Stomatitis: Difference between revisions
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'''Stomatitis''' is an [[inflammation]] of the [[mucous lining]] of any of the structures in the [[mouth]], which may involve the [[cheeks]], [[gums]], [[tongue]], lips, [[throat]], and roof or [[floor of mouth|floor of the mouth]]. The inflammation can be caused by conditions in the mouth itself, such as poor [[oral hygiene]], dietary protein deficiency, poorly fitted [[dentures]], or from mouth burns and scars from food or drinks, toxic plants, or by conditions that affect the entire body, such as [[medications]], [[allergic reactions]], radiation therapy, or [[infections]].<ref>{{cite web|year=1969|format=PDF|work=The Reports of the Surgeon General|url=http://profiles.nlm.nih.gov/NN/B/B/L/N/_/nnbbln.pdf|title=Effects of Smoking on Pregnancy|accessdate=2006-06-23}}</ref> |
'''Stomatitis''' is an [[inflammation]] of the [[mucous lining]] of any of the structures in the [[mouth]], which may involve the [[cheeks]], [[gums]], [[tongue]], lips, [[throat]], and roof or [[floor of mouth|floor of the mouth]]. The inflammation can be caused by conditions in the mouth itself, such as poor [[oral hygiene]], dietary protein deficiency, poorly fitted [[dentures]], or from mouth burns and scars from food or drinks, toxic plants, or by conditions that affect the entire body, such as [[medications]], [[allergic reactions]], radiation therapy, or [[infections]].<ref>{{cite web|year=1969|format=PDF|work=The Reports of the Surgeon General|url=http://profiles.nlm.nih.gov/NN/B/B/L/N/_/nnbbln.pdf|title=Effects of Smoking on Pregnancy|accessdate=2006-06-23}}</ref> |
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==Terminology== |
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The term ''gingivostomatitis'', refers to inflammation of the [[gingiva]] (i.e. [[gingivitis]]) and the mouth generally. Examples of medical terminology which utilize this term include: |
The term ''gingivostomatitis'', refers to inflammation of the [[gingiva]] (i.e. [[gingivitis]]) and the mouth generally. Examples of medical terminology which utilize this term include: |
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* Allergic gingivostomatitis, or allergic contact gingivostomatitis.<ref>{{cite journal|last=Kanerva|first=L.|coauthors=Alanko, K.; Estlander, T.|title=Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates|journal=Allergy|date=1 December 1999|volume=54|issue=12|pages=1316–1321|doi=10.1034/j.1398-9995.1999.00074.x}}</ref> |
* Allergic gingivostomatitis, or allergic contact gingivostomatitis.<ref>{{cite journal|last=Kanerva|first=L.|coauthors=Alanko, K.; Estlander, T.|title=Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates|journal=Allergy|date=1 December 1999|volume=54|issue=12|pages=1316–1321|doi=10.1034/j.1398-9995.1999.00074.x}}</ref> |
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==Classification== |
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Severe [[iron deficiency anemia]] can lead to stomatitis. Iron is necessary for the upregulation of transcriptional elements for cell replication and repair. Lack of iron can cause the genetic downregulation of these elements, leading to ineffective repair and regeneration of epithelial cells, especially in the mouth and lips. This condition is also prevalent in people who have a deficiency in vitamin B<sub>2</sub> (Riboflavin), B<sub>3</sub> (Niacin), B<sub>6</sub> (Pyridoxine), B<sub>9</sub> (folic acid) or B<sub>12</sub> (cobalamine). |
Severe [[iron deficiency anemia]] can lead to stomatitis. Iron is necessary for the upregulation of transcriptional elements for cell replication and repair. Lack of iron can cause the genetic downregulation of these elements, leading to ineffective repair and regeneration of epithelial cells, especially in the mouth and lips. This condition is also prevalent in people who have a deficiency in vitamin B<sub>2</sub> (Riboflavin), B<sub>3</sub> (Niacin), B<sub>6</sub> (Pyridoxine), B<sub>9</sub> (folic acid) or B<sub>12</sub> (cobalamine). |
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It may also be seen in ariboflavinosis (riboflavin deficiency) or [[neutropenia]]. |
It may also be seen in ariboflavinosis (riboflavin deficiency) or [[neutropenia]]. |
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===Aphthous stomatitis=== |
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{{main|Aphthous stomatitis}} |
