Chronic stomatitis - Causes, Symptoms, Diagnosis and Treatment
Chronic stomatitis - Inflammation of oral mucosa, having a long duration with periodic remissions and exacerbations. Depending on the clinical form, chronic stomatitis accompanied by limited or diffuse redness of the mucous membrane, the formation of vesicles in the mouth or painful ulcers, excessive salivation, symptoms of intoxication, regional lymphadenitis. Diagnosis of chronic stomatitis include scrapings and study of oral fluid (bacteriological, cytological, PCR, biochemical, immunological), consulting a dentist and others. Specialists. Treatment of chronic stomatitis involves removal of etiological factors, local treatment of oral, systemic causal treatment.
Chronic stomatitis
aphthous stomatitis: among the various diseases of the oral mucosa, accounting for 5% of cases. By type of chronic stomatitis may occur recurrent herpetic stomatitis, necrotizing ulcerative stomatitis Vincent, prosthetic stomatitis, stomatitis smokers, fungal stomatitis, and others. In most cases, the development of chronic stomatitis caused not only by local factors, but also violations of the various systems of the body that It makes the disease relevant for dentistry, and for immunology, gastroenterology, endocrinology, otolaryngology and others.
streptococcus, E. coli. There is evidence pointing to a possible etiological role of adenovirus infection.
In some patients with this form of chronic stomatitis history can be traced autoimmune diseases (ulcerative colitis, Crohn's disease, Behcet's disease, and others.), Functional disorders of the digestive system (gastritis, bacteria overgrowth, constipation, diarrhea, biliary dyskinesia), endocrine disorders. Cases of family forms of chronic recurrent aphthous stomatitis, which indicates the role of hereditary predisposition to the disease.
The etiology of chronic necrotizing ulcerative stomatitis Vincent leading role belongs to the association fusiform bacillus (Bacillus fusiformis) and spirochetes of Vincent (Spirochaeta vincenti), which can also cause ulcerative gingivitis, ulcer sore throat, etc. Activation of the resident microflora of the mouth comes a sharp decrease in the body's resistance infection.
Chronic recurrent herpetic stomatitis is caused by the herpes simplex virus and is particularly common in young children. Fungal stomatitis or oral candidiasis, caused by the yeast Candida genus, develops when uncontrolled and chronic administration of antibacterial agents.
On the mechanism of chronic prosthetic stomatitis may be allergic, bacterial and traumatic. Allergic form of prosthetic stomatitis most often associated with hypersensitivity to the components included in the acrylic resin used to make dentures. Chronic bacterial origin prosthetic stomatitis caused by poor hygienic care of dentures. The causes of traumatic stomatitis become permanent damage to the mucous membrane properly fitting dentures, his faults (cracks, breakage).
Stomatitis is caused by smokers chronic irritation of the oral mucosa and gums the nicotine present in tobacco products.
Factors that provoke the exacerbation of various forms of chronic stomatitis, may make diet violations, taking certain medicines, stress, acute respiratory viral infection, hypothermia, exacerbation of chronic somatic diseases and focal infections, hypo-and avitaminosis, helminth infections. Support for chronic stomatitis is bad hygienic state of the oral cavity (dental plaque, tartar), launched or multiple cavities, the presence of local traumatic factors (the roots of decayed teeth, sharp edges of fillings, and others.), Chronic infections of upper respiratory tract (sinusitis, tonsillitis) .
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Relapses chronic canker sores occur at intervals of several weeks to several months. Frequent exacerbations exhausting sick, causing apathy, sleep disturbance, cancerophobia.
Depending on the frequency of exacerbations distinguish 3 degrees of chronic recurrent aphthous stomatitis: a light (with single and recurrent aphthae 1 every few years), moderate (relapsed 1-3 times per year) and heavy (with relapses frequently 4 times a year sometimes monthly).
Chronic necrotizing ulcerative stomatitis Vincent
The course of chronic necrotizing ulcerative stomatitis Vincent erased. The main complaints of patients are associated with pain and bleeding gums, hypersalivation, putrid odor from the mouth. In the mouth, there are lots of congestive hyperemia with ulcerations and necrotic changes in the interdental spaces. In severe cases of necrotizing stomatitis in the process of probing the gingival margin may be determined by the naked bone.
Common symptoms are not pronounced; submental and submandibular lymph nodes are sealed, and prolonged course of the disease become chondroid consistency.
Chronic necrotizing ulcerative stomatitis often develops on the background of ulcerative gingivitis, and combined with the defeat of the throat - Vincent's angina.
Chronic herpetic stomatitis
Exacerbations of chronic herpes sores usually occur in autumn and spring. Morphological features of chronic herpes sores are small blisters (vesicles), quickly turning into erosion covered with bloom. Bubbles and erosion are localized in the mucosa of the tongue, palate, cheeks and lips. Elements rash sharply painful, difficult eating and speaking. Oral mucosa is inflamed and swollen; increased salivation.
In mild form of chronic recurrent stomatitis do not occur more frequently than 2 times per year and proceed with few blisters in the mouth. To moderate rash is characterized by a moderate amount, and frequency of exacerbations from 3 to 6 times a year. Severe herpetic stomatitis accompanied by frequent (more than 6 times a year) and exacerbations of multiple eruptions.
Chronic prosthetic stomatitis
Chronic prosthetic stomatitis occurs in 40-50% of patients using complete dentures. This form of stomatitis occurs with inflammatory changes in the mucous membrane in contact with the prosthesis.
On examination of the oral cavity revealed a sharp diffuse hyperemia prosthetic bed. On mucosal sites traumatized denture base, can form chronic ulcers dekubitalnye, local bleeding occurs. Pain in the area of inflammation increases with use of dentures.
Chronic trauma mucosal hyperplasia may be associated with it and the formation of papillomas (traumatic oral papillomatosis).
Chronic stomatitis
smokers.Usually observed in men middle-aged and elderly with great smoking experience. In chronic nicotine stomatitis oral mucosa acquires a bluish-brown color, covered with a slightly whitish bloom. Eventually it develops hyperkeratosis palate with multiple keratotic papules. These changes give the palate a rough terrain, having the form of "cobblestones".
At the same time the defeat of the mucous membrane occurs language glossostomatit nicotine. Stomatitis smoking is a risk factor for oral cancer.
a dentist, a patient can be displayed consulting gastroenterologist, endocrinologist, allergist-immunologist, otolaryngologist.
Establishing clinical and morphological forms of chronic stomatitis helps cytological picture of smears from the surface of ulcers mucosa, histopathological study sites ulcer edges, bacteriological examination, swabs PCR, determination of lysozyme and immunoglobulins in saliva. To eliminate the allergic genesis of chronic stomatitis skin allergy tests are carried out. In order to identify related disorders studied general and biochemical blood tests, blood glucose, immunogram, RW, coprogram, fecal bacteria overgrowth.
With the help of X-ray dental system are identified pockets of chronic infection in the oral cavity.
In the process of diagnostics you want to exclude exudative erythema multiforme, secondary syphilis, lichen planus, pemphigus, and others.
professional oral hygiene, sanitation of foci of infection (treatment of caries and upper respiratory diseases, removal of damaged teeth).
chronic stomatitis Treatment involves local application of drugs (anesthetics, proteolytic enzymes), treatment of mucous membrane antiseptic solutions, application keratoplasty funds. Patients may be administered immunomodulatory, antibacterial, antiviral, anti-allergic therapy, vitamin therapy, physiotherapy (laser, UFO, phonophoresis). In allergic genesis of chronic stomatitis it can be shown holding a particular cause significant allergen desensitization.
In chronic prosthetic stomatitis patient should contact the dentist, podiatrist, who can recommend the right solution to the problem - handling, replacement or repair of the prosthesis.
Prediction and prevention of chronic stomatitis
In chronic stomatitis possible cure or a significant reduction in the number of exacerbations. Frequent relapses significantly reduce the patient's quality of life, are a risk factor of progression of periodontal disease, the development of malignant and benign tumors of the oral cavity.
The main role in the prediction and prevention of chronic stomatitis plays eliminate local foci of chronic infection, treatment of comorbidity, a systematic oral care, smoking cessation, rational prosthesis.