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Stomatitis (Sore Mouth)

Definition: It is the Inflammation of the buccal mucous membrane. (click here for pic)

Etiology/types:
  1. Catarrhal stomatitis: It is due to local irritation from-
    Excessive smoking
    drinking
    Gum infection
    Spicy diet
    erruption of teeth
    Antibiotics
    Various toxic agents or drugs
    Malnutrition in children
    During fever
    Anaemia
    Systemic disease: Leukaemia
                                 Pemphigus
                                 Lichen planus
    Other reasons: Measules
                            German measules
                            Scarlet fever
  2. Ifective stomatits:
    -Bacterial: Streptococci
                      Cornybacterium diptheriae
    -Viral: herpes simplex
               Herpes zoster
               Infectious mononucleosis
               Measles
    -Fungal (thrush or moniliasis): Candida albicans
                                                      Common in: after prolonged use of steroids, antibiotics or                                                                                  cytotoxic drugs
                                                                           In infants
                                                                           In immunocompromised subjects e.g. AIDS
                                                                           Diabetes mellitus
  3. Allergic stomatitis:
    It is seen in angioneurotic oedema
    Some vegetable foods
    Latrogenic: antibiotics, iodides, bismuth, gold, lead
    Poisons: Arsenic, Mercury
    Ateven Jhonson's syndrome
  4. Stomatits due to heavy metal and drugs:
    Arsenic, Bismuth, gold, lead and mercury
    anti epileptic drugs may also cause stomatitis.
  5. Stomatitis due to blood disease:
    aplastic anaemia, agranulocytosis and leukaemia
  6. Stomatits due to malnutrition:
    Vitamin-B complex
    Cianocobalamine or Vit-B12
    Iron deficiency
  7. Stomatits due to metals and drugs
    Arsenic
    Bismuth
    Gold
    Lead
    Mercury
    Entiepileptic drugs.
  8. Apthous:
    Gastrointestinal disorder
    Herpes virus 6
    HIV infection
    Trauma
    Stress
    Hormonal imbalance
  9. Stomatits due to skin disease
    Lichen planus
    pemphigus
    Erythema multiform
  10. Gangrenous stomatits
    Seen in 2-5years old but girls are high in number
    In covalescense from measles
    During Kala azar
    Typhoid fever
    Patient becomes toxic with high temperature and tachycardia.
Treatment:
  1. Catarrhal stomatits:a) Belladonna
                                    b) Arsenicum album
                                   c) Mercurius solubilis
                                   d) Sulphur
                                   e) Vitamin-B Complex
                                   g) Boroglycerine for buccal application
                                   h) Alkaline mouth wash
  2. Infective stomatitis: a) Bacterial & viral: Arsenicum Album
                                                                      Heper sulph
                                                                      Mrcurius solubilis
                                                                      Sulphurosum acidum
                                                                      Penicilin lozense
                                                                      Metronidazole 200mg in Vincent's angina
                                    b) Fungal (Thrush or moniliasis): Aethusa
                                                                                          Borax
                                                                                          Hydrastis
                                                                                          Kali Chloratum
                                                                                          1% Gentain violet paint is to be applied
                                                                                          Nystatin of general nutrition is to be done
                                   c) Allergic stomatitis: Apis mel
                                                                       Arsenicum album
                                                                       Mercurius solubilis
                                                                       Nitric acid
                                                                       Antiallergic drugs including steroid
                                   d) Aphthous stomatits: Arsenicum album
                                                                        Heper sulph
                                                                        Mercurius solubilis
                                                                        Nitric acid
                                                                        Anaesthetic and steroid lozenges (Triamcinolone                                                                           acetonide)
                                                                        Trianquilliser
                                                                        Silver nitrate for local application
                                                                        DGL or Alkaline mouth wash
                                                                        A short course of steroids.
Advice:
  • Maintenance of local hygiene
  • Removal of the cause is required                                                                                   

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