STOMATITIS

Inflammation of the epithelial lining of the oral mucosa

Causes

  • Nutritional deficiency, e.g. vitamin A
  • Hormonal changes
  • Infections: Spirochaetes, Bacilli, Candida, Measles virus, Herpes simplex virus

Clinical features

  • Inflammation of the tongue and lining of mouth – tongue is red, raw, and painful
  • Ulcers on the gum, palate, lips
  • Thrush (in babies and HIV/debilitated patients)
  • Swelling and bleeding of gums

Differential diagnosis

  • Allergic reactions, erythema multiforme, pemphigus
  • Lead poisoning
  • Lichen planus

Investigations

  • swab mouth for microscopy, and culture and sensitivity of bacteria and fungi (though normal oral flora may give false positives)
  • Blood: For Rapid Plasma Reagin (RPR) test, HIV serology

MANAGEMENT

  • Rinse mouth 3 times a day with Salt solution (dissolve 1 teaspoon of salt in a cup of warm
    water)
  • Or Hydrogen peroxide solution 6% (add 15 ml to a cup/200 ml of warm water)
  • Or chlorhexidine mouth wash 0.2%
  • Paracetamol 1 g every 8 hours
    Child: 10-15 mg/kg every 8 hours
  • Or a topical analgesic
  • Continue treatment until healing takes place