry out this procedure or be present at it;
• make sure that the baby's hands are always washed;
• eat only clean foods;
• timely treatment of infection and inflammatory diseases;
• strengthening immunity and rationalization of nutrition (consume a lot of vitamins);
• stop smoking and drinking alcohol. Adults need to protect the child from tobacco smoke and refrain from smoking in the room where he is;
• to carry out the prevention of SARS and at home;
• regular visits to the dentist (every three months).

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

Aphthous stomatitis in children and adults is a type of stomatitis, the development of which is associated with infection of the body with the herpes simplex virus.

Another name for the disease is. As a result of the activity of the pathogen, aphthae appear in the mouth - pathological foci. They make it difficult to eat and cause discomfort to the patient.

It is necessary to treat aphthous stomatitis, because. it signals other disorders in the body - colitis, gastritis, helminthic invasions, hormonal instability, malignant neoplasms, and other pathological conditions.

Causes of aphthous stomatitis

Aphthous stomatitis causes not only herpes. Among the reasons for its development, doctors single out the recent incidence of influenza, chicken pox or measles, the weakening of the body's defense reactions and concomitant dental ailments - caries, gum disease, pulpitis. In some cases, AS is associated with an abnormal course of digestive processes, diseases of the stomach or intestines.

In adult women, aphthous stomatitis can appear during pregnancy and menopause, when the body undergoes hormonal changes. In adolescent children, they are registered at a transitional age for the same reason - a change in hormonal status.

The development of the disease is also facilitated by factors such as:

• Bad habits.
• Insufficient or excessively meticulous oral hygiene.
• Prolonged use of toothpastes with sodium lauryl sulfate.
• Nervous strain. Strong and frequent stresses negatively affect the body, which worsens its immune capabilities.
• Injury to the oral mucosa. Careless handling of cutlery, the presence of poor-quality fillings or damaged teeth, the habit of eating too hot food contribute to damage to the thin mucous tissues of the oral cavity and the invasion of pathogenic strains.
• Taking medications that suppress salivation.
• Unbalanced diet with deficiency of folic acid, zinc, selenium, iron.

Aphthous, or herpetic stomatitis, is most susceptible to people with very weak immunity. If the body is powerless against the virus, the disease takes on a chronic form and periodically recurs.

Clinical signs of aphthous stomatitis

At different stages of development, the symptoms of aphthous stomatitis are not the same. In the initial period, the disease manifests itself with signs of SARS:

As the pathology develops, aphthae are formed in the oral cavity - small separately located or grouped ulcers with a diameter of up to 5 mm. The edges of the ulcers are distinguished by a reddish tint with a gray coating. External signs of aphthous stomatitis are shown in the photo below.

The presence of defects in the mouth creates discomfort during a conversation, eating, any movement of the tongue. The patient complains of increased salivation and the inability to fully perceive the taste of food.

Aphthae are areas of the mucosa with impaired integrity, which are clearly demarcated from healthy tissues. The shape of the ulcers is oval or round.

In children

Herpes stomatitis (aphthous) in children is often diagnosed at the age of 1 to 5 years. During this period, babies actively learn about the world around them and drag toys and various objects into their mouths, exposing the oral mucosa to the risk of injury and infection. In addition, young patients are more prone to infectious diseases than adults due to imperfect immunity.

As in an adult patient, aphthous stomatitis in a child proceeds with signs of SARS. Attentive parents will also notice the baby's salivation and bad breath, refusal to eat and restlessness, tearfulness and irritability. Aphthae with herpes stomatitis in children can first form in the corners of the mouth, and then spread to the oral mucosa.

In severe pathology, nausea, vomiting, indifference to what is happening appear.

Forms of aphthous stomatitis

Acute aphthous stomatitis is spread by airborne droplets, so it is easiest to catch it in a team setting. The causative agent of the disease can be not only herpesvirus, but also a strain of streptococcus, staphylococcus and diplococcus.

Symptoms of the acute form of herpetic stomatitis will be all the pathological changes characteristic of influenza, inflammation of the upper respiratory tract, whooping cough, diphtheria, scarlet fever and measles in children:

• Hyperthermia.
• Headache.
• Defecation disorder (constipation, diarrhea).
• Soreness of the lymph nodes on palpation.

Signs of chronic aphthous stomatitis do not differ from the defects accompanying the acute form. The difference is only in the duration of the disease. In the acute period, aphthae heal within 5 days from the moment of appearance without tissue scarring.

If stomatitis is not treated and the predisposing factor is not eliminated, the healing of sores occurs within a month. Due to long-term non-healing ulcers, the tissues are partially scarred, but subsequently the process develops again. Adults and children with chronic appendicitis, colitis, and helminthic invasions are prone to chronic aphthous stomatitis.

With an allergic origin of aphthosis, the sensitivity of the oral mucosa increases to all irritants. The state of oral hypersensitivity is characteristic of migraine, urticaria and bronchial asthma.

Video:

How to cure herpes stomatitis

Treatment of aphthous stomatitis of a viral nature is carried out at home. The therapeutic regimen for adults is based on a diet with the exclusion from the diet of rough, traumatic food for the mouth and allergen products.

For external treatment of aphthous stomatitis in adults, dentists recommend using boric acid and chamomile. Rinse the mouth with the preparations several times a day.

For the same purpose, a solution of furacilin, potassium permanganate, hydrogen peroxide is suitable (the peroxide is diluted with water 1: 1). You can lubricate aphthae with Kalanchoe juice, peach and sea buckthorn oil. If aphthous stomatitis is allergic in nature, it is treated with intravenous injections of sodium thiosulfate.

Since AS therapy in an adult patient lasts from 7 to 30 days, it is important to quickly eliminate soreness and discomfort in the oral cavity. In this patient will help drugs:

In chronic recurrent aphthous stomatitis, treatment is carried out in the form of rinsing the mouth with Chlorhexidine gluconate and treatment with local glucocorticoids:

• Ointment Clobetasol.
• Ointment Fluocinonide.
• Dexamethasone rinse.

Treatment of children

With aphthous stomatitis in children, treatment also begins with a diet. If the disease arose as a reaction to taking the drug, parents should consult a doctor about the advisability of canceling it.

Complex therapy of herpetic stomatitis in children includes antihistamines:

• Tsetrin.
• Diazolin.
• Telfast.
• Suprastin.

Local treatment of sores is carried out with the help of antiseptics and anti-inflammatory gels (Miramistin, Holisal). Irrigation and lubrication do up to 4 p. per day. As soon as the acute phase subsides, Actovegin-gel is added to the treatment. It accelerates the epithelialization of aphthae and relieves soreness.

Of the local immunomodulators, children are prescribed toothpaste with lysozyme, glucose oxidase, lactoferrin. Enzymes strengthen the immunity of the oral cavity and increase the resistance of the mucosa to viruses and bacteria.

Aphthous stomatitis is one of the most common dental diseases. A characteristic sign of this disease is the appearance of painful ulcers on the mucous membrane of the mouth.

The causes of the disease are very different. And in the presence of concomitant pathologies and weakened immunity, the transition of the disease to a chronic form is possible.

What it is?

Aphthous stomatitis is an inflammatory disease of the oral mucosa. It is characterized by a violation of the surface layer of the mucosa with the formation of single or multiple aphthae (erosions) - painful sores.

About 20% of the population at least once encountered aphthous stomatitis. It can occur at any age, but is most common in children and adolescents. In women, the disease occurs slightly more often than in men.

Causes of aphthous ulcers

Clinical observations suggest that a variety of causes may contribute to the disease, although the etiology of aphthous stomatitis has not been fully elucidated.

