How and with what to treat stomatitis in children

Pharyngitis is an inflammatory process that forms on the back wall of the larynx and affects the mucous membrane, as well as deeper layers, tissues of the soft palate and lymph nodes. The acute form of pharyngitis can develop into chronic if the patient does not seek help from a doctor and self-medicates.

Since the pathological process in the larynx is caused by the spread of pathogenic bacteria, the risk of developing pharyngitis increases in people with a weak immune system and in those who suffer from ENT diseases or are predisposed to them.

How dangerous is pharyngitis and how does it manifest itself? Which doctor should I contact and how to treat the disease? We will answer these and other questions in this article.

ICD - pharyngitis:

• J02 - acute pharyngitis
• J02.0 - streptococcal pharyngitis
• J02.8 - acute pharyngitis caused by other specified pathogens
• J02.9 - acute pharyngitis, unspecified
• J31.2 - chronic pharyngitis
• J31.1 - chronic nasopharyngitis

Pharyngitis is rarely isolated as a separate disease; the diagnosis is usually acute respiratory viral disease (ARVI).

ARVI is a general name; the doctor usually specifies how exactly ARVI manifests itself.

This may be rhinitis (runny nose), pharyngitis (red throat), nasopharyngitis (inflammation of the nose and throat), etc.1,2

It is important not to confuse pharyngitis with tonsillitis.

To do this, let's understand the structure of the pharynx and oral cavity.

Structure of the pharynx

The pharynx is divided into 3 sections:

• upper (nasopharynx)
• middle (oropharynx)
• lower (larynx)

This division is very conditional, because There are no clear boundaries between departments. When inflammation occurs, it rarely happens that the inflammatory process is localized in one section; usually infectious processes spread and move throughout all sections of the pharynx5,7

As can be seen in the picture below, the oropharynx is composed of the velopharyngeal arches, the uvula and the soft palate.

Pharyngitis usually affects:

• temples
• tongue
• soft sky
• posterior wall of the pharynx

The doctor uses a spatula to completely examine the pharynx. It is needed to improve visibility of the back of the throat.

The palatine tonsils also become inflamed with pharyngitis, because it is impossible to limit the inflammation process. This widespread nature of inflammation in pharyngitis distinguishes it from tonsillitis, where the tonsils are predominantly affected.

How common is pharyngitis?

Pharyngitis, like a common ARVI (viral infection), occurs quite often. The incidence rate increases during the season from September to May, with a peak in February and March. A decrease in the incidence of pharyngitis by 3-5 times is observed in the summer months.10,11

Acute pharyngitis occurs more often in childhood than in adults. Children under 5 years of age suffer viral infections, including pharyngitis, 6-8 times a year.8,9

In the first year of visiting a preschool institution, the incidence of the disease is 10-15% higher than in children at home. But, unfortunately, “home” children subsequently get sick more often at school age.

Pediatric infectious diseases

Many infectious diseases that manifest as a rash on the palate are known as “childhood” diseases. But this does not mean that adults are not susceptible to infection. Having suffered from such diseases once, a person receives lifelong immunity. But if you do not get the same chickenpox in childhood, there is a risk of contracting this infection in adulthood.

Rubella

With rubella, red spots may first appear on the child's palate, and only then on the face and body. Rubella usually resolves easily and without complications in childhood, with the exception of infants up to one year old. These babies endure the disease very hard, so scarlet specks in the mouth, which quickly merge into specks, should alert parents: this may be the first symptom of rubella. This disease is also dangerous for adults who did not have it in childhood, especially for pregnant women.

Measles

As with rubella, with measles a rash in the mouth may appear earlier than on the body - sometimes within a day or two. But the nature of the rash is very different: with measles, the rash looks like dots of white or pale gray color, reminiscent of semolina. Their accumulations on the upper palate, tonsils and back of the throat are surrounded by a pinkish border, this phenomenon is called Belsky-Filatov syndrome.

