Traditional medicine

Nicotine stomatitis. Stomatitis: types, causes and treatment

If you smoke, then your dentist has probably drawn your attention more than once to problems in the oral cavity associated with this bad habit. If you do not smoke, then this information will also be important for you.

When a dentist insists on stopping such a bad habit as smoking, this is not only due to plaque on the teeth (from gray to brown-black) and bad breath. Unfortunately, all therapeutic restoration work in smoking patients quickly loses its freshness, shine and takes on a dull, gray appearance. But a more serious problem is the development of nicotine stomatitis (smoker's leukoplakia) in smokers. is one of the most pressing dental problems of our time.

Nicotine stomatitis is a protective reaction of the oral mucosa to the long-term toxic effects of tobacco fumes when smoking or chewing. Such stomatitis manifests itself in the oral cavity in the form of single or multiple foci of excessive keratinization of the epithelium (whitish films) against the background of chronic inflamed mucosa.

As a rule, patients with nicotine stomatitis do not complain. Sometimes they may notice a slight cosmetic effect in the form of white stripes or circles on the mucous membranes of the cheeks and tongue, roughness and dryness of the oral mucosa, and decreased taste sensitivity. Less commonly, there are complaints of burning of the mucous membrane when eating spicy or hot food.

When examining the oral cavity, the dentist discovers whitish films of various shapes that are not removed when scraped with an instrument. The favorite place for localization of films are areas of the mucous membrane that are subject to constant irritation by smoke, namely: hard palate, anterior

soft palate, corners of the mouth, back of the tongue. You can often see lesions in the form of white stripes on the mucous membrane of the cheeks along the line where the teeth meet. These stripes rise slightly above the level of the mucosa and are most often intermittent due to constant biting of the elevated areas. The patient does not feel pain; biting the cheek mucosa over time becomes simply a habit and is observed in most patients. Against the background of white films, soft reddish tubercles with pinpoint openings of the excretory ducts of the salivary glands are often visible.

Diagnosis of nicotine stomatitis is not difficult for a specialist, but the success of treatment largely depends on the patient. If smoking is eliminated as the main cause of the disease, then changes in the oral cavity are easily reversible with treatment. If the long-term irritating factor is not eliminated, the disease can transform into a malignant form. Tobacco smoke contains nicotine, tar deposits in large quantities, hydrocyanic acid, hydrogen sulfide, ammonium, carbon monoxide, and phenols. Nicotine itself, when smoked, does not have a significant effect on the mucous membranes of the oral cavity and respiratory tract, but the purine formed during its destruction is a very dangerous substance that has a pronounced carcinogenic effect. Nicotine stomatitis is a facultative precancer and occurs in 13% of patients with various dental diseases.

It is perhaps rare that a disease can “boast” of so many varieties and so many causes as stomatitis, which, depending on the cause that caused it, is treated differently. Experts highlight:

Acute herpetic stomatitis

According to statistics, it accounts for more than 80% of cases of all diseases of the oral mucosa in children.

Origin: The herpes virus is transmitted by airborne droplets and contact, and children just love to share sweets with each other, touchingly removing candy from their mouths to let a friend lick it, and playing with shared toys.

Features of the flow: The disease can be severe, with high temperatures, nausea, vomiting, and diarrhea. Bubbles appear in the oral cavity, which quickly turn into small ulcers. After 3-4 days, the ulcers gradually heal and disappear without a trace. The illness usually lasts one to two weeks.

Aphthous stomatitis

It most often occurs in adults and is dangerous for its relapses, which occur mainly in spring and autumn, as well as a long course with periodic exacerbations.

Origin: The appearance of aphthous stomatitis is associated with a decrease in general and local immunity.

Features of the flow: Aphthae are small formations of oval or round shape. They appear on the oral mucosa in both single and multiple quantities. Each such formation is surrounded by a thin bright red border and covered with a yellow-gray coating.

