From the Guidelines
Stomatitis is caused by various factors, including viral, bacterial, and fungal infections, as well as physical trauma, certain medications, and systemic diseases, which damage the delicate mucosal lining of the mouth, triggering inflammation and sometimes creating an environment where opportunistic infections can develop. The causes of stomatitis can be broadly categorized into:
- Infections: viral infections (like herpes simplex virus, coxsackievirus), bacterial infections, fungal infections (such as candidiasis) 1
- Physical factors: physical trauma to the mouth, certain medications (including chemotherapy drugs, antibiotics, and NSAIDs) 1
- Systemic factors: autoimmune conditions (like Behçet's disease or lupus), and systemic diseases, such as renal failure 1
- Nutritional factors: nutritional deficiencies (particularly vitamin B12, iron, and folate)
- Other factors: allergic reactions, spicy or acidic foods, tobacco use, alcohol consumption, stress, and hormonal changes
Treatment depends on the specific cause and may include:
- Antiviral medications (like acyclovir for herpes-related stomatitis)
- Antifungal treatments (such as nystatin for candidiasis)
- Topical corticosteroids to reduce inflammation
- Pain relievers
- Maintaining good oral hygiene
- Avoiding irritating foods and using alcohol-free mouthwashes can help manage symptoms while the underlying cause is being treated 1.
It is essential to note that the management of stomatitis should prioritize preventive measures, such as maintaining good oral hygiene, avoiding irritating foods, and using non-alcoholic mouthwashes, as well as patient education about the risk and causes of stomatitis/mucositis before starting therapy 1.
From the Research
Causes of Stomatitis
- Stomatitis, also known as oral candidiasis, is a common opportunistic fungal infection caused by commensal Candida species 2.
- The disease has various local and systemic predisposing factors, including xerostomia, HIV, immunosuppression, and wearing of dentures 3.
- Denture stomatitis is a type of stomatitis that occurs in patients who wear dentures, and it is often associated with oral candidiasis 2, 4.
Risk Factors
- Wearing of dentures is a significant risk factor for developing stomatitis, as it can lead to the accumulation of Candida species on the denture surfaces 2, 4.
- Immunocompromised patients, such as those with HIV or undergoing organ transplantation, are also at a higher risk of developing stomatitis 3.
- Other risk factors include xerostomia, immunosuppression, and poor oral hygiene 3.
Treatment Options
- Topical antifungal agents, such as nystatin, fluconazole, and clotrimazole, are commonly used to treat stomatitis 2, 4, 5, 3, 6.
- The choice of treatment depends on the severity of the infection, the patient's immune status, and the presence of any underlying medical conditions 6.
- In some cases, a combination of topical and systemic antifungal agents may be necessary to effectively treat stomatitis 4, 5.