Chicken pox

With chickenpox, a red rash in the mouth should alert you, as it indicates a complicated course of the disease. Bubbles filled with liquid can shed the gums, tongue, inner surfaces of the baby’s lips and cheeks, and are often found at the top - on the hard and soft palate. Breaking through, they form ulcerations in the oral cavity.

Scarlet fever

With scarlet fever, a small red rash covering the child's body may also appear on the upper palate. The mucous membranes of the pharynx with scarlet fever are bright red, the regional lymph nodes and tonsils are enlarged, the tongue becomes crimson in color and is covered with a white coating - see photo.

Speckled rashes are usually accompanied by a very high fever and vomiting, and in severe forms of the disease - convulsions and clouding of consciousness.

• Causes of rashes in children

Roseola

Since the disease begins with a high fever, and after a couple of days, when the temperature subsides, a rash appears, roseola is often mistaken for ARVI and an associated allergy to medications. Small red spots and blisters in the throat and palate precede the appearance of similar rashes on the body. Their presence is accompanied by redness of the pharynx and pain when swallowing.

The difference between a rash in the mouth and on the body with roseola and any other is that it disappears when pressed.

Causes of pharyngitis and tonsillitis

Etiology (origin, cause) of pharyngitis. In 70-90% of cases, pharyngitis is caused by viruses. Pharyngitis can also be caused by bacteria, fungi, allergies, injuries, and exposure to irritating factors.

The most common viruses are rhinoviruses, adenoviruses, influenza, parainfluenza, enteroviruses, Coxsackie A, coronaviruses, a group of herpes viruses (Epstein-Barr virus, cytomegalovirus, HSV).12

There are pharyngitis, which are classified as a separate diagnosis depending on the pathogen, for example streptococcal pharyngitis ICD J02.0

Classification of pharyngitis

Pharyngitis can be acute or chronic. Acute is inflammation that just arose (suddenly), and chronic is a disease that persists for a long time, and it may not bother a person, but under certain circumstances again cause complaints and anxiety.3

Causes of stomatitis

Inflammation of the oral mucosa can be caused by various reasons.

1. Mucosal injury6.
2. Viral, bacterial or fungal infection6.
3. Allergy2.
4. Immunity disorders (autoallergy, that is, a reaction to one’s own altered tissues2).
5. Diseases of the blood, digestive, cardiovascular, nervous and endocrine systems2.
6. Hypovitaminosis - lack of vitamins C, B1, B12, E, D32.
7. Common infectious processes: measles, rubella, scarlet fever and diphtheria, infectious mononucleosis, tuberculosis and others1.

Only a specialist can understand the causes of stomatitis. Therefore, if symptoms of the disease appear, you should definitely contact your dentist.

Inflammatory diseases of the oral cavity can occur in a child of any age6. Immaturity of the body is the primary factor predisposing to the occurrence of stomatitis in children under one year of age. The mucous membrane of the oral cavity during this period of a child’s life is very vulnerable, its natural protective properties are reduced. The immunity received from the mother during fetal development and which protected the baby immediately after birth weakens every day. Therefore, the infection easily penetrates the mucous membrane and causes its inflammation. Most often at this age, candidal stomatitis occurs, commonly called thrush1,6.

From the age of one to 3 years, children actively develop immune mechanisms to protect the oral mucosa (local immunity), but its permeability to viruses remains extremely high. Therefore, in a 2-3 year old child, stomatitis is more likely to be viral, in the vast majority of cases - herpetic1,3,4.

From 4 to 12 years of age, stomatitis in children is more often caused by allergic and autoimmune reactions. In particular, chronic aphthous forms of the disease occur during this period1.

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Diagnosis of pharyngitis

Acute pharyngitis can be determined by patient complaints and examination of the oropharynx (pharyngoscopy).

