Oral candidiasis - symptoms and treatment

Types of disease

According to ICD-10, aphthous stomatitis is assigned code K.12. Within the code there are three qualifying diagnoses, including K.12.0 - “recurrent aphthae of the oral cavity,” which also includes aphthous ulcers.

According to the form of occurrence, acute and chronic aphthous stomatitis are distinguished. The first is characterized by the appearance of ulcers and severe hyperemia - swelling, redness of the mucous membranes. Severe pain occurs, especially when eating or talking. Submandibular lymph nodes may enlarge and body temperature may rise.

Chronic recurrent aphthous stomatitis may be the result of improper or untimely treatment, as well as the inability of the immune system to cope with the disease. It is characterized by periodic exacerbations. Outside of exacerbation, symptoms may be erased or completely absent.

The disease is classified into three forms depending on the severity:

• light. From 1 to 2 afts up to 10 mm in size. Moderate pain during mechanical action, relapses occur no more than 2 times a year;
• average. Up to 5 aft, the course of treatment takes up to 3 weeks. The pain is quite pronounced, there is an enlargement of the lymph nodes, relapses up to 2 times a year;
• heavy. Multiple aphthae appear, severe pain. An increase in temperature occurs, and symptoms of general intoxication appear. Treatment takes up to a month, relapses occur up to 6 times a year.

Also, according to the form of occurrence, the following types of inflammatory diseases are distinguished:

• fibrous: blood microcirculation in the upper layer of the mucosa is disrupted, aphthae appear, covered with a fibrous film (plaque). Such ulcers heal completely within 14 days. The disease affects the mucous membrane of the lips, the lateral surfaces of the tongue, and transitional folds. This stomatitis recurs up to 3 times a year;
• necrotic. The epithelium is destroyed, the mucosal area dies. Replacement of tissues with normal epithelium takes from 14 to 30 days. This aphthous stomatitis is not accompanied by acute pain; it is usually observed in patients with severe diseases, including blood pathologies;
• grandular. Damage to the ducts of the minor salivary glands occurs. In this regard, aphthae form close to the glands, and drying of the mucous membranes of the oral cavity occurs due to a decrease in saliva production. Ulcerations are painful and heal within 1–3 weeks;
• scarring. Damage to the cavity of the salivary glands leads to the involvement of connective tissue in inflammation. Aphthae are observed both at the location of the glands and on the mucous membranes of the pharynx and palate. The disease develops into large painful ulcers (up to 1.5 cm). Healing takes up to 12 weeks; after the acute process, pronounced scars remain;
• deforming. The most severe form of the disease, which provokes changes in connective tissue. Aphthae heal extremely slowly, which is accompanied by deformation of the palate, lips, and sometimes narrowing of the oral cavity occurs (if aphthae was observed in the corners of the mouth).

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How to recognize the disease

It is not difficult to understand that discomfort in the mouth is associated with stomatitis. At first, mild swelling appears. In certain places, the mucous membranes become red and more shiny. Afterwards, zones covered with plaque form on their surface. Then the person begins to feel severe itching and burning.

Gradually, painful lesions turn into ulcers (aphthae) and oval or round wounds. Most often they are located on the palate, under the tongue, on the inner surface of the lips and cheeks. Due to aphthae, normal eating becomes impossible - when trying to eat something solid, a person experiences acute pain.

Causes of aphthous stomatitis

Not all causes of aphthous stomatitis are fully understood. The mechanism of aft formation is often associated with activation of the local immune system - immune cells begin to destroy the epithelium of the mucous membranes, which leads to ulcers.

Local reasons include the following:

• allergic reactions;
• pathogenic microorganisms;
• mechanical damage (biting mucous membranes, injury from sharp edges of fillings or orthopedic, orthodontic structures);
• temperature or chemical influences.

Systemic causes of aphthous stomatitis:

• menstruation, pregnancy in women;
• sudden cessation of smoking;
• enteropathy, celiac disease, malabsorption;
• blood diseases;
• diseases of the immune system;
• lack of vitamins;
• other systemic diseases (lupus erythematosus, Crohn's disease, HIV infection, etc.).

