What and how to treat stomatitis?

All diseases of the oral cavity are related to dentistry, which is quite logical, since "stoma" means mouth in translation. Accordingly, to the question of which doctor treats stomatitis, the answer is one - a dentist, adult or pediatric, depending on the age of the patient. Babies with stomatitis are supervised by the attending pediatrician, but children from 3 years old are already subject to examination in a children's dental institution. If the inflammatory process is combined with other pathologies of the oral cavity, the disease is treated with the help of other doctors - a gastroenterologist, endocrinologist, immunologist, allergist. Everything depends on what caused the inflammation, this sometimes determines which doctor treats stomatitis.

In order to clarify the type and features of the inflammatory process, the doctor examines the oral cavity, but first he questions the patient, that is, collects anamnesis. It is very important to find out the root cause of the disease, since this determines what the therapeutic strategy will be, how to treat stomatitis and how long the treatment course will last. To date, there are no specific laboratory tests that help differentiate stomatitis from other inflammatory processes in the oral cavity, the main diagnostic criterion is the appearance of the mucous membranes and the localization of ulcerated areas. Often, studies of the gastrointestinal tract, analysis of the state of the hormonal system, tests and samples to determine allergens and other examinations that are not related to traditional dental methods help to find the provoking factor. Often, recurrent stomatitis is a consequence of decreased immune activity or chronic pathologies of the digestive organs. Changes in local immunity, diseases of the throat, nose, neurological problems can be identified by an ENT doctor, neurologist, immunologist. This may require microbiological studies of nasopharyngeal smears, determination of immunoglobulins, radiography of the entire jaw apparatus. Thus, the specified cause and specification of the type of stomatitis help to build an effective treatment strategy, select adequate drugs and achieve a lasting result.

How to treat stomatitis?

The selection of drugs, means and methods that help relieve inflammation and, in principle, cure stomatitis depends on the etiology of the disease, the intensity of the process, the localization of ulcers (aphthae) and the general condition of the patient. The doctor will decide how to treat stomatitis after a comprehensive examination; the following groups of means and methods are included in the treatment measures:

• Antiseptic solutions for rinsing.
• Oral cleaners, special toothpastes that do not contain SLS - sodium lauryl sulfate. Many dentists are convinced that it is the addition of SLS to dental care products that is the cause of 30% of all cases of stomatitis. Statistics show that using rinses and dental pastes without sodium lauryl sulfate for a month improves the condition of the oral mucosa by 75%.
• Antibacterial agents that sanitize the oral cavity and cleanse bacterial plaque on ulcers that have formed.
• Anesthetics.
• Antiviral drugs.
• Preparations that promote the regeneration of the oral mucosa.
• Immunomodulators.
• Antihistamines.
• Vitamins.
• Diet therapy.
• Preventive measures.

If it is possible to accurately determine the etiology and type of stomatitis, then it is possible to develop an effective therapeutic strategy and determine how to treat stomatitis.

Cause and type of inflammation	Methods and preparations
Viral stomatitis, herpetic stomatitis	Antiviral agents for local use: zovirax oxolinic ointment acyclovir tebrofen ointment alpizarin Healing preparations: rosehip oil sea buckthorn oil mundisal gel caratolin vinylin solcoseryl (paste) Anesthesia – local applications: anesthesin lidocaine tricaine pyromecaine Activation of local immunity: Imudon (tablets for resorption) Immunal Levamisole
Thrush, candidal stomatitis	Antiseptic treatment of the oral cavity with pimafucin, chlorhexidine, mouthwash solutions, rotokan. Locally - applications of antifungal ointments - clotrimazole, nystatin ointment Treatment of the candidal surface - trypsin, vitaon Activation of local immune protection - resorption of Imudon tablets Activation of general immunity: Viferon Lafarobion
Aphthous stomatitis	Oral cavity treatment: Dexamethasone solution Clobetasol ointment Injectable or tablet form of betamethasone, prednisolone, azathioprine
Stomatitis of bacterial etiology, caused by mechanical trauma or poor oral hygiene	Antibacterial agents, local: Tantum Verde Orasept Hexoral Vagotyl Miramistin Chlorophyllipt

Most often, stomatitis is treated with local antiseptics - solutions, special lozenges, tablets. If the inflammation is diagnosed in time, at an early stage of development, local treatment provides a fairly quick and lasting result. How to treat stomatitis in more severe cases is decided by the dentist or pediatrician (in children under 3 years old), the effectiveness of the therapy depends on many factors, including the responsibility of the patient. Prescribed rinses and sanitizing procedures must be performed in accordance with the recommendations and not stop the course even if the symptoms of stomatitis do not cause discomfort. You should also pay attention to the important role of diet, from which sweet foods are excluded. Nutrition should be rational, such that it can support, strengthen the immune system and at the same time not create a favorable environment for the spread of bacterial infection.

Treatment of the mouth for stomatitis

In the treatment of stomatitis, one of the most important actions is considered to be regular treatment of the oral cavity. The mucous membrane should be exposed to almost simultaneous action of antiseptic solutions, antibacterial agents, and pain-relieving gels or ointments are applied to it.

Treatment of the mouth for stomatitis is carried out using the following means:

• Rinsing with antiseptic preparations.
• Treatment of ulcerated areas with gels or ointments – anesthesia and relief of inflammation.
• Removal of inflammation products (crusts).
• Resorption of anti-inflammatory tablets.
• Irrigation of the oral cavity with antibacterial sprays and aerosols.

The first step in treating the oral cavity is to remove specific crusts that have formed on the site of ulcers, aphthae. These growths are the ones that cause pain, and as soon as they are removed, the pain begins to subside. In order for the growths to be removed as painlessly as possible, the oral cavity should be rinsed or irrigated with a special solution to soften the crusts. The growths are removed using oil solutions with a sterile cotton swab. After the first stage of treatment has been completed, it is necessary to carry out antiseptic sanitation of the mouth using a decoction of medicinal herbs (sage, chamomile, calendula). Effective treatment of the mouth for stomatitis is with Tantum Verde spray, which is used 2-3 times a day until the aphthae are completely neutralized. Drying the ulcers with chlorhexidine, furacilin solution, and trypsin is also effective. Point cauterization is performed with a sterile swab soaked in a medicinal preparation; this action helps stop the spread of aphthae and stops the process of opening of aphthous blisters.

The complex of oral cavity sanitation also includes the use of gels and ointments, which not only relieve pain during the inflammatory process, but also promote rapid healing of wounds and regeneration of mucous membrane tissue.

Treatment of the mouth for stomatitis requires following these rules:

• Before the procedure, you must wash your hands thoroughly, preferably with a disinfectant.
• Oral irrigation should be carried out according to the regimen prescribed by the doctor, as a rule, this is done every four hours.
• Irrigation or rinsing of the mouth should be done after each meal to remove the breeding ground for bacteria.
• In case of exacerbation of stomatitis, solutions and products in lower concentrations should be used so as not to create additional irritation of the oral cavity.
• Cauterization of aphthae and ulcers is performed only after rinsing or irrigation.
• Cauterization of ulcerated areas should be carried out at least 3 times a day.

Preparations that can be used to treat an inflamed oral cavity:

1. Rinsing:
   • Chlorhexidine.
   • Hydrogen peroxide solution – 1 tablespoon of the product is diluted in 100 ml of boiled cooled water.
   • Furacilin solution - 2 tablets are dissolved in a glass of boiled cooled water.
   • Baking soda solution – 1 teaspoon dissolved in 100 ml of boiled warm water.
   • Rotokan – 1 teaspoon of the product is diluted in a glass of warm water.
   • Malavit – 1 teaspoon diluted in 200 ml of boiled water.
   • Miramistin.
   • Chlorophyllipt.
2. Cauterization of aphthae, ulcerated areas:
   • Iodinol.
   • Methylene blue solution.
   • Lugol's solution.
   • Fucorcin solution.
3. Antibacterial lozenges:
   • Foxbact.
   • Imudon.
   • Tantum Verde.
   • Pharyngosept.
   • Grammidin.
   • Hexalysis.

If the oral cavity is treated according to all the rules, systematically and comprehensively, stomatitis can be cured within 7-10 days, bacterial inflammation in the initial stage is especially quickly stopped. Other types of stomatitis are treated longer, but can also be cured, provided that all medical recommendations are followed.

How long does stomatitis take to heal?

If stomatitis is diagnosed at an early stage of development, when aphthae are still just forming, if the patient promptly begins complex treatment of the oral cavity and responsibly follows all medical recommendations, then relief of symptoms is noticeable already on the second day, and complete recovery is possible after 10 days. A mild form of inflammation really responds only to antiseptic treatment and does not require the use of other methods of therapy, epithelialization of the mucous membrane occurs quickly, but signs of inflammation can persist for another 10-14 days.

Severe, complicated forms of stomatitis are treated much longer, the therapeutic course can last up to one month, everything depends on the type of disease and the severity of symptoms. Herpetic stomatitis in children is especially difficult to treat, at least a week is required to stop the acute phase, and complete neutralization of the virus is possible only after 3 weeks with a properly selected course of treatment. Herpetic aphthae heal for a long time and often even the use of adequate drugs cannot stop their development. Therefore, viral stomatitis must be treated using all available medical methods, including physiotherapy. Treatment cannot be stopped even after the pain has subsided and the ulcers have healed, since this type of inflammation is prone to relapse.

How long stomatitis is treated is determined by the attending physician, who diagnoses and classifies the disease according to the presented symptoms and objective examination data. In dental practice, there is an opinion, confirmed by many years of practice, that the period of treatment and recovery time depend on the correctly chosen therapeutic strategy. The more active the medicine is, the more effective the drug is, the more successfully the infectious process is stopped, the focus of inflammation is neutralized, the faster the regeneration of the mucous membrane and the restoration of local immunity. In some sources, you can read information that stomatitis cannot be completely cured, but this is outdated information. Modern pharmacology, experience and knowledge of doctors allow us to say that an approach to the treatment of aphthous inflammation of the oral cavity exists and regardless of how long stomatitis is treated, sooner or later it will be neutralized.

Vitamins for stomatitis

Vitamin complexes play an important role in the treatment of stomatitis. There is an opinion that such a wide prevalence of inflammatory diseases of the oral cavity is directly related to a decrease in immune activity and vitamin deficiency in the body. Often, the deficiency of some vitamin groups leads to looseness and bleeding of the gums, vulnerability of the oral mucosa. Several years ago, Swiss pharmacologists found that about 25% of patients with stomatitis suffer from a deficiency of B vitamins, as well as microelements - iron, zinc, folic acid, selenium. The absence of a normal amount of biologically active substances in the body leads to a decrease in the local immune barrier, increased sensitivity and a potential threat of developing erosions in the oral mucosa.

In dentistry, a new direction has even emerged – orthomolecular therapy, which offers the following methods and vitamins for stomatitis:

• Massive replenishment of biologically active elements to restore the barrier functions of the epithelium and increase its regenerative properties •
• Creation of an anti-inflammatory and anti-allergic barrier, increasing the potential of the mucous membrane functions •
• Prescribing vitamin and mineral complexes, amino acids, polyunsaturated fatty acids to restore all body functions •
• Purpose of prebiotics, probiotics, fiber

The list of vitamins that can help in the treatment of oral inflammation is huge. Their choice depends on the type and stage of the disease. However, the most effective are considered to be vitamins of group B, vitamins C, A, E and PP. What vitamins can be prescribed for stomatitis:

• Ascorbic acid.
• Quercetin or other bioflavonoids.
• Vitamin B1.
• Vitamin B3 (niacin).
• Folic acid.
• Vitamin B12.
• Vitamin A.
• Pantothenic acid.

As minerals, the intake of iron-containing preparations is shown, especially important for bleeding of the oral cavity, as well as zinc, selenium and calcium. Omega 3 PUFAs promote better epithelialization of tissues, activate their nutrition, normalize the state of the vascular system, lysine can increase the protective functions of the mucous membrane, zinc and calcium strengthen the gum tissue.

How can you use vitamins for stomatitis at home?

• Open the ampoule with vitamin B12.
• Wrap a piece of sterile bandage around your finger.
• Wet your finger in a solution of vitamin B12.
• Treat the entire oral cavity with your finger, including aphthae.
• The procedure is carried out 3 times a day.

An additional course can be taken with a vitamin complex, focusing on group B. According to statistics, 55% of patients with stomatitis after 2 weeks of taking vitamins significantly improved the condition of the mucous membrane, even in the most severe cases. Of course, vitamins cannot serve as the only treatment method to get rid of stomatitis, but their role is very important in general therapeutic measures.

Summarizing the extensive information about therapeutic measures aimed at curing inflammations of the oral cavity, we note that the treatment of stomatitis depends on two external factors - the responsibility of the patient and the competent actions of the attending physician.

The general directions that are assumed for the treatment of all types of stomatitis without exception are reduced to the following stages:

• Relief of pain symptoms.
• Neutralization of the root cause – virus, bacterial infection, traumatic factor, allergy.
• Detoxification measures.
• Activation of local and general immune defense.
• Prevention of relapses.

The speed of the patient’s recovery and return to normal life depends on how comprehensively and timely the treatment of stomatitis is carried out.