Contact Stomatitis, sometimes referred to as Allergic Stomatitis, is a condition that affects your mouth. ‘Stoma’ comes from the Greek word for mouth, and ‘itis’ implies inflammation. To put it in plain language, Contact Stomatitis is a type of inflammation or irritation that happens inside your mouth. You might feel uncomfortable, with symptoms like a sore mouth or tongue, and this discomfort is typically a response to an allergen.
Contact stomatitis, also known as contact dermatitis of the mouth, is a condition that occurs when the tissues in the mouth react to something that comes into contact with them. The term “stomatitis” can sound a bit scientific, but if we break it down, it becomes simpler. “Stoma” means mouth and “itis” means inflammation. So, stomatitis is just a fancy term for inflammation of the mouth.
Types of Contact Stomatitis
Understanding the types of contact stomatitis helps you identify which type you might have, so you can better address it. There are mainly two types of contact stomatitis – allergic and irritant.
- Allergic Contact Stomatitis: This is like when your body overreacts to a harmless substance. It’s as if you’ve eaten a peanut and your body thinks it’s harmful and reacts in defense. So, if you’re allergic to a certain food or a substance in your toothpaste, your mouth might react, leading to allergic contact stomatitis.
- Irritant Contact Stomatitis: This happens when something actually harmful or overly strong comes in contact with your mouth. This is like washing your hands with a very harsh soap that leaves your skin red and irritated. If you use a very strong mouthwash, for instance, it could irritate your mouth tissues and lead to irritant contact stomatitis.
Causes
Now, let’s talk about the possible causes of contact stomatitis. It’s worth mentioning that the following list does not contain every single possible cause but highlights the most common ones. Also, each person is unique, and something that might trigger contact stomatitis in one person might not do the same in another.
- Allergic reactions: Some people are allergic to certain ingredients found in food or even toothpaste. These allergic reactions can cause inflammation in the mouth.
- Hot and spicy foods: Eating foods that are too hot or spicy can sometimes irritate the mouth and lead to contact stomatitis.
- Chemicals: Contact with harsh chemicals, such as those found in certain mouthwashes or tooth-whitening products, can cause mouth inflammation.
- Medications: Certain medicines, especially some types of antibiotics or chemotherapy drugs, can cause contact stomatitis.
- Dry mouth: If your mouth isn’t producing enough saliva to keep it moist, this can lead to irritation and potentially cause contact stomatitis.
- Dental appliances: Braces, dentures, or other dental appliances can sometimes rub against the mouth and cause irritation.
- Tobacco and alcohol: Both of these substances can irritate the lining of the mouth and potentially cause contact stomatitis.
- Vitamin deficiencies: Lack of vitamins, such as B12, folic acid, and iron, can cause contact stomatitis.
- Poor dental hygiene: Not cleaning your teeth and gums regularly can lead to an increase in bacteria, causing inflammation.
- Viral infections: Certain viruses, like the herpes simplex virus, can cause sores in the mouth.
- Bacterial infections: Bacteria, such as streptococcus or staphylococcus, can also cause mouth sores.
- Fungal infections: Oral thrush, a fungal infection in the mouth, can lead to contact stomatitis.
- Hormonal changes: Changes in hormones, especially during menstruation or pregnancy, can cause inflammation in the mouth.
- Autoimmune diseases: Conditions like lupus or Behcet’s disease can cause mouth sores.
- Stress: Emotional stress or physical stress on the body can lead to inflammation in the mouth.
- Trauma: Accidental biting, burns from hot food or drink, or any injury to the mouth can lead to contact stomatitis.
- Genetic factors: Some people are just more prone to mouth sores due to their genetics.
- Excessive mouth breathing: This can cause your mouth to dry out and potentially lead to contact stomatitis.
- Exposure to radiation: People who undergo radiation treatment for cancer can experience mouth sores.
- Certain diseases: Diseases such as diabetes, Crohn’s disease, or celiac disease can cause contact stomatitis.
- Dehydration: Lack of adequate water can cause dryness and irritation in the mouth.
- Excessive caffeine intake: Too much caffeine can dry out the mouth and cause irritation.
- Abrasive foods: Foods with rough textures can scratch the lining of the mouth and cause irritation.
- Food sensitivities: Some people might react to certain foods, such as acidic fruits, which can lead to contact stomatitis.
- Immune system disorders: Disorders that weaken the immune system can lead to inflammation in the mouth.
- Excessive alcohol consumption: Alcohol can dry out and irritate the mouth, leading to contact stomatitis.
- HIV/AIDS: This disease can cause many oral problems, including contact stomatitis.
- Chemotherapy and radiation therapy: These cancer treatments can cause inflammation in the mouth.
- Age: Older individuals are more susceptible to contact stomatitis due to decreased salivary gland function.
- Environmental factors: Dry air, cold weather, or air pollution can lead to mouth dryness and cause contact stomatitis.
Symptoms
Here are symptoms that might be associated with contact stomatitis:
- Redness: This is often one of the first signs. The affected area of your mouth might look redder than usual.
- Swelling: Your mouth’s tissues might become puffy or swollen.
- Pain: It could hurt, especially when you’re eating, drinking, or brushing your teeth.
- Burning Sensation: You might feel like your mouth is burning, even when it’s not in contact with anything hot.
- Metallic Taste: Some people notice a metallic taste in their mouths.
- Dry Mouth: You might find that your mouth feels drier than usual.
- Blisters: Small sores or blisters could form on the inflamed areas.
- Cracked Lips: The corners of your mouth might crack and feel sore.
- White Patches: You may notice white patches on the gums, tongue, or inside cheeks.
- Ulcers: Sores, known as ulcers, might appear in your mouth.
- Bad Breath: This is medically known as halitosis and may occur.
- Bleeding Gums: If your gums are swollen and irritated, they might bleed, especially when you brush your teeth.
- Difficulty Swallowing: If the inflammation is severe, it might be uncomfortable or difficult to swallow.
- Changes in Taste: You might notice that foods and drinks taste different than they normally do.
- Sore Throat: You might have a sore throat, particularly if the inflammation has spread down your throat.
- Loss of Appetite: Eating might become uncomfortable, which could lead to a loss of appetite.
- Fever: In some cases, you might also develop a mild fever.
- Lymph Node Swelling: The lymph nodes in your neck might swell and become tender to the touch.
- Fatigue: Feeling unusually tired could be a sign of your body trying to fight off an allergic reaction.
- Mouth Sensitivity: You might find that your mouth is more sensitive to hot, cold, or spicy foods and drinks.
The specific symptoms can vary from person to person, and the severity can range from mild to severe. It is crucial to seek medical advice if you notice any of these symptoms, especially if they persist or cause a significant amount of discomfort.
Diagnosis
Diagnosing contact stomatitis involves a series of steps to identify the underlying cause of the condition. Here are some common diagnostic methods:
- Medical History: Your dentist or healthcare provider will inquire about your medical history and recent changes in oral care products or medications.
- Oral Examination: A thorough examination of your mouth will be conducted to identify any visible signs of stomatitis.
- Patch Testing: If an allergic reaction is suspected, patch testing may be performed to identify specific allergens.
- Elimination Diet: In cases related to food sensitivity, an elimination diet may be recommended to pinpoint the trigger foods.
- Biopsy: In rare cases, a small tissue sample may be taken for biopsy to rule out other potential oral health issues.
Tests for Contact Stomatitis: Here are some tests that may be conducted to diagnose contact stomatitis:
- Patch Test: This test involves applying small amounts of potential allergens to your skin to see if any cause a reaction.
- Blood Test: A blood sample may be taken to check for specific antibodies that indicate an allergic response.
- Culture Test: If an infection is suspected, a swab may be taken from the affected area to identify the type of bacteria or fungi present.
- Biopsy: A tissue sample may be collected from the affected area and examined under a microscope to rule out other conditions.
- Saliva Test: Saliva may be analyzed to check for any imbalances or signs of inflammation.
- Allergy Test: Allergy tests, including skin prick tests, may be performed to identify allergens.
- X-rays: In some cases, X-rays may be taken to determine if dental appliances are contributing to the condition.
- Endoscopy: If the throat or esophagus is affected, an endoscopy may be conducted to examine the area and take biopsies if necessary.
- Cytology Test: A swab or brush may be used to collect cells from the affected area and examine them under a microscope.
- Microbial Test: If infection is suspected, a sample may be analyzed for the presence of harmful microorganisms.
Treatment
Different ways to treat contact stomatitis. Bear in mind that not all treatments will work for everyone, and the best approach depends on the specific cause and severity of your condition. However, the most important step in any treatment plan is to identify and avoid the substance that is causing the reaction.
- Avoidance: Once the allergen or irritant has been identified, avoid it. If it’s a certain food or a type of toothpaste, for instance, stop consuming or using it.
- Topical Corticosteroids: These are medicated creams or gels that you apply directly to the inside of your mouth. They can help to reduce inflammation and speed up the healing process.
- Oral Corticosteroids: In severe cases, you might need to take corticosteroids orally (by mouth). This can help to reduce severe inflammation.
- Antihistamines: These can help to control allergic reactions. They work by blocking histamine, a substance that your body produces during an allergic reaction.
- Topical Analgesics: These are medications that you apply directly to your mouth to help numb the area and reduce pain.
- Mouth Rinses: Special mouthwashes can soothe the mouth and help to clean the area, reducing the risk of further irritation or infection.
- Oral Hygiene: Keeping your mouth clean can help to prevent further irritation or infection. This includes brushing and flossing regularly and gently.
- Avoid Hot, Spicy Foods: These can irritate the mouth further. Stick with bland, soft foods until your mouth has healed.
- Stay Hydrated: Drinking plenty of water can help to keep your mouth moist and reduce discomfort.
- Avoid Alcohol and Tobacco: These can both irritate your mouth and slow down the healing process.
- Over-the-counter Pain Relievers: Non-prescription pain relievers can help to control pain.
- Cool Compresses: Applying a cool, wet cloth to your mouth can help to soothe the area and reduce inflammation.
- Honey: Applying honey to the affected area can help to soothe the mouth and speed up the healing process.
- Chamomile Tea: Rinsing your mouth with chamomile tea can help to soothe the area.
- Aloe Vera: Applying aloe vera to the affected area can help to reduce inflammation and speed up the healing process.
- Coconut Oil: Swishing coconut oil in your mouth (a process known as oil pulling) can help to soothe your mouth and reduce inflammation.
- Vitamin B12 Supplements: If your contact stomatitis is due to a vitamin B12 deficiency, taking supplements can help.
- Calcineurin Inhibitors: Topical medicines that work by suppressing the immune system to reduce inflammation.
- Ice Chips: Sucking on ice chips can help to soothe your mouth and reduce inflammation.
- Yogurt: Eating yogurt can help to soothe your mouth and provide probiotics, which can promote healing.
- Acupuncture: This traditional Chinese medicine approach can help to manage pain and reduce inflammation.
- Zinc Supplements: Zinc can boost the immune system and promote healing.
- Avoid Acidic Foods and Drinks: These can irritate your mouth and slow down the healing process.
- Green Tea: Rinsing your mouth with green tea can help to soothe the area.
- Echinacea: This herb can boost the immune system and promote healing.
- Vitamin C Supplements: Vitamin C can boost the immune system and promote healing.
- Probiotics: These can promote a healthy balance of bacteria in your mouth, which can promote healing.
- Omega-3 Fatty Acids: These can reduce inflammation and promote healing.
- Immunomodulators: These are medicines that can help to regulate your immune response, reducing inflammation.
- Phototherapy: This uses light to reduce inflammation and promote healing.
Medications
Potential treatments for contact stomatitis are explained in straightforward language.
- Saline Rinses: A saline rinse is just a fancy term for rinsing your mouth with saltwater. This simple, at-home treatment helps to clean the mouth and soothe inflamed tissues.
- Magic Mouthwash: Despite its whimsical name, magic mouthwash is a serious medication often prescribed for mouth sores. It’s not a single drug but a mixture of ingredients like lidocaine (a local anesthetic), diphenhydramine (an antihistamine), and antacids to coat and soothe the mouth.
- Topical Anesthetics: These are medications like benzocaine that you apply directly to the sore areas in your mouth. They numb the area and reduce the pain.
- Corticosteroids: Corticosteroids, such as prednisone, are potent anti-inflammatory drugs that can decrease swelling and discomfort. They may be taken orally or applied directly to the sore as a paste.
- Antibiotics: If your contact stomatitis is caused by a bacterial infection, antibiotics like amoxicillin or erythromycin can help clear the infection.
- Antiviral Medications: If a virus like herpes simplex causes your symptoms, antiviral medications such as acyclovir can be useful.
- Antifungal Medications: In some cases, a yeast infection can cause contact stomatitis. Antifungal medicines like nystatin or fluconazole can treat these infections.
- Pain Relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage the pain associated with contact stomatitis.
- Hydrogen Peroxide: Rinsing with a diluted hydrogen peroxide solution can help cleanse the mouth and promote the healing of sores.
- Topical Steroids: Medications like fluocinonide can be applied directly to sores to reduce inflammation and speed healing.
- Mucosal Protectants: These are substances that form a protective coating over the sores, promoting healing and preventing further irritation. Examples include sucralfate and oral balance gel.
- Dietary Supplements: Supplements such as L-lysine, vitamin B12, iron, and folic acid might help the body repair damaged cells and speed up the healing process.
- Coating Agents: These are products like orabase that create a protective film over the sores, giving them a chance to heal.
- Immunosuppressants: In severe or persistent cases, medications that suppress the immune system like azathioprine or methotrexate may be used to reduce inflammation.
- Ice Chips: This home remedy can help numb the mouth and provide temporary relief from pain.
- Allergy Medications: If your contact stomatitis is caused by an allergic reaction, medications like diphenhydramine (Benadryl) can help alleviate symptoms.
- Laser Therapy: In certain cases, low-level laser therapy can be used to relieve pain and promote healing.
- Hydration and Moisturizers: Staying hydrated and using lip balms and oral moisturizers can keep the mouth moist, reducing discomfort and promoting healing.
- Dental Care Products: Using a soft-bristled toothbrush and mild toothpaste can help avoid further irritation of the mouth’s lining.
- Antioxidants: There is some evidence that antioxidants, such as vitamins E and C, can help the body heal from contact stomatitis.
