What is Angular Stomatitis?

Stomatitis is inflammation of the oral mucosa, which can affect the buccal mucosa, tongue, gums, and palate. More common in childhood, especially infants and young children, can be purely onset or secondary to diarrhea, malnutrition, acute infection, chronic illness and other systemic diseases. The main causes of stomatitis are bacteria, viruses and fungi.

Basic Information

English name

stomatitis

Visiting department

Stomatology

Multiple groups

Infants

Common locations

Buccal mucosa, tongue, gums, palate

Common symptoms

Ulcerative stomatitis, herpes stomatitis, drug allergic stomatitis, candidiasis cheilitis

Causes of stomatitis

Streptococcus and staphylococcus are the main pathogenic bacteria for bacterial infectious stomatitis. Under the condition of low body resistance such as acute infection and long-term diarrhea, if the oral cavity is unclean, the bacteria will multiply and cause acute oral mucosal damage.

Clinical manifestations of stomatitis

Ulcerative stomatitis

Can occur in all parts of the oral cavity, common in the lips, tongue and buccal mucosa, etc., can spread to the lips and throat. Mucosal hyperemia, edema, and herpes may be present at first, followed by erosion or ulcers of various sizes. The wound is covered with a gray-white or yellow pseudomembrane formed by a thick cellulose exudate. The border is clear and easy to wipe off, leaving bleeding after wiping The erosive surface of pseudo-membrane soon reappeared. Local pain, enlarged lymph nodes. Antifeeding, irritability, fever 39 ~ 40 . In mild patients, the body temperature returned to normal in about a week, and the ulcers gradually recovered; in severe cases, dehydration and acidosis may occur.

Herpes stomatitis

Fever reached 38 ° C ~ 40 ° C at the onset of the disease. After 1 to 2 days, single or clustered small herpes appeared in the oral mucosa of the gums, lips, tongue, buccal mucosa and other parts, with a diameter of 2 ~ 3mm, and there were redness around it, which quickly broke. Ulcers form after ulceration, covered with yellow-white cellulose secretions, multiple ulcers can be fused into large irregular ulcers, sometimes involving the palate and pharynx. Sores and herpes often occur in the corners of the mouth and around the lips, with severe pain, refusal to feed, salivation, irritability, and often submandibular lymph nodes. The body temperature returned to normal after 3 to 5 days, and the course of disease was 1 to 2 weeks. Local lymphadenopathy can last for 2 to 3 weeks.

The disease should be distinguished from herpetic angina, which is caused by coxsackie virus and occurs mostly in summer and autumn. The sores mainly occur in the pharynx and soft palate, and are sometimes seen on the tongue but do not involve the gums and buccal mucosa. Swelling.

3. Drug allergic stomatitis

After taking a certain drug, the oral mucosa has acute inflammation. Usually onset about 24 hours after taking the drug. Its early symptoms are congestion of the oral mucosa, edema or erythema and blisters. As the drug is continuously absorbed, the early symptoms gradually worsen and a mucous membrane ulcer is formed. This mucosal ulcerated face is different from ordinary aphthous ulcers. The ulcerated face is covered with bloody secretions. The ulcerated face is swollen, which often causes irritating severe pain. Children refuse to eat due to pain.

4. Candida cheilitis

It is characterized by bilateral attacks, cracks in the skin and mucous membranes in the corner of the mouth, and congestion in the adjacent skin and mucous membranes. The clefts often have erosions and exudates, or thin palate, and pain or bleeding when opening. This fungal cheilitis, characterized by wet white erosion, should be distinguished from vitamin B2 deficiency or bacterial cheilitis. The former is accompanied by glossitis, cheilitis, scrotalitis, or vulvitis, while the latter is mostly single-sided. , Bacterial culture is positive (mainly streptococcus); Candida cheilitis occurs mostly in children, physically weak patients and patients with hematological diseases.

Oral cheilitis in older patients is mostly related to shortening the vertical distance of occlusion. The skin in the corner area collapses into a groove, causing saliva to overflow from the corner of the mouth into the groove, so it is often moist, which is conducive to mold growth and reproduction.

Stomatitis examination

Blood test

The total number of white blood cells of bacterial stomatitis increased; the number of white blood cells of herpes stomatitis was usually normal.

2. Histopathological examination

Tissue staining at the bottom of the blister showed multinucleated giant cells with eosinophil particles in the nucleus. When observed under an electron microscope, hexagonal herpes simplex virus was seen second only to the center of the nucleus.

Differential diagnosis of stomatitis

This disease should be distinguished from herpes angina caused by Coxsackie A virus.

Stomatitis prevention

Pediatric stomatitis

Common stomatitis includes thrush, herpes stomatitis, and bacterial stomatitis. There are five key points for its prevention: pay attention to scientific feeding, improve disease resistance, strengthen physique, and avoid malnutrition and vitamin deficiency; pay attention to oral hygiene, especially when oral infections occur; pay attention to diet and utensils 3. Clean and disinfect the nipples to reduce the occurrence of diarrhea; take Banlangen prophylactically once a day for 3 days during the epidemic of herpes stomatitis; rationally use antibiotics to avoid abuse and induce thrush and secondary infection in children.

2. Allergic stomatitis

(1) Awareness and common sense of drug allergic reactions. During the first or re-application of the same drug, if there is an unexplained fever, rash with itching, or sudden chest tightness, palpitations, dizziness, cold sweats, nausea, When vomiting, etc., allergic reactions to the drug should be considered in time, and the doctor should be diagnosed and treated.

(2) If you have a history of allergies to a certain drug, you must actively inform your doctor about the history of allergy to prevent recurrence.

(3) In the course of treating diseases, do not use too much, too much disorder, too much medicine, and do not use too much medicine.

(4) People who work in the open air for a long time should be alert to the photosensitivity caused by drugs.

3. Membrane stomatitis

The most important thing is to clean your teeth every day and brush your teeth correctly. You should use the vertical brushing method. Brush your teeth 8-10 times in the morning and evening. About 20 minutes of chewing gum; change a new toothbrush every month; visit the dentist every 3 months; pay attention to the amount of fluoride toothpaste (especially children), generally the size of a pea; Eversion should be replaced; if there is no periodontal disease, you can wash your teeth once a year in your dentistry; drink less carbonated drinks.