Folk remedies for stomatitis in children

Treatment of stomatitis in children with folk remedies involves the following measures:

• rinsing with antiseptic solutions;
• wiping the affected surface of the mucous membrane with medicinal decoctions;
• applying medicinal mixtures to the surface of the ulcers.

For rinsing it is best to use:

• water-soda solution (1 teaspoon of soda per 1 glass of water);
• decoction of calendula or chamomile flowers.

Suitable for wiping:

• propolis tincture solution;
• calendula tincture solution;
• freshly squeezed aloe juice.

Apply to the surface of the ulcers:

• honey;
• egg white;
• rose jam;
• a mixture of egg white, honey and novocaine.

The drugs are applied to the surface of the mucous membrane until completely absorbed.

Symptoms of aphthous stomatitis

Usually, 1–2 days before the appearance of aphthae, areas of the mucous membrane with increased sensitivity are detected, and a burning sensation may occur. The aphthae themselves are round, have clear boundaries, and are covered with a gray or yellowish coating. Their size, as a rule, does not exceed 1 cm, and the mucous membranes around them turn red.

Such areas of erosion heal within up to 2 weeks without scarring. But in 1 case out of 10, the diameter of the ulcers is more than 1 cm, they affect deeper areas of tissue, and the borders of the pathological area may look raised. Healing in this case takes up to 6 weeks, after which a scar forms.

Aphthous stomatitis is characterized by damage to the mucous membranes of the cheeks, the inside of the lips, the soft palate, tonsils, and the lateral surfaces of the tongue. This is due to the lack of keratinization of the epithelium in these areas. Much less often, aphthae appear on the hard palate, back of the tongue, and gums.

Diagnostic features

At the initial appointment, the dentist examines the oral cavity and analyzes complaints. To make an accurate diagnosis, you need to distinguish this form of the disease from others, as well as differentiate it from other pathologies that have similar symptoms. For extensive lesions, different diagnostic methods may be used:

• clinical blood tests;
• microflora smear;
• blood for PCR to determine the causative agent of the disease;
• biopsy (if indicated).

They are also necessary for recurrent forms of the disease. In simple cases, laboratory diagnostics are not required; aphthae are determined visually by an experienced specialist.

With the help of a comprehensive examination, the doctor will determine which microorganism caused inflammation with subsequent ulceration of the mucous membrane. He also differentiates the disease from herpetic stomatitis and oncological pathology.

Features of treatment

The main goal of treating aphthous stomatitis is to completely get rid of the disease or at least reduce the frequency of relapses to a minimum. Therapy is aimed at relieving inflammation, relieving unpleasant symptoms, and accelerating the recovery processes of the mucous membrane.

For each specific case, the doctor will develop a set of measures. The main ones include local and systemic drug treatment.

Rinsing with antiseptics can be done using medications or mouth rinses that contain antibacterial components. An alternative to rinsing is to use a spray. Typically, the treatment regimen includes 2-3 sessions of 1-minute rinsing immediately after brushing your teeth.

Local treatment methods include the application of gels with anti-inflammatory and analgesic effects.

Occlusive agents can reduce pain and speed up the healing of mucous membranes. They form an insoluble film on the ulcer, protecting the affected area from exposure to adverse factors.

Local glucocorticoid therapy is used against the background of immune diseases, as well as when standard measures are ineffective. They eliminate pain and quickly relieve inflammation, shortening the healing period. Such products are used only according to indications and are available with a prescription. In some cases, it is advisable to inject the drug under the base of the ulcer; this is done by a doctor.

Epithelialization drugs are used after acute inflammation has resolved. The specialist will prescribe a gel with an analgesic and healing effect, usually this occurs 5–6 days after the start of complex therapy.

Local laser therapy can relieve pain, speed up the healing process, and minimize the risk of relapse.

Systemic treatment of aphthous stomatitis in adults involves taking the following drugs:

• antihistamines (anti-allergic, anti-edematous effect);
• glucocorticoids (anti-inflammatory, analgesic effect);
• immunomodulators (to stimulate defenses and accelerate recovery).

And if antiallergic drugs can be recommended to any patient even in the absence of information about the exact causes of stomatitis, then other drugs are prescribed only according to indications: in case of acute severe course of the disease, frequent relapses, and the presence of severe systemic pathologies. An additional method of treatment is vitamin therapy - taking vitamins C, group B.

In addition to the main course of treatment, all patients without exception are recommended to adhere to a hypoallergenic diet, avoid taking too hot drinks and dishes, and spicy, irritating foods. It is better to give preference to toothpaste without sodium lauryl sulfate, this component can provoke the disease.

It is important to continue your oral hygiene, even if it is difficult. To make brushing your teeth easier, choose a soft toothbrush. If the disease recurs frequently, it is necessary to pay attention to the general state of health, promptly treat teeth and gums, replace fillings and dental structures.

Forecast and prevention of the disease

If you consult a doctor in a timely manner, the treatment prognosis is favorable. Strict adherence to the doctor’s recommendations allows you to achieve remission.

The main prevention of stomatitis is maintaining oral hygiene. In order not to injure the mucous membrane, it is recommended not to use a hard brush. From time to time it is worth using pastes with an anti-inflammatory effect (contain oak bark).

After each meal you need to rinse your mouth with an herbal solution or special compositions. Regular visits to the dentist twice a year increases the chance of noticing the first manifestations of the disease.

It is the responsibility of parents to ensure that the child washes his hands frequently and thoroughly with soap and rinses vegetables and fruits before eating them.

Features of treatment in children

The dentist will tell you how to treat aphthous stomatitis in a child. You can contact him at the direction of your pediatrician or on your own if you find characteristic ulcers in the oral cavity. The treatment regimen is the same as that used in the treatment of adult patients, but there are some differences: children under a certain age cannot rinse the mouth, so preference is given to drugs for application to mucosal ulcers. Otherwise, the treatment regimen is developed individually, taking into account the severity, symptoms of the disease, frequency of relapses, and the presence or absence of concomitant ailments in the child. Symptomatic therapy can be used to quickly alleviate the baby’s condition.

Specialists at STOMA clinics successfully treat aphthous stomatitis. By contacting us, you will receive qualified assistance, detailed recommendations on the treatment and prevention of relapse of the disease, and comprehensive assistance from dentists of all specializations, if necessary.

Herbal infusions

In modern herbal medicine, both herbal decoctions (chamomile, sage, yarrow, oak bark) and tinctures (calendula, propolis) are used to successfully treat oral diseases. Traditional methods of treating stomatitis allow you to:

• relieve inflammation of the mucous membrane;
• reduce pain and swelling;
• relieve itching, reduce burning sensation;
• cure ulcers (aphthae) formed on the surface of the mucous membrane;
• improve the patient’s overall well-being;
• prevent relapses of the disease.

Chamomile, aloe, sage, oak bark for stomatitis can significantly reduce swelling and soreness of the mucous membrane, and prevent the development of the inflammatory process. They have an anti-inflammatory effect.

Herbal infusions can be used either alone or in combination with traditional medicines.

1. Decoctions . To prepare them, you need to grind the herb in a coffee grinder, pour boiling water over it in a certain proportion, boil for at least 10 minutes, and then leave to infuse. A decoction is prepared from one plant (for example, chamomile, calendula, sage, St. John's wort) or from several (herbal mixture). After infusion, it should be strained and stored in the refrigerator for no more than three days. In the treatment of oral diseases, decoctions of chamomile, yarrow, sage, calendula, and cinquefoil are most often used. It should be remembered that when treating stomatitis with herbs, the therapeutic effect does not occur immediately, but 1-3 weeks after the start of therapy. Therefore, the patient must tune in to a long-term regular process.
2. Infusions . They are prepared in much the same way, only they should not be boiled. Usually the herbal mixture is poured with boiling water, tightly closed and infused, after which it is filtered. It should be stored in the refrigerator and diluted with water before use. Infusions are prepared from the same herbs as decoctions. You can infuse herbs not with water, but with alcohol. They have a powerful antiseptic and anti-inflammatory effect.
3. Solutions . Medicinal solutions are prepared immediately before use; their preparation consists of diluting the finished product with boiled water to obtain the required consistency. In no case should you apply undiluted alcohol infusions to the surface affected by stomatitis, as there is a high probability of getting a burn to the mucous membrane.