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Catarrhal stomatitis: it's not as simple as it seems
Medical expert of the article
Last reviewed: 05.07.2025
Although the human oral cavity, according to the Latin terminology accepted in medicine, is called cavitas oris, such a common disease as catarrhal stomatitis has a Greek origin: katarrhoos - flow (or inflammation) and stomatos - mouth. That is, catarrhal stomatitis is a pathological condition of the oral mucosa, which is expressed in its inflammation.
Pathologies of the oral mucosa (stomatitis) have different origins (etiology) and many different clinical symptoms (manifestations). Clinical classification divides these diseases into catarrhal stomatitis, ulcerative stomatitis and aphthous stomatitis. From the point of view of clinical diagnostics, catarrhal stomatitis is recognized as the most common variant.
[ Causes of catarrhal stomatitis
Classification based on the causes of stomatitis divides them into the following types:
Traumatic (mechanical, thermal or chemical damage to the mucous membrane, including as a result of professional activity);
Infectious (lesion of the mucous membrane by pathogenic microbes, including those associated with infections such as influenza, parainfluenza, adenosine, herpes, chickenpox, measles);
Specific (mucosal lesions characteristic of certain diseases, such as tuberculosis, syphilis and leprosy);
Symptomatic (when damage to the oral mucosa is one of the manifestations of pathology of the hematopoietic, digestive, cardiovascular, endocrine or nervous systems of the body, as well as a symptom of systemic diseases - pemphigus, streptoderma, lichen planus, immunodeficiency).
The main cause of catarrhal stomatitis, recognized by all dentists, is a purely local factor - insufficient oral hygiene. At the same time, the pathological condition of its mucous membrane is facilitated by dental diseases, the presence of deposits on them (tartar), as well as an imbalance of microflora in the mouth (dysbacteriosis). In addition, any manipulations of dentists, or rather their violations, such as microtrauma during dental treatment or poorly fitted dentures, can cause catarrhal stomatitis.
However, everything is not as simple as it seems. Because the list of purely dental causes of catarrhal stomatitis is supplemented by such general negative factors as: iron deficiency anemia; vitamin deficiency (A, B, B9, C); insufficient salivation (xerostomia); smoking; dehydration (with vomiting, diarrhea, polyuria or significant blood loss); helminthic invasion; some cancers and side effects of chemotherapy; hormonal changes of various etiologies. And even the notorious sodium lauryl sulfate - a surfactant used to form foam in the production of most toothpastes (as well as hair shampoos and shower gels). This substance causes persistent dryness of the mucous membranes and skin...
Moreover, recently doctors are inclined to believe that the cause of catarrhal stomatitis is immune in nature. This disease is a response of our immune system to antigenic peptides of foreign cells that are not recognized by T-lymphocytes. It is not without reason that catarrhal stomatitis most often occurs in small children and in the elderly, when immunity is reduced due to age-related characteristics of the body. For the same reason (i.e., decreased protective functions), catarrhal stomatitis is a common complaint of patients with gastrointestinal tract pathologies.
Symptoms of catarrhal stomatitis
The distinctive feature of catarrhal stomatitis is inflammation of the upper epithelial layer of the oral mucosa in the absence of damage to its deeper layers.
The main symptoms of catarrhal stomatitis are swelling, redness and soreness of the oral mucosa. At the same time, due to swelling, "imprints" of teeth appear on the mucosa of the cheeks - along the line of closure of the teeth, and on the sides of the tongue. The mucosa is covered with a white or yellowish coating, the secretion of saliva increases (hypersalivation), an unpleasant odor from the mouth (halitosis) is noted. The swollen gingival papillae between the teeth are injured and bleed. Pain when chewing food is a concern. But at the same time, there are no obvious defects (ulcers or papules) on the mucosa.
These symptoms give reason to believe that this is an inflammatory disease of the oral mucosa - acute catarrhal stomatitis.
But if the disease is not treated, then its clinical picture changes, and the pathological process takes a chronic form. This is what specialists often call ulcerative stomatitis, which in most cases is actually the next stage of acute catarrhal stomatitis.
At this stage of the disease, the deepest layers of the oral mucosa are affected, and erosions and ulcers join the plaque. The destruction of tissues leads to the appearance of serous plaque along the edge of the gum, after removal of which a painful, bleeding erosion remains.
The general condition of the body worsens with an increase in body temperature to +37.5-38°C, weakness and headache. Eating and the process of articulation become excruciatingly painful, the submandibular lymph nodes enlarge and cause pain when palpated.
Catarrhal stomatitis in children
Inflammation of the oral mucosa most often occurs in very young children - from birth to three years. Pediatricians diagnose catarrhal stomatitis in infants as thrush, which is called candidiasis, since it is caused by yeast-like fungi of the genus Candida. With this catarrhal stomatitis, the mucous membrane in the child's mouth swells, turns red and becomes covered with a white coating that looks like curdled milk. Often, blisters appear on the mucous membrane, and after they open - ulcers. At the same time, skin rashes (urticaria), dyspepsia and muscle pain can be observed.
Catarrhal stomatitis in children may accompany infectious diseases such as measles, chickenpox, diphtheria. The cause of catarrhal stomatitis at an early age is often mechanical damage to the oral mucosa, as well as allergies after treatment with antibiotics or sulfonamides.
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Diagnosis of catarrhal stomatitis
Diagnosis of catarrhal stomatitis is made by a doctor during an examination of the patient’s oral cavity, taking into account the anamnesis and data on the presence of other diseases, primarily gastric and intestinal.