Allergic stomatitis

It is considered one of the most severe types of this disease.

Origin: Allergies to medications (for example, antibiotics), to the materials from which dentures are made, to certain foods (oranges, strawberries...).

Features of the flow: The patient complains of burning, itching, and discomfort in the oral cavity. For a person suffering from allergic stomatitis, it is often painful not only to chew, but even... to swallow air.

Catarrhal stomatitis

It occurs more often than others and is considered the easiest.

Origin: Poor oral hygiene, dental disease, dental plaque.

Features of the flow: The main symptom is dry and painful oral mucosa. If the symptoms have not disappeared after 5-10 days of treatment, it is carried out together with a gastroenterologist.

Fungal stomatitis

Most often, this type of stomatitis affects children, from the first days of life, but also among adults, usually elderly and weakened, candidomycosis is not uncommon, and it is more common in women.

Origin: There are two ways of occurrence of fungal candidiasis - infection from a sick person with candidomycosis through direct contact or through household items and the transition of one's own opportunistic fungi into pathogenic ones under the influence of factors favorable for the development of the fungus (hypothermia or weakening of the body). Newborns become infected with such stomatitis when passing through the birth canal of a mother suffering from vulvovaginal candidiasis.

Features of the flow: This type of stomatitis can be identified by a white, “curdled” coating on the tongue, palate, and inner surface of the cheeks.

Nicotine stomatitis

Origin: It is not difficult to guess that its cause is many years of smoking - concentrated hot smoke, constantly affecting the oral cavity, leads to chronic irritation of the soft and hard palate, tissue compaction and the formation of multiple ulcers.

Features of the flow: Most often, nicotine stomatitis is painless and over time can develop into an oncological disease - oral cancer.

Important

The choice of treatment tactics is dictated by the cause of stomatitis: for bacterial types, antibiotics are recommended, for viral types, antiviral agents are recommended, and for stomatitis caused by hypovitaminosis, taking vitamins.

At the appointment, the doctor will teach you how to properly treat the mucous membrane and aphthous elements using antiseptics and painkillers.

To prevent re-infection with bacteria, antibacterial drugs are prescribed, and to speed up the recovery of damaged mucous membranes, sea buckthorn oil, rose hips, and propolis ointment are prescribed.

The term chronic stomatitis implies various inflammatory processes in the oral cavity, which either worsen or subside. Many factors in the occurrence of this process can be listed, but the main one is the lack of timely and correct treatment at the 1st acute stage.

Common types of chronic stomatitis include: recurrent aphthous, viral (herpetic), prosthetic, ulcerative-necrotic Vincent and smokers' stomatitis.

Periodic rash of multiple or single aphthae and ulcers is characteristic of chronic relapsing. Small aphthae (3–5 mm) with a gray-yellow coating and a swollen red rim are localized on the palate, tongue, gums, walls of the pharynx, inner surface of the lips and cheeks. Before aphthae appear, there is a burning sensation and short-term pain at the site of their appearance.

When eating, the aphthae is very painful, as is when brushing your teeth. In children, the symptoms of this stomatitis are the same as in adults, but the signs of the disease may be the following: fever, lethargy, irritability, vomiting. The reasons for adults can be:

trauma to the oral mucosa (burns, bites and other injuries);
lack of oral hygiene;
food and drug allergies;
staphylococcus (a bacterium contained in dental plaque and stones, with untreated caries, inflammation of the tonsils);
viruses (adenovirus), bacterial and fungal infections;
chronic diseases (in adults);
weakened immunity (local and general) due to stress and overwork.