The most reliable causes in children and adults are:

1. immune response- the most reasonable reason at the moment. In this case, the immune system cannot recognize the molecules of substances that are present in saliva. As a result, lymphocytes are activated, which attack the chemical agent as a foreign one, and aphthae are formed. Weakened immunity contributes to the transition of the disease into a chronic form.
2. The influence of viruses. Sometimes it is preceded by viral diseases - influenza, adenovirus, herpes virus, measles.
3. Hormonal fluctuations- transitional age, pregnancy, menopause.
4. In favor hereditary predisposition says the fact that one or both parents suffered from a third of patients with chronic aphthous stomatitis.
5. The occurrence of aphthous stomatitis can provoke allergic reactions. Patients are advised to follow a hypoallergenic diet.
6. Diseases of the gastrointestinal tract, diseases of the teeth and gums can also become a trigger in the development of aphthous stomatitis.
7. Traumatic lesions due to biting, scratches from a chipped tooth, burns from hot food, adversely affect the health of the oral mucosa.
8. About 40% of patients with aphthous stomatitis associate the onset of the disease with a traumatic lesion of the oral mucosa.
9. nutritional deficiency adversely affects the health of the oral mucosa, which contributes to the occurrence of aphthae. Often the disease is combined with hypovitaminosis C, B, A, as well as with a lack of zinc, folic acid, selenium and iron.
10. Neuropsychic tension and stress. 16% of people suffering from stomatitis confirm that ulcers develop after stressful situations.

Diagnostics

To diagnose "aphthous stomatitis", it is enough for an experienced doctor to see the clinical picture.

Aphthous mouth ulcers are a typical symptom of the disease.

To confirm the diagnosis, the doctor collects an anamnesis: specifies the time of appearance of the first symptoms, soreness of the aphthae, the presence of traumatic injuries and burns of the oral cavity, food allergies, the presence of similar diseases in close relatives.

Sometimes they resort to laboratory tests to identify the pathogen.

Differences from herpetic stomatitis

It is necessary to carry out differential diagnosis with herpetic stomatitis, since their symptoms are similar.

Photo: Comparison of aphthous (left) and heretic (right) stomatitis

Stages and symptoms

In its development, the disease goes through several stages, each of which is characterized by specific clinical manifestations.

1. prodromal stage. The disease begins with a general malaise, the symptoms of acute respiratory infections predominate, such as: fever up to 40 ° C, chills, headache, loss of appetite, lethargy, enlargement and soreness of the occipital and cervical lymph nodes are possible. There are changes in the oral mucosa, tongue and gums. They become bright, dry and shiny. Areas of redness appear, which turn into foci of ulceration. Already at this stage, pain may appear in the mouth, at the site of the formation of aphthae.
2. aphthous stage. The main symptom of the next stage of the disease is the formation of painful aphthae. Aphtha is single or multiple, grouped into several pieces of ulcers, up to 5 mm in diameter. Aphthae are formed on the mucous membrane of the cheeks, lips, floor of the mouth, on the tonsils, on the lateral surfaces of the tongue. The aphtha is usually round or oval in shape, with clear borders in the form of a narrow red border. Its center is covered with a grayish-yellow fibrin coating. In the period of active rash, general symptoms and pain in the mouth increase. There is a change in the blood test: the number of leukocytes sharply decreases ((to 1–1.2) * 109/l), the ESR increases to 45 mm/hour.
3. Healing stage. The final stage of the disease is recovery, which occurs 1-2 weeks after the onset of the disease. The fibrous film separates on its own, healing occurs at the site of the aphthae without scar formation, but hyperemia, that is, redness, is observed for several more days.

Forms

Depending on the nature of the lesion in aphthous stomatitis, the following forms are distinguished:

• fibrinous. (the clinical picture is described above).
• Necrotic. Aphthae cause dystrophic disorders of the mucous membrane, necrosis and necrobiosis of the epithelial tissue occurs. This form of stomatitis is diagnosed most often in people with blood diseases and severe somatic diseases. Aphthae are almost painless, epithelialize from 2 to 4 weeks.
• Grandular. It develops due to damage to the ducts of the salivary glands. The glands do not work in the usual mode and provoke the formation of aphthae, which are localized near the ducts of the salivary glands. Aphthae are painful, heal in 1-3 weeks.
• scarring. Occurs when the acini of the salivary glands are damaged. Aphthous elements are located at the exit point of the duct of the salivary glands, on the palatine arches, on the mucous membrane of the pharynx. Aphthae turn into large, up to one and a half centimeters in diameter, painful ulcers. Epithelialization begins at least 3 months later. After healing, scars remain.
• deforming- the most severe form of the disease. It is characterized by the presence of deep destructive changes in the connective tissue. Ulcers heal slowly, after epithelialization, deformations of the palatine arches, lips, and soft palate occur.

Photo: scarring form of chronic aphthous stomatitis

Varieties of the disease

Depending on the nature of the course of aphthous stomatitis, two types of the disease are distinguished: acute and chronic.

acute form

Acute aphthous stomatitis is characterized by the appearance of single or multiple aphthae on the oral mucosa.

Aphthae disappear after 1-2 weeks, but if left untreated, the disease can become chronic.

Chronic relapsing

Chronic recurrent aphthous stomatitis is characterized by the periodic appearance of aphthous elements over many years, with periods of remission and exacerbation.

The most likely causes of the development of the disease are: mechanical trauma to the mucosa, a decrease in immunological reactivity, and chronic diseases.

This type of stomatitis differs from acute in the absence of an acute reaction of the body, the appearance of single aphthae and a recurrent course.

When examining the oral cavity, aphthae can be found at various stages of development. The exacerbation lasts 7-10 days, after which remission occurs.

Treatment

Treatment is aimed at eliminating the cause, as well as the clinical manifestations of the disease. To achieve the desired effect, you need to apply a whole range of medical manipulations and procedures.

Medical treatment

Drug treatment consists of the use of local and general drugs.

Local treatment is aimed at eliminating inflammation in the oral cavity.

For rinsing, antiseptic solutions are used - chlorhexidine, hydrogen peroxide, furatsilin. With a strong pain syndrome, aphthae are treated with an aerosol of Proposol or a glycerin suspension (5-10%) with novocaine or lidocaine.

General treatment includes the use of antihistamines and desensitizing drugs, antiviral drugs. In some cases, treatment with antibiotics and steroids is prescribed. All patients are prescribed a course of vitamin therapy and immunomodulation.

Patients are shown a sparing hypoallergenic diet, with the exception of solid and coarse food.

Symptomatic treatment - antipyretic and analgesic drugs.

At home

How to treat aphthous stomatitis at home? Indeed, in addition to traditional methods of treating stomatitis, there are many folk remedies and recipes.

For disinfection of the oral cavity, you can also use such a composition. Mix 60 ml of water with the same amount of hydrogen peroxide, add 1 tsp. soda and 1 tsp. salt, stir. Rinse your mouth with this solution several times a day.

Another antiseptic solution for home treatment is calendula infusion (1-2 teaspoons of dry herb per glass of boiling water).

No less effective are infusions of lemon balm leaves and chamomile, sage and burdock, knotweed, St. John's wort, yarrow and thyme.

To increase immunity from homeopathic preparations, echinacea is used in tablets and infusions.

In adults

Treatment in adults allows you to expand the list of acceptable drugs.

Treatment plan:

• For anesthesia, local anesthetics are used: Anestezin powder, Geksoral-tabs, Lidocaine asept, Lidochlor gel.
• To cure aphthous ulcers helps rinsing the mouth, local ointments, sprays and gels, which include: sprays - Ingalipt, Cameton, Geksoral, Vinilin and Lugol; gels - Holisal, Kamistad, Actovegin.
• The healing effect is provided by drugs: Solcoseryl, Karatolin, sea buckthorn oil, Vinylin and propolis spray.
• Vitamin therapy - Vit B1, B6, B12, C, nicotinic and folic acid.

Photo: Hexoral-tabs preparations and Lugol spray

In children

If symptoms of stomatitis appear in children, you need to seek medical help, in no case self-medicate.

Before seeing a doctor, adults should provide the child with a sparing diet, excluding sour, spicy and hot foods, as they can provoke increased pain. Food should be tender, contain a large amount of vitamins and minerals.

For pain relief, doctors usually give children teething gels. They are applied around the aphtha.

With a significant increase in temperature, antipyretic drugs based on paracetamol are prescribed.

For antiseptics, the child's oral cavity is treated with Miramistin solution, as well as herbal tinctures.

Children, like adults, are prescribed antihistamines and vitamins.

Scientific research and innovation

Modern studies of aphthous stomatitis are mainly aimed at studying defects in the immune system of patients with this disease. An important question in their work is why some people are susceptible to repeated outbreaks of the disease, while others are not?

Scientists conducted a study of the blood of two groups of people - patients with aphthous stomatitis and healthy ones. The result showed differences in the functioning of the immune system of the subjects. However, scientists cannot say that it is these differences that cause aphthous stomatitis; this requires additional research.

Pharmacological research is carried out annually. New drugs are being developed and tested for the treatment of recurrent aphthous stomatitis, aimed at changing the functions of the immune system of patients.

They will be able to go on sale only after their safety and effectiveness has been proven.

One of the latest pharmacological developments, which are currently at the testing stage, is the drug Amlexanox. The drug has anti-inflammatory and antiallergic effects. There is already evidence of its effectiveness.

A photo

Photographs will help to better present the picture of this disease.

Prevention of the disease consists in observing the rules of oral hygiene, regular visits to the dentist, avoiding provoking factors (injuries and burns of the mucous membrane, nervous strain).

Rough food and allergens should be excluded from the diet, nutrition should be balanced in terms of vitamin and mineral composition.

Another important condition for prevention is to maintain immunity at a high level.

When the first signs of the disease appear, you should consult a doctor.

The appearance of wounds on the mucous membrane of the oral cavity is always accompanied by soreness and discomfort. Many people know why it occurs and what traumatic stomatitis or herpes looks like. But aphthous stomatitis in adults, although it is common, remains an unresolved and clarified issue. In our article, we will consider the causes of development, risk factors, symptoms and treatment of this disease.

Stomatitis is detected with the same frequency in both men and women. There is no specific age that would correspond to the peak incidence. The main causes of aphthous stomatitis are:

• increasing the body's sensitivity to certain foods, medicines;
• dysfunction of the digestive system;
• mucosal injury;
• acute respiratory infections.

Most researchers consider the main pathogenetic mechanism in the development of aphthous stomatitis to be an allergic reaction. As allergens, there can be not only food products known to many, but also staphylococci, E. coli, streptococci, viruses. In the event of a bacterial allergy, dysbacteriosis of the oral cavity and distal gastrointestinal tract is of great importance. And the fact that a large number of immune complexes are detected in a blood test in patients with stomatitis also proves the autoimmune mechanism for the development of recurrent stomatitis.

There is a theory of cross-immune reaction. What does it mean? In the oral cavity there are bacteria and cells that are produced by the body's defense system to eliminate them - antibodies. In their structure, pathogenic microorganisms can be similar to epithelial cells; accordingly, antibodies attack not only bacteria, but also the mucous membrane. As a result, a local violation of integrity occurs - an aphtha is formed.

Dentists call predisposing factors:

• chronic diseases of the gastrointestinal tract;
• errors in the diet;
• immunodeficiency states;
• long-term medication;
• hypovitaminosis.

Many people ask: "Is stomatitis contagious?" No, unlike herpes, it is impossible to become infected with acute stomatitis, which is characterized by the appearance of aphthae in the mouth, either by contact, or by airborne droplets, or by other means. After all, the cause of everything is not viruses and bacteria, but the morphological and functional state of the digestive tract, the level of the body's immune status.

How to recognize aphthous form of stomatitis?

