From the Guidelines
Treatment for oral mucosal lesions after swimming in a river should prioritize supportive care, including rinsing the mouth with warm salt water and using topical anesthetics like viscous lidocaine 2% or benzocaine oral gel for pain relief. The management of these lesions can be guided by the principles outlined in the UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 1, which, although focused on a specific condition, provide valuable insights into the care of oral mucosal lesions. Key recommendations include the use of antiseptic oral rinses, such as 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash, twice daily to reduce bacterial colonization 1.
For suspected secondary infections, particularly candidal infections, treatment with nystatin oral suspension 100,000 units four times daily for 1 week or miconazole oral gel 5–10 mL held in the mouth after food four times daily for 1 week is recommended 1. It's also crucial to consider the possibility of waterborne pathogens, such as those causing schistosomiasis, especially if the swimming occurred in freshwater lakes or rivers in endemic areas 1. In such cases, medical evaluation is essential for the diagnosis and treatment of specific infections, which may involve antiparasitic medications like praziquantel 1.
Given the potential for various etiologies, including chemical irritants, trauma, or infectious agents, maintaining good oral hygiene, avoiding irritants, and seeking medical advice if symptoms persist or worsen is paramount. The use of topical corticosteroids, such as betamethasone sodium phosphate or clobetasol propionate, may also be considered for their anti-inflammatory properties 1.
In terms of specific treatment regimens, the following can be considered:
- Rinsing the mouth with warm salt water 3-4 times daily
- Using topical anesthetics like viscous lidocaine 2% or benzocaine oral gel for pain relief
- Antiseptic oral rinses twice daily
- Treatment of secondary infections as appropriate
- Consideration of antiparasitic treatment if exposure to freshwater in endemic areas is suspected.
It's essential to approach each case individually, considering the patient's specific symptoms, exposure history, and response to initial treatments, and to seek professional medical advice if symptoms persist or worsen.
From the Research
Oral Mucosal Lesions after Swimming in a River
There are no research papers directly related to the treatment options for oral mucosal lesions (dots inside the mouth) after swimming in a river. However, some studies discuss the risks associated with swimming in fresh water:
- Swimming in fresh water lakes and rivers has been linked to an increased risk of otitis externa, an infection of the outer ear canal 2, 3.
- Certain bacteria, such as Pseudomonas aeruginosa, can be found in fresh water lakes and may cause otitis externa 3.
- Swimming in cold water can also trigger cold-induced urticaria, a condition that can cause hives or angioedema 4.
- While not directly related to oral mucosal lesions, a study on rhinologic and oral-maxillofacial complications from scuba diving discusses various complications that can occur in the head and neck region, including barodontalgia and odontocrexis 5.
Possible Considerations
When considering treatment options for oral mucosal lesions after swimming in a river, it may be helpful to:
- Consult a healthcare professional for proper diagnosis and treatment
- Consider the possibility of infection or allergic reaction
- Take steps to prevent future occurrences, such as avoiding swimming in contaminated water or taking precautions to protect the mouth and ears while swimming