Dmitry Sidorov
Orthopedic dentist
The role of certain toothpastes, worms and toxic products of their vital activity, hypovitaminosis, and genetic predisposition in the occurrence of pathology has been proven.
The period between relapses depends on the severity of the disease and ranges from several years for a mild form of the disease to several weeks for a severe one. In a mild form of aphthous stomatitis, the aphthae heal without a scar within a week; in a severe form, healing takes about 2–4 weeks and scars remain (Setton's form).
Aftas look like this:
On the palate. On the tongue. On the cheek. On the lip.
Swelling and redness of the mucous membrane, the appearance of groups of multiple blisters with transparent contents on the palate, tongue, inner surface of the cheeks and lips, periodic repetition of these rashes indicates the viral (herpetic) nature of the disease.
The contents of the bubbles become cloudy, and after a couple of days from the moment the bubbles appear, they burst. A bright red erosion forms, which is then covered with a pale yellowish fibrinous coating. Herpetic stomatitis is usually accompanied by gingivitis.
Herpetic stomatitis
Symptoms such as poor health and fever with herpetic stomatitis are more pronounced in children than in adults. The duration of the disease is about 2 weeks. The cause is the herpes virus, and relapses are caused by the following factors:
hypothermia;
decreased immunity;
lack of vitamins;
injury to the oral mucosa.

The frequency of exacerbations in mild forms is 1–2 times a year, in severe forms about 6 times a year.
About half of people who use removable dentures may experience stomatitis, when the mucous membrane in contact with the denture becomes inflamed and painful. In these areas of the mucous membrane, decubital ulcers may form and bleeding may occur.
Constant trauma to the delicate membrane in the mouth provokes its hyperplasia and the appearance of papillomas. An allergy to an unfairly manufactured prosthesis or poor care of the prosthesis are also important points.
Unexpressed symptoms and a mild course of the disease, bleeding gums, ulcers and tissue necrosis give rise to a diagnosis of necrotizing ulcerative stomatitis or Plaut-Vincent stomatitis. Occurs when there is insufficient. Weakened immunity, smoking and previous acute respiratory viral infections contribute to the development of this form of chronic stomatitis.
Ulcerative form.
Smokers may experience a feeling of dry mouth, swelling of the gums, a specific odor, and a bluish-brown tint to the mucous membrane. This is chronic stomatitis of smokers or nicotine stomatitis. This stomatitis becomes chronic due to the reluctance to give up the bad habit. The addition of a bacterial infection can complicate the course of the disease.
Dmitry Sidorov
Orthopedic dentist
Chronic for all forms: swelling and redness of the mucous membrane in the mouth, slight changes in size and soreness of the submandibular lymph nodes.
Treatment

For correct and effective treatment, it is necessary to determine the causes of the disease, which involves visiting a dentist who can refer you to other specialists (gastroenterologist, endocrinologist, ENT doctor). Bacteriological and pathohistological examinations and various tests may be required.
For all forms of stomatitis, the doctor begins treatment with professional oral hygiene. Next, local applications and medicinal solutions for treatment are prescribed. Medicines are prescribed based on the nature of the disease (viral, bacterial, allergic). It is recommended to take vitamins and immunomodulators.
If it is not possible to immediately visit a dentist, the manifestations of chronic stomatitis can be alleviated. You need to avoid spicy and rough foods, as well as allergenic foods (citrus fruits, nuts, honey, chocolate, strawberries). If necessary, you can take antipyretic or painkillers, use an anesthetic emulsion of 3–5%.
The use of ointments on the oral mucosa (Oxolinic) is inappropriate, and in some cases contraindicated (Acyclovir). Only gels are suitable for this (for example, Metrogyl Denta for inflammation and bacterial infection). Rinsing with Chlorhexidine solution helps with aphthous bacterial stomatitis, but does not work with viral stomatitis.
For the viral (herpetic) form, Miramistin rinse solution is effective. You can rinse with chamomile during the inflammatory process or with a solution of baking soda (1 tsp per 200 grams of warm, clean water). It is recommended to drink rosehip decoction to get rid of bacteria and improve immunity.
Prevention