However, experts claim that correct diagnosis of catarrhal stomatitis is not an easy task, since a visual assessment of the situation in a fairly large number of clinical cases does not reveal the true cause of this disease, and there is no specially developed diagnostic technique for stomatitis yet.
Therefore, a good doctor will not only examine the patient’s oral cavity, but will also take a scraping of the mucous membrane and give a referral for a general blood test.
What do need to examine?
How to examine?
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Treatment of catarrhal stomatitis in adults and children
Treatment of catarrhal stomatitis is mainly local, aimed at eliminating inflammation and associated external signs.
In acute catarrhal stomatitis, frequent rinsing of the mouth with antiseptic solutions and decoctions of medicinal plants is recommended. For this purpose, a solution of hydrogen peroxide is used (a tablespoon of 3% hydrogen peroxide per 100 ml of boiled water); a 2% solution of baking soda (a teaspoon per 0.5 liters of water). The antimicrobial drug Chlorhexidine (Gibitan, Sebidin) is used: a 0.05-0.1% solution is used to rinse the mouth 2-3 times a day.
Both adults and children need to rinse their mouths every 2-3 hours with decoctions of chamomile, sage, calendula, oak bark, walnut leaves, plantain, yarrow, cinquefoil, and arnica. To prepare the decoction, take two tablespoons of dry herbs per glass of boiling water, boil for 5-7 minutes, and let it brew for half an hour. To quickly prepare a mouthwash, you can use ready-made alcohol tinctures of calendula, St. John's wort, and eucalyptus, adding 30 drops of tincture to 100 ml of boiled water. Alcohol tincture of propolis is very effective in treating catarrhal stomatitis: rinse your mouth several times a day with a solution prepared from 100 ml of warm water with a teaspoon of this tincture added.
To relieve swelling of the mucous membrane, doctors recommend taking a 5% solution of calcium chloride (calcium chloride) orally: the medicine is taken twice a day after meals, a single dose for adults is a dessert or tablespoon, for children - a teaspoon. Calcium chloride is contraindicated in case of a tendency to thrombosis and severe forms of atherosclerosis.
Antibacterial agents such as Tantum Verde and Hexoral are also used in local therapy of catarrhal stomatitis. The nonsteroidal anti-inflammatory drug Tantum Verde in the form of lozenges is prescribed one tablet 3-4 times a day. In the form of an analgesic and anti-inflammatory solution for rinsing the mouth, this drug is prescribed 1 tablespoon every 2-3 hours. The solution for local use is contraindicated for children under 12 years of age.
Tantum Verde spray is used three times a day, 4-8 doses (i.e. 4-8 presses on the spray). For catarrhal stomatitis in children, the spray is used as follows: children aged 6-12 years - 4 doses, children under 6 years - at the rate of 1 dose for every 4 kg of body weight. Side effects of this drug are manifested in the form of a feeling of numbness, burning or dry mouth; skin rash and insomnia are possible.
The drug Hexoral has antiseptic, antimicrobial, analgesic, enveloping and deodorizing properties. Hexoral solution should be used undiluted for rinsing or rinsing the mouth, or applied to the affected areas of the mucous membrane. The dose for one procedure is 10-15 ml, the duration of the procedure is 30 seconds. Hexoral spray is sprayed on the affected areas of the oral mucosa for 2 seconds twice a day after meals. A side effect of this drug is a violation of taste sensations, it is contraindicated for use in catarrhal stomatitis in children under three years of age.
The prescription of oral medications for the treatment of catarrhal stomatitis depends on the etiology of the inflammation. Thus, in infectious catarrhal stomatitis in adults and in catarrhal stomatitis in children in the form of thrush (candidiasis) - doctors most often prescribe the antifungal combination antibiotic Nystatin (in tablets of 500,000 IU). The dosage of this drug for adults is one tablet 3-4 times a day or 0.5 tablet 6 times a day. The average duration of treatment is 10 days.
Dosage of Nystatin for children under 1 year: a quarter of a tablet (125,000 IU), from 1 year to 3 years - half a tablet (250,000 IU) 3-4 times a day, and for older children - 2 to 3 tablets per day in 4 doses. The tablets are swallowed without chewing, but in case of significant lesions of the mucous membranes of the oral cavity, the tablets are placed behind the cheek after meals, where they are kept until completely dissolved.
In the treatment of catarrhal stomatitis in children - thrush in infants - drops with Nystatin are used, which are prepared at home as follows: one Nystatin tablet is crushed into powder and mixed with the contents of one ampoule of vitamin B12 (it is possible with boiled water). The resulting solution is used to treat the child's oral cavity 2-3 times a day using a tampon or cotton swab.
Nystatin usually does not cause side effects, but with increased sensitivity to the antibiotic, nausea, vomiting, diarrhea, fever, chills are possible. Among the contraindications of this drug: liver failure, pancreatitis, gastric ulcer and duodenal ulcer, pregnancy, hypersensitivity to the drug.
For successful treatment of catarrhal stomatitis, you should avoid hot, cold, spicy, sour and coarse food. You should drink rosehip infusion and take vitamin preparations containing vitamins A, B and C.
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Prevention of catarrhal stomatitis
In order to prevent catarrhal stomatitis, it is necessary to remove tartar, promptly treat carious teeth, regularly and thoroughly brush your teeth and rinse your mouth after eating. If you have a history of gastrointestinal diseases and endocrine pathologies, you should start treating them.
A balanced diet, eating foods rich in vitamins, primarily vegetables and fruits, taking good multivitamin complexes in the winter, quitting smoking... In general, everything that can help increase the protective functions of the immune system will contribute not only to the prevention of catarrhal stomatitis, but also many other diseases.