Objective symptoms of pharyngitis, which are assessed by a doctor when examining the throat:

• swelling and hyperemia (redness) of the pharyngeal mucosa
• purulent or mucopurulent plaque on the walls of the pharyngeal mucosa
• the presence of inflammation in the arches, tonsils, orifices of the auditory tubes
• the presence of bright red tubercles on the back surface of the pharynx and on the side - hypertrophied (enlarged) lymphoid follicles
• thinning of the mucosa with areas of exfoliating epithelium, crusts and viscous mucus (atrophic pharyngitis)

Based on this, the doctor can make not only a diagnosis of pharyngitis, but also suggest its cause (viral inflammation, fungal infection, etc.).

Despite the fact that 70% of acute pharyngitis is a viral disease, sometimes it is necessary to exclude a bacterial cause. This is very important for further treatment tactics and prevention of complications. To do this, you should conduct a rapid test to exclude the streptococcal nature of pharyngitis.

In some cases, with fever, long-term complaints, or a temperature exceeding 3 days, it is also necessary to take a general blood test to understand the cause of acute pharyngitis.

Candidiasis (thrush)

This is a fungal disease that occurs as a result of the proliferation of fungi of the genus Candida on the oral mucosa.

Transmission of a fungal infection to a child is possible:

• during passage through the birth canal of a mother suffering from candidomycosis;
• through contact and household means (through pacifiers, underwear and other items for caring for the newborn).

Weak children in the first weeks of life are more likely to get sick.

Main signs of the disease:

the disease begins asymptomatically, and then the child becomes restless, eats and sleeps poorly. Regional lymph nodes may be enlarged, body temperature is normal, but may also be elevated, a plaque in the form of white dots appears in the oral cavity on the mucous membrane of the cheeks along the line where the teeth meet; on the palate, lips, and tongue; As the fungus multiplies, the plaque increases in size, forming a film resembling curdled milk.

In order to prevent the occurrence of the disease, it is necessary to promptly treat thrush in women during pregnancy and maintain a healthy gastrointestinal tract in a young mother; observe sanitary and hygienic measures in maternity hospitals and at home, sterilize pacifiers and bottle nipples.

Prevention

in children is the timely detection and treatment of dysbiosis, and with long-term prescription of antibiotics - timely administration of probiotics.

If there are signs of disease, you should consult a pediatric dentist!

Complications of pharyngitis

Acute pharyngitis usually responds well to treatment. The prognosis for viral pharyngitis is recovery.

Bacterial (streptococcal pharyngitis) can be complicated by the formation of a retropharyngeal abscess, and subsequently have a negative effect on the heart and kidneys, causing endocarditis and glomerulonephritis.

Symptoms of pharyngitis can persist even with proper treatment, if the true cause of pharyngitis is not eliminated. For example, if gastroesophageal reflux disease (damage to the gastrointestinal tract) is not treated, then pharyngitis will constantly remind itself.

Acute pharyngitis can become chronic.

Prevention of pharyngitis

To prevent pharyngitis, it is recommended:

• avoid hypothermia and dress appropriately for the weather
• avoid contact with tobacco and chemical irritants
• carry out frequent ventilation of working and living spaces
• walk outdoors more often. Walking will help strengthen the body's defenses in the fight against pharyngitis.
• don't drink ice water
• do not share food and cutlery, cups
• avoid crowded places and, if possible, stay in them for as little time as possible
• use disinfectants, including in public places,
• transport, etc.
• wash your hands often

Pharyngitis in pregnant women

During pregnancy, a woman's body's protective properties decrease. In this regard, the risk of contracting infectious diseases, as well as exacerbation of chronic diseases, greatly increases.

Pregnant women need to carefully monitor their health and prevent diseases: avoid contact with people with respiratory diseases, avoid crowded places, wash your hands, eat regularly and properly.

If you develop acute pharyngitis or exacerbation of chronic pharyngitis, treatment is required. It is not recommended to use drugs that can affect the entire body. They can pass through the placenta to the baby and cause harm to him. To treat pharyngitis, pregnant women are advised to consult a doctor and use saline mouth rinses.

Other reasons for finding red dots in the sky

Red dots on the upper palate may be the result of the following rare diseases:

Pyogenic granuloma

Occurs in a place often subject to trauma. It is necessary to excise the tumors at the root, after which electrocoagulation therapy is prescribed.

Kaposi's sarcoma

It is a malignant neoplasm with a purple hue. Local chemotherapy is prescribed, and measures are taken to increase the patient’s immunity.

Pathechia in the sky

These are small flat spots that often appear during mononucleosis. May be a manifestation of smallpox, thrombocytopenia, typhoid fever and endocarditis.

If a red rash occurs in the mouth, you do not need to make a diagnosis and prescribe treatment yourself.
It is necessary to consult with a specialist, find out the cause of the spots and receive appropriate treatment. The DentalGuru dental clinic employs experienced and professional dentists who guarantee painless and effective treatment of stomatitis and other dental diseases. This article is for informational purposes only, please consult your doctor for details!

FAQ

Can pharyngitis be treated at home?

Pharyngitis usually does not require hospitalization (hospital treatment). You can treat strep throat at home on your own by using topical remedies to relieve sore throat and sore throat. If, after self-treatment, the sore throat does not go away within 3 days, then you should consult a doctor. If you have a fever in addition to a sore throat, you should immediately consult a doctor.

Which doctor should I contact if I have a sore throat?

If you have a sore throat, sore throat, or difficulty swallowing, you should first consult a therapist or pediatrician if you are a child. If there are indications, the doctor will prescribe a consultation with an ENT doctor.

Very severe sore throat. Are you sure I don't have a sore throat?

With pharyngitis, the pain syndrome may be more pronounced than with tonsillitis (tonsillitis). To treat pharyngitis, it is good to use a remedy that has an analgesic effect, for example Tantum® Verde. To exclude sore throat (streptococcal tonsillitis) or streptococcal pharyngitis, it is recommended to conduct a rapid test (streptotest).

Do you need an antibiotic for pharyngitis?

The antibiotic is indicated ONLY for bacterial pharyngitis. For a quick diagnosis, perform a rapid test for streptococcus. It will allow you to exclude or confirm the bacterial nature of pharyngitis. If streptococcus is detected, the doctor will prescribe antibiotics.

Is strep throat contagious?

Most often, strep throat is a viral disease, so a person can shed the virus and infect other people. A sick person is contagious, so you should stay at home until you recover.

What happens if pharyngitis is not treated?

Complications may arise. If pharyngitis is not treated, complaints persist much longer, inflammation does not go away and begins to become chronic.

Is it possible to get vaccinated for pharyngitis and when?

Against the background of an acute illness or exacerbation of chronic pharyngitis, vaccination is contraindicated. Wait until you have fully recovered and then you can get vaccinated. The exception is vaccination against influenza. It can be done when the temperature is normalized, i.e. There is no need to wait for all symptoms to disappear.

Is it possible to eat cold food if you have a sore throat?

If you have pharyngitis, it is not recommended to eat very cold foods, including ice cream. This can increase inflammation and slow down recovery.

What causes red dots in the sky?

Experts identify several factors that contribute to the appearance of red dots on the palate in a child or adult:

1. Pathological processes in the circulatory system and vessels.
2. Infectious diseases.
3. Allergic reaction.
4. Rare diseases.

Based on the causes and individual characteristics of the body, a red rash can appear either once in a lifetime or quite often. If spots appear repeatedly, then we can talk about herpes viruses, thrush or enteroviral infections.

When exposed to infection, in addition to red dots on the palate, the child’s temperature rises, pain in the throat and larynx appears, weakness, and it becomes painful to swallow. The rash affects not only the palate, but also the tongue, as well as the inside of the cheeks. Infections that cause a rash include:

• Flu.
• Roseola.
• Scarlet fever.
• Meningitis.
• Typhus.
• Rubella.
• Staphylococcal infections.
• Chickenpox.
• Mononucleosis.
• Erythema.
• Syphilis.

Children suffer from chickenpox, rubella and scarlet fever in a milder form than adults, receiving immunity for life. In adults, these diseases occur with complications. But coping with herpes sore throat and stomatitis is much more difficult for children. These diseases progress quickly and greatly worsen the child’s condition.