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Aphthous stomatitis (canker sores) is the recurrent appearance of mouth ulcers in otherwise healthy individuals. The cause is not completely understood, but it is thought that the condition represents an [[T cell] mediated immune response which is triggered by a variety of factors. The individual ulcers (aphthae) recur periodically and heal completely, although in the more severe forms new ulcers may appear in other parts of the mouth before the old ones have finished healing. Aphthous stomatitis is one of the most common diseases of the oral mucosa, and is thought to affect about 20% of the general population to some degree.<ref name= "Neville 2002">{{cite book|last=Neville BW, Damm DD, Allen CM, Bouquot JE.|title=Oral & maxillofacial pathology|year=2002|publisher=W.B. Saunders|location=Philadelphia|isbn=0721690033|pages=253–284|edition=2nd}}</ref> The symptoms range from a minor nuisance to being disabling in their impact on eating, swallowing and talking, and the severe forms can cause people to loose weight. There is no cure for aphthous stomatitis,<ref>{{cite journal|last=Brocklehurst|first=P|coauthors=Tickle, M; Glenny, AM; Lewis, MA; Pemberton, MN; Taylor, J; Walsh, T; Riley, P; Yates, JM|title=Systemic interventions for recurrent aphthous stomatitis (mouth ulcers).|journal=The Cochrane database of systematic reviews|date=2012 Sep 12|volume=9|pages=CD005411|pmid=22972085}}</ref> and therapies are aimed at alleviating the pain, reducing the inflammation and promoting healing of the ulcers, but there is little evidence of efficacy for any treatment that has been used. |
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=== Angular stomatitis === |
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{{main|Angular cheilitis}} |
{{main|Angular cheilitis}} |
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Inflammation of the corners (angles) of the lips is termed angular stomatitis or angular cheilitis. In children a frequent cause is repeated lip-licking and in adults it may be a sign of underlying [[iron deficiency anemia]], or [[vitamin B]] deficiencies (e.g. B<sub>2</sub>-[[riboflavin]], B<sub>9</sub>-[[folate]] or [[vitamin B12|B<sub>12</sub>]]-[[cobalamin]], which in turn may be evidence of poor diets or malnutrition (e.g. [[celiac disease]]). |
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Also, angular cheilitis can be caused by a patient's jaws at rest being 'overclosed' due to edentulousness or tooth wear, causing the jaws to come to rest closer together than if the complete/unaffected dentition were present. This causes skin folds around the angle of the mouth which are kept moist by saliva which in turn favours infection; mostly by ''Candida albicans'' or similar species. Treatment usually involves the administration of topical nystatin or similar antifungal agents. Another treatment can be to correct the jaw relationship with dental treatment (e.g. dentures or occlusal adjustment). |
Also, angular cheilitis can be caused by a patient's jaws at rest being 'overclosed' due to edentulousness or tooth wear, causing the jaws to come to rest closer together than if the complete/unaffected dentition were present. This causes skin folds around the angle of the mouth which are kept moist by saliva which in turn favours infection; mostly by ''Candida albicans'' or similar species. Treatment usually involves the administration of topical nystatin or similar antifungal agents. Another treatment can be to correct the jaw relationship with dental treatment (e.g. dentures or occlusal adjustment). |
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==Migratory stomatitis== |
===Migratory stomatitis=== |
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{{main|Migratory stomatitis}} |
{{main|Migratory stomatitis}} |
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* [[Cheilitis]] |
* [[Cheilitis]] |
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* [[Pyostomatitis vegetans]] |
* [[Pyostomatitis vegetans]] |
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* [[Aphthous ulcer]] |
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* [[Bovine papular stomatitis]] |
* [[Bovine papular stomatitis]] |
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* [[Oral ulceration]] |
* [[Oral ulceration]] |
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Revision as of 16:20, 27 August 2013
| Stomatitis | |
|---|---|
| Specialty | Oral medicine, dermatology  |
Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth. The inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene, dietary protein deficiency, poorly fitted dentures, or from mouth burns and scars from food or drinks, toxic plants, or by conditions that affect the entire body, such as medications, allergic reactions, radiation therapy, or infections.[1]
Terminology
The term gingivostomatitis, refers to inflammation of the gingiva (i.e. gingivitis) and the mouth generally. Examples of medical terminology which utilize this term include:
- Herpetic gingivostomatitis -- this is inflammation of the mouth caused by herpes simplex virus. Sometimes the term gingivostomatitis is used as a synonym for gingivostomatitis caused specifically by herpes simplex infection.
