Stomatitis (foot and mouth disease): treatment, symptoms and causes

What is stomatitis?

Stomatitis is characterized by any inflammatory process that affects the oral mucosa. The infection can be caused by the herpes simplex virus, or by the coxsackie , responsible for the disease known as hand-foot and mouth. This type of infection occurs throughout the oral region, and canker sores can appear on the cheeks, roof of the mouth, tonsils, tongue and on the bottom of the mouth. Although stomatitis is a word that reminds the stomach, the disease has nothing to do with that organ.

Stomatitis is very common in children, it can appear from 6 months of age, when weaning can occur, but it is more common to appear mainly at age 2 to 5 years of age, as it is the time when they start going to the schools.

In addition, people with an immune system compromised by diseases, such as AIDS , may also have stomatitis. Wounds usually appear every 15 days, once a month or annually, it varies from person to person.

Types

Foot-and-mouth disease

Foot-and-mouth disease is an inflammatory disease that causes ulcers, canker sores, sores, redness and pain in the mouth. Most of the time, it arises when the immune system is weakened.

This type of stomatitis usually appears fortnightly or monthly and the treatment can be done with natural, homeopathic and even home remedies.

Herpetic Stomatitis

Herpetic stomatitis is the most common in children between 6 months of age and 5 years of age. The disease is known as herpetic gingivostomatitis and manifests itself on first contact with the virus.

One of the main symptoms of the disease is the appearance of red spots in the mouth and throat. Tonsils, tongue, inner part of cheeks and lips, roof of mouth and gums can bleed easily.

Often these spots can be mistaken for thrush, because the lesions are whitish vesicles in the central area surrounded by a red halo. If their size increases, they can attach to others, forming very painful ulcers.

Causes

The herpes simplex virus is the biggest cause of the disease, but the coxsackie viruses can also cause stomatitis. When the body has low immunity, viruses take the opportunity to cause this type of infection.

There are still other reasons for stomatitis to appear, such as:

  • Gingivitis;
  • Caries;
  • Smoking;
  • Oral lesions;
  • Excessive consumption of alcoholic beverages;
  • Diseases that affect immunity (HIV, Lupus, Crohn’s disease);
  • Go through radiotherapy and chemotherapy sessions;
  • Oral ulcers;
  • Use of dental appliances.

Some other causes of stomatitis exist and are listed below:

Bacterial infection

  • Syphilis;
  • Gonorrhea;
  • Necrotizing periodontal disease;
  • Tuberculosis;
  • Actinomycosis.

Fungal infection

  • Oral candidiasis;
  • Thrush;
  • Cryptococcosis;
  • Zygomycoses;
  • Blascomycosis.

Viral infection

  • Infection with Epstein-Barr virus (infectious mononucleosis);
  • Measles (Koplik spots);
  • Chickenpox or herpes zoster infection;
  • Infection with enterovirus foot and mouth, or herpangina;
  • Herpes simplex virus infection.

Systemic disorder

  • Behçet’s disease;
  • Kawakaki disease;
  • Inflammatory bowel disease;
  • Malnutrition, including iron deficiency and vitamin C (scurvy) deficiency;
  • Erythema multiforme;
  • Stevens-Johnson syndrome / toxic epidermal necrolysis.

Physical irritation

  • Dental stomatitis;
  • Thermal burns from hot feet or drink.

Drugs

  • Toxicity of chemotherapeutic drugs;
  • Nicotine stomatitis;
  • Lichenoid drug rash;
  • Methotrexate-induced stomatitis.

Immobility Syndrome

  • Pemphigus vulgaris;
  • Paraneoplastic pemphigus;
  • Bullous pemphigoid;
  • Pemphigoid of the mucous membrane;
  • Pemphigoid during pregnancy;
  • Immunoblastic disorders;
  • Linear bullous dermatosis of IgA.

Contact stomatitis

Contact stomatitis can occur due to irritating foods and allergies.

Other causes

  • Chronic ulcerative stomatitis;
  • Oral leukoplakia (precancerous state);
  • Erosive lichen planus;
  • Lupus erythematosus;
  • Recurrent aphthous ulceration;
  • Autoimmune progesterone dermatitis;
  • Geographic language / migratory glossitis.

At what time of the year is stomatitis most common?

The disease is more likely to happen during winter and autumn, at colder times and when there is more crowding of people with the flu or colds indoors, making the immune system more vulnerable.

Stomatitis symptoms

Canker sores, wounds caused by stomatitis, usually bring a lot of discomfort and pain, especially to small children. First, the gum appears reddish and small rounded rashes may appear. These wounds are usually between 1 and 5 millimeters in diameter, have a yellowish or grayish appearance on the inside and reddish on the outside. The gums can become inflamed and cause bleeding.

As the wound causes pain, the child may refuse to eat, drink and, often, may even drool for fear of swallowing saliva. In these cases, it is important to offer some type of liquid several times until hydration occurs, because in cases of dehydration, hospitalization may be necessary.

If the child does not urinate for 6 consecutive hours, it is advisable to consult the doctor, as it is a sign of dehydration. The bad breath , a headache and fever that can reach up to 40 degrees are also common symptoms.

It is necessary to keep tooth brushing up to date, no matter how much it causes discomfort in the little ones.

Symptoms can last up to two weeks, the first being the most difficult, as the mouth is very sensitive, causing a lot of pain.

Diagnosis

The specialists recommended to treat stomatitis are: pediatrician, dentist, gastroenterologist, immunologist, infectologist and general practitioner.

Going to the consultation with some information can be essential for the diagnosis to be made more quickly:

  • How long have the symptoms been felt?
  • What are the main symptoms?
  • Have any medications been used to relieve symptoms?
  • Does the child complain of pain when eating?

For the diagnosis to be given, the doctor will perform a physical examination, in which the patient’s mouth will be analyzed, ask questions and, after that, the diagnosis can be made.

Treatment

Even without treatment, mouth sores do not usually last more than 2 weeks. With the cause of the stomatitis identified, the doctor can make the correct treatment. However, if it is not discovered, only treatment is done to relieve the patient’s symptoms.

It is necessary to keep the patient always hydrated. Try to offer drinks that do not contain gas, are not acidic and preferably cold, such as water, milkshake, yogurt and ice cream.

Making foods without too much seasoning is indicated so that it does not cause pain to patients. Macaroni in butter, mashed potatoes or cassava can be good options to keep the person fed.

If there is a burn in your mouth, gargling with ice water or sucking on ice will help relieve symptoms.

Medicines for stomatitis

  • Gingilone ;
  • Hexomedine ;
  • Pinavério bromide ;
  • Blistex and Campho-Phenique can relieve the symptoms of thrush and sores;
  • Paracetamol or ibuprofen to decrease pain and control fever.

Attention! 

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Complications

As the patient’s immunity becomes very low, secondary infections can occur, such as candidiasis , even though they are not common.

The most well-known complication of stomatitis is dehydration.

In rare cases, stomatitis caused by the herpes virus can spread to the eyes and infect the cornea. If this occurs, the damage to the eyes can be forever. Therefore, if your child has stomatitis and red eyes, is sensitive to light or watery, take him to the emergency room quickly for the diagnosis to be made.

Prevention

Keeping up to date is the best way to avoid virus contamination. Keeping an eye on children’s mouths is also important to avoid further suffering before the diagnosis is made.

Brushing the teeth of the little ones is the responsibility of the parents, because keeping their oral hygiene up to date is a way to prevent stomatitis. Maintaining the child’s hand hygiene is also a form of prevention.


Stomatitis is very common in childhood. Having information about the disease is critical to knowing how to deal with it when it affects someone you know. So that your colleagues, family and friends are also informed about stomatitis, share this text with them!

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