The first symptoms of aphthous stomatitis occur even before the appearance of visible changes in the mucosa. Patients indicate a burning sensation, slight soreness in those parts of the oral cavity, where, after a short period of time, a characteristic morphological element appears, confirming the diagnosis. It's about affa.

Let's take a look at what aphthous ulcers are and what they look like:

• these are painful wounds of a round or oval shape, covered with a white coating on top;
• the average diameter is 0.5-1 cm;
• on the periphery the aphtha is limited by a red corolla;
• when you try to remove plaque with a cotton ball, the bleeding bottom is exposed.

The favorite localization of erosion is the mucous membrane of the lips, cheeks, the zone of transitional folds. Stomatitis on the tongue is also quite common, the typical site of the lesion is the lateral surfaces.

Clinical variants of the course of stomatitis

Aphthous variety of stomatitis always has a recurrent course. Aphthae heal for 8 days. Reappear after 1-2 months or more. Chronic recurrent aphthous stomatitis has the following clinical forms.

1. fibrinous. It is characterized by the mildest course. There are up to 5 aphthae, which are tightened within 10 days without a scar. The general condition is practically not disturbed.
2. Necrotic. It develops against the background of a weakened immune status, in addition to stomatitis, patients are also diagnosed with severe somatic diseases, blood diseases. In adults, symptoms occur as a result of a short-term spasm of the mucosal vessels, which leads to the appearance of a local surface area of ​​necrotic (dead) cells. Aphthae heal over a longer period, which averages up to 20 days.
3. Glandular. It proceeds with damage to the epithelium of the excretory ducts of the small salivary glands. Aphthae can be seen on the cheek, hard and soft palate, which is not typical for the fibrinous form. Recovery processes in the oral cavity last from 10 to 30 days.
4. Scarring. This is one of the most severe forms, since the wounds form deep, respectively, and the aphthae in the mouth are tightened with the formation of fibrous tissue. In other words, scars are formed that deform the surface of the mucosa. Ulcers exist up to 2 months or even longer. In patients against this background, the general condition worsens. The temperature rises, lymph nodes increase, sleep and appetite are disturbed.

Along the course, chronic recurrent aphthous stomatitis is usually divided into the following degrees.

1. A mild form is diagnosed if single aphthae occur every few years.
2. They say about the average degree when wounds on the oral mucosa appear up to 3 times within one year. But at the same time they exist up to 7 days, the general condition is not disturbed. Sometimes patients can still complain of nausea, abdominal pain.
3. The severe form is characterized by frequent relapses - up to 4 times or more per year, a long, sluggish course, deterioration in general condition, exacerbation of somatic diseases.

Local treatment

How to cure aphthous form of stomatitis? In most cases, dentists offer a set of therapeutic measures aimed at accelerating regenerative processes, combating the addition of a secondary bacterial infection, reducing the frequency of relapses of the disease up to their complete disappearance, and improving the immune status. Topical treatment in adults includes the following.

1. Elimination of pain. To do this, you can use Lidocaine (spray 10%), Diplen films with an anesthetic, Holisal gel.
2. For oral baths, a solution of Chlorhexidine, Hydrogen Peroxide, Dimexide is suitable. It is recommended to rinse your mouth up to 2 times a day. This will not only prevent infection of the wound, but also preserve the factors of local immunity.
3. In order to cleanse the surface of the mucosa from plaque covering aphthae, enzymes such as Lidaza, Trypsin are used. They are sold in powder form. To treat the affected area, enzyme crystals are pre-dissolved in an isotonic solution. And then, after soaking a cotton ball, apply for 5 minutes. As a rule, the attending physician performs this procedure in the dental office. After all, in order for the proteolytic enzymes to work, you need to observe the exact ratio when breeding.
4. How to treat stomatitis to speed up the healing process? Dentists recommend using rosehip oil, sea buckthorn. These drugs are highly effective and do not cause allergies. Curiosin is also widely used in clinical practice. It is desirable to apply the gel on wound surfaces 2-3 times a day after preliminary antiseptic treatment of the oral cavity. To prolong the action of the active substance, after applications for two hours, it is better not to eat.
5. Treatment of aphthous stomatitis at home can also be carried out with the help of corticosteroid ointments. There is evidence that hormonal drugs interrupt the development cycle of aphthae. But they are used only in rare cases with a severe long-term course of the disease against the background of concomitant somatic pathology. After all, with the wrong use of corticosteroids, you can do more harm than good.

Do not forget that the treatment of aphthous stomatitis or its other varieties should be carried out under the supervision of a specialist. Be sure to coordinate the use of this or that drug with your doctor, do not self-medicate!

General treatment

Let's look at how to treat severe chronic recurrent aphthous stomatitis. If, when a classic fibrinous form is detected, inflammation can be stopped only with the help of local therapy, then necrotic, glandular and scarring forms require general treatment. The main activities should focus on the following aspects.

1. Inhibition of the action of histamine - a substance responsible for the appearance of signs of inflammation (burning, redness of the mucosa, soreness). To do this, prescribe antihistamines (Claritin, Tavegil). A good antitoxic and anti-inflammatory effect can be obtained from the use of sodium thiosulfate, which for the treatment of aphtha can be administered not only as intravenous injections, but also taken orally with milk.
2. Improving metabolic processes, increasing the body's resistance is achieved through the use of ascorbic acid, multivitamin complexes. A combination of vitamins C and P is on sale - the drug Askorutin, which is also often prescribed for herpetic aphthous stomatitis.
3. Normalization of the functioning of the organs of the digestive system. When hypoacid, anacid gastritis is detected, B vitamins are used: Cyanocobalamin, Folic acid.
4. Correction of general and local immunity. After making such a diagnosis as chronic aphthous stomatitis, an immunological examination should be carried out. If the results of the analysis reveal that the content of protection factors is below the norm, immunocorrectors are prescribed.

The drug Imudon refers to the means of biological origin. It contains lysates of those types of fungi and bacteria that most often initiate the inflammatory process of the oral cavity. Leukinferon is also widely used to enhance not only local but also general resistance.

In severe cases of herpetic aphthous stomatitis, against the background of a low content of T-lymphocytes, T-stimulants (Timalin) are prescribed. This drug accelerates recovery processes, reduces the likelihood of relapse. In order to achieve a stable remission, along with an increase in the effectiveness of treatment, Interferon is used, which is a natural corrector and regulator of the immune system.

To treat aphthous stomatitis in elderly patients, drugs with a sedative effect are used. For this purpose, tinctures of valerian, peony, motherwort are prescribed. Chronic recurrent aphthous stomatitis is a direct indication for physiotherapy. A good effect can be achieved using phonophoresis, laser, electrophoresis.

Particular attention should be paid to the nature of the food consumed. Doctors recommend excluding spicy, spicy, hard foods from the diet in order to avoid additional injury to the mucosa.

Disease prevention

In order to stop acute aphthous stomatitis and achieve a stable remission, in addition to taking medications, preventive measures are also important. Maximum efforts should be made during the period of subsiding of the signs of the disease.

1. Sanitation of the oral cavity will help eliminate foci of chronic infection.
2. Treatment of concomitant pathology will increase immunity, which will undoubtedly reduce the likelihood of a relapse.
3. Nutrition correction plays a significant role, especially in patients suffering from chronic gastrointestinal diseases.
4. The correct ratio of work and rest, moderate physical activity have a beneficial effect on the body, increasing the rates of local and general resistance.

Treatment of aphthous stomatitis in adults should be carried out comprehensively. Considering the fact that the presence of foci of chronic infection plays a significant role in the pathogenesis of the disease, patients should be examined not only by a dentist, but also by related specialists: an otorhinolaryngologist, a gastroenterologist, an allergist and an immunologist. And if there is a need, then other doctors for the presence of organ pathology.