Careful oral hygiene and regular visits to the dentist will help you avoid complications of acute stomatitis. Also, treatment of the root causes of the disease (diseases of the gastrointestinal tract, liver, sore throat, etc.) will help get rid of relapses of chronic stomatitis.
Adhering to a healthy lifestyle, eating on time and properly, strengthening the immune system and, if possible, preventing injury to the oral mucosa are simple and at the same time necessary actions for the health of the oral cavity and the body as a whole.
In order to detect acute stomatitis in a child in time and prevent its complications in the form of transition to a chronic form, you need to be attentive to the state of his health.
Keep your child’s hands clean, limit his consumption of sweets and teach him to brush his teeth properly. Both adults and children need to eat natural foods rich in vitamins and microelements.

Let's look at what forms of stomatitis there are and their obvious signs. Detailed examples and options.

Stomatitis is an inflammation of the mucous membrane of the oral cavity, including the mucous membrane of the lips, cheeks, palate, tonsils, and tongue. The disease occurs most often in children, but in some cases adults are also affected. The disease can be acute, or it can last.

There are four main forms of stomatitis:

Ulcerative-necrotic, Vincent;
Chronic recurrent();
(fungal).

Classification of stomatitis

The disease is distinguished by provoking agents, course, and clinic.

According to the forms of the process:

Acute;
Chronic.

According to the factors provoking the disease:

As a result of injury (mechanical damage, chemical damage, exposure to high temperatures, radiation, so-called nicotine stomatitis);
As a result of damage by pathogenic microorganisms:

Viral (herpes viruses, chickenpox, measles).
Candidiasis (fungal).
Bacterial.
Mycoplasma.
Allergic.
Stomatitis that developed against the background of an underlying disease (diseases of the stomach and intestines, blood, due to pathology of the endocrine system, HIV infection).

According to the clinic, types of stomatitis are classified as follows:

Catarrhal;
Ulcerative;
Aphthous.

Types of stomatitis photo

Stomatitis looks similar. It is characterized by these symptoms on the tongue and in the oral cavity.

The picture above shows detailed photos of different types of stomatitis.

Such a coating on the tongue indicates a disease of one of the types of stomatitis.

More information about all forms of stomatitis

Allergic stomatitis

The allergic variant of the disease is a form of stomatitis that occurs as a response to increased sensitization of the body as a result of the release of allergens into the oral cavity. Such allergens include elements of plastic dentures, fillings, and crowns.

Sometimes intolerance occurs as a result of the use of products for treating the mouth and gums, to retain dentures. In some cases, toothpastes can be allergenic.

There are difficult to diagnose types of stomatitis , which includes allergic ones. On examination, patients experience hyperemia of the oral mucosa (it acquires a bright red tint). Accompanied by pain and swelling.

The main treatment is aimed at eliminating the factors that caused the allergy, prescribing antihistamines, and treating the oral cavity with antiseptic drugs.

Traumatic inflammation of the mouth

As a consequence of a form of stomatitis of traumatic origin. Injuries to the oral cavity occur as a result of exposure to low or high temperatures, chemical agents, and radiation. When making a diagnosis, it is very important to correctly collect an anamnesis of the disease. The patient is asked about the onset of the disease, its development, what the patient did, what he took.

On examination, redness of the oral mucosa, swelling, and pain are observed. The lesion covers the inner surface of the cheeks, lips, gums, and tongue.

If there has been a chemical burn, then along with treatment of the oral cavity it is necessary to prescribe antidotes.

If inflammation of the mouth is caused by arsenic, along with gastric lavage and the use of antidotes, the mouth should be immediately treated with iodinol (1% solution) or unithiol (5% solution). Take measures to sanitize the oral cavity. This is achieved by using rosehip oil, vitamin A,.

Photo of a type of stomatitis resulting from injury.

Smokers may experience nicotine stomatitis. The disease occurs as a result of prolonged exposure to cigarette smoke, which contains tar. This has an irritating effect on the oral mucosa, causing inflammation.

Upon examination, such stomatitis looks like hyperemic areas of the oral mucosa, sometimes with ulcerations and tissue compactions. The main requirement in the treatment of this disease is to quit smoking (in extreme cases, limit it, replace it with less aggressive agents), and carry out hygiene measures.

Stomatitis of viral etiology

Types of viral stomatitis: A common disease caused by the herpes virus. The most common form of the disease.

Viral stomatitis can occur easily, only with local manifestations, but in children it is manifested by general phenomena: caused by intoxication of the body, deterioration of the general condition, lack of appetite, diarrhea, muscle pain.

Patients are concerned about pain in the oral cavity, which intensifies when eating. Upon examination, redness of the mucous membranes of the oral cavity is visible, in places there are areas of erosion and blisters.

With a viral infection, a bacterial infection may occur, aggravating the patient’s condition. In this case, measures to combat bacteria are added to the treatment of the viral disease.

Types of viral stomatitis, photo.

During treatment, antiviral drugs and analgesics are prescribed. As with other types of diseases, great importance is given to the oral cavity. At the same time, concomitant pathologies are treated.

Important! If you have any, do not try to treat yourself. This may not have the desired effect and may be hazardous to your health. Contact your doctor in a timely manner: he will prescribe an examination and the necessary therapy. .

Bacterial diseases of the mouth

There are also forms of stomatitis that have a bacterial nature.

Vincent's ulcerative necrotizing stomatitis is one of the representatives of a type of stomatitis caused by bacteria. This disease is caused by pathogenic microorganisms – streptococci and staphylococci. Like viral ones, they most often occur in childhood. The likelihood of development increases with teething; in adults, wisdom teeth. Aggravating factors include stress, chronic pathology, frequent colds, and poorly sanitized oral cavity.

Along with the local reaction in severe cases, a general reaction is also observed: patients complain of malaise and elevated body temperature. Children may experience bowel dysfunction, refusal to eat due to pain when eating, and sometimes when swallowing.

When examining the oral cavity: hyperemia of the mucous membrane, local ulcerations, in some places with a crater-like configuration. In severe forms, an increase in peripheral lymph nodes is observed, most often cervical and/or submandibular. The patient feels pain when swallowing, which intensifies while eating.

Types of bacterial stomatitis, photo.

When treating this form of stomatitis, antihistamines are used. It is planned to take the drugs orally, as well as local application: rinsing the mouth with antiseptics, using anti-inflammatory ointments.

Oral candidiasis

Types of stomatitis of fungal etiology: The most common candidiasis is caused by fungi of the genus Candida. This disease is popularly called thrush.

The main patients with this lesion are infants and young children, as well as adults with certain diseases and pathological conditions (decreased immunity, after taking hormones and antibiotics, as a result of the use of dentures, plates, with severe vitamin deficiencies).

Upon examination, against the background of the bright red mucous membrane of the oral cavity, the phenomena of a white, “curdled” coating are clearly visible. The white coating is easily removed when treated with a soda solution (1 teaspoon per 1 glass of boiled water).

Patients feel soreness, children often have a fever, and other symptoms of intoxication are observed.

Types of stomatitis in which inflammation of the oral cavity occurs are treated by reducing the growth and development of fungal flora. For this, rinses with alkaline solutions are used (see soda solution above), also rinses with iodine preparations, aniline dyes, and antifungal ointments are used.

Along with the main therapy, antiallergic drugs, vitamin complexes are used, and oral hygiene is monitored. In severe cases, antifungal drugs are prescribed.

A fungus on the tongue usually appears with the development of fungal stomatitis.

Chronic aphthous inflammation of the mouth

There are many types of stomatitis, the cause of which is not clear. These include, for example, chronic aphthous lesions.

In this case, the occurrence of a disease involving decreased immunity, diseases of the gastrointestinal tract, and viruses is assumed.

On the mucous membrane of the mouth, peculiar formations appear - aphthae. They are round ulcerations with a diameter of 1 to 5 millimeters, covered with a whitish-yellow coating. There is a pronounced rim of hyperemia around the formation. There may be one or more afts; there is a tendency for them to merge.

The following types of aphthous stomatitis are distinguished:

Fibrinous (single aphthae with the presence of a whitish coating);
Necrotic (necrosis appears in the lesion - dead tissue);
Glandular (with damage to the ducts of the salivary glands);
Scarring (the phenomena of aphthous inflammation in the form of deep ulcers heal through the formation of scars on the mucous membrane);
Deforming (healing ends with deformations of the mucosa).

Stomatitis as a consequence of certain diseases

Sometimes inflammation of the oral cavity acts as a secondary reaction of the body to the underlying disease.

May develop with the following pathologies:

Diseases of the intestines and stomach (colitis, hepato-cholecystitis, various dysbacteriosis);
Heart and blood vessels (manifestations of cardiovascular failure in decompensated forms);
Diseases of the hematopoietic organs (anemia, forms of leukemia, hemophilia;
Diseases of the endocrine system (thyroid disease, diabetes).

Upon examination, redness of the mucous membrane, various types of rashes, bleeding gums, and ulcerations may be detected. The severity of changes depends on the underlying disease, the nature and severity of its course, and the individual characteristics of the patient.

Patients feel a burning sensation and pain in the mouth, symptoms intensify with the act of eating. Therapy includes treatment of the underlying disease, oral hygiene and treatment of stomatitis, depending on the pathogen.

Conclusion

Any disease poses a certain danger to the human body. And a disease detected in an advanced form is doubly dangerous. Stomatitis is no exception. Therefore, timely consultation with a doctor, examination and adequate treatment will help you cope with this nasty disease.

The herpes virus is transmitted by contact and airborne droplets, so children who tend to share goodies with each other and play with common toys most often get herpetic stomatitis.

The disease is characterized by fever, vomiting, nausea and diarrhea. Blisters appear in the mouth, which later turn into small ulcers. As a rule, ulcers heal and disappear after 3-4 days, and the disease as a whole can last 1-2 weeks.

Aphthous stomatitis

This type of stomatitis is characteristic of stomatitis and is dangerous due to relapses, prolonged course and exacerbations. Aphthous stomatitis most often occurs against the background of decreased immunity. As a result, aphthae appear - small round or oval formations. They can be single or multiple; the formation, as a rule, has a bright red border, and a yellow-gray coating is present.

Allergic stomatitis

One of the severe types of diseases that is provoked by an allergy to medications, certain products and materials from which prostheses are made. Symptoms of allergic stomatitis are itching, burning and discomfort in the mouth. Often the patient cannot not only chew without pain, but also swallow air.

Catarrhal stomatitis

This type of stomatitis is the mildest and is caused by poor oral hygiene, dental plaque and dental disease. The main symptom is a painful and dry oral mucosa.

Fungal stomatitis

This type of stomatitis is typical, but also occurs with weakened immunity. The second name of the disease is candidomycosis. Infection occurs through household items or through direct contact with a sick person. The disease can be recognized by a “cheesy” white coating on the inner surface of the cheeks, palate or tongue.

Nicotine stomatitis

Long-term smoking provokes chronic irritation of the palate (soft and hard), leading to the formation of multiple ulcers. Nicotine stomatitis can develop into oral cancer.

How to treat stomatitis

Any stomatitis requires examination by a doctor. Depending on the type of stomatitis, treatment will be prescribed:

Bacterial - treated with antibiotics;

Viral - antiviral agents;

Stomatitis caused by decreased immunity - vitamins, changes in diet and lifestyle in general.

In addition, the doctor will treat the aphthous elements and mucous membrane with painkillers and antiseptics.

To prevent stomatitis, you can treat the mucous membrane with propolis-based ointment, rosehip oil or sea buckthorn. These same agents accelerate the restoration of damaged mucous membranes.