- Necrotizing ulcerative gingivostomatitis -- this is sometimes used as a synonym of the Necrotizing periodontal disease more commonly termed necrotizing ulcerative gingivitis, or a more severe form (also termed necrotizing stomatitis). The term necrotizing gingivostomatitis is also sometimes used.[2]
- Plasma cell gingivostomatitis -- a synonym, or a severe form of plasma cell gingivitis.
- Atypical gingivostomatitis -- another synonym of plasma cell gingivitis.[3]
- Idiopathic gingivostomatitis -- another synonym of plasma cell gingivitis.[4][5]
- Allergic gingivostomatitis, or allergic contact gingivostomatitis.[6]
Classification
Severe iron deficiency anemia can lead to stomatitis. Iron is necessary for the upregulation of transcriptional elements for cell replication and repair. Lack of iron can cause the genetic downregulation of these elements, leading to ineffective repair and regeneration of epithelial cells, especially in the mouth and lips. This condition is also prevalent in people who have a deficiency in vitamin B2 (Riboflavin), B3 (Niacin), B6 (Pyridoxine), B9 (folic acid) or B12 (cobalamine).
When it also involves an inflammation of the gingiva (gums), it is called .
It may also be seen in ariboflavinosis (riboflavin deficiency) or neutropenia.
Aphthous stomatitis
Aphthous stomatitis (canker sores) is the recurrent appearance of mouth ulcers in otherwise healthy individuals. The cause is not completely understood, but it is thought that the condition represents an [[T cell] mediated immune response which is triggered by a variety of factors. The individual ulcers (aphthae) recur periodically and heal completely, although in the more severe forms new ulcers may appear in other parts of the mouth before the old ones have finished healing. Aphthous stomatitis is one of the most common diseases of the oral mucosa, and is thought to affect about 20% of the general population to some degree.[7] The symptoms range from a minor nuisance to being disabling in their impact on eating, swallowing and talking, and the severe forms can cause people to loose weight. There is no cure for aphthous stomatitis,[8] and therapies are aimed at alleviating the pain, reducing the inflammation and promoting healing of the ulcers, but there is little evidence of efficacy for any treatment that has been used.
Angular stomatitis
Inflammation of the corners (angles) of the lips is termed angular stomatitis or angular cheilitis. In children a frequent cause is repeated lip-licking and in adults it may be a sign of underlying iron deficiency anemia, or vitamin B deficiencies (e.g. B2-riboflavin, B9-folate or B12-cobalamin, which in turn may be evidence of poor diets or malnutrition (e.g. celiac disease).
Also, angular cheilitis can be caused by a patient's jaws at rest being 'overclosed' due to edentulousness or tooth wear, causing the jaws to come to rest closer together than if the complete/unaffected dentition were present. This causes skin folds around the angle of the mouth which are kept moist by saliva which in turn favours infection; mostly by Candida albicans or similar species. Treatment usually involves the administration of topical nystatin or similar antifungal agents. Another treatment can be to correct the jaw relationship with dental treatment (e.g. dentures or occlusal adjustment).
Migratory stomatitis
Migratory stomatitis is a condition in which extensive areas in the oral cavity mucosa are affected by annular atrophic red lesions that surrounded by a thin white rim. This is a relatively uncommon form of the geographic tongue condition that, as opposed to migratory stomatitis, is confined to the dorsal and lateral aspects of the tongue mucosa only.[9]
See also
References
- ^ "Effects of Smoking on Pregnancy" (PDF). The Reports of the Surgeon General. 1969. Retrieved 2006-06-23.
- ^ Horning, GM (1996 Oct). "Necotizing gingivostomatitis: NUG to noma". Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995). 17 (10): 951–4, 956, 957-8 passim, quiz 964. PMID 9533316.
{{cite journal}}: Check date values in:|date=(help) - ^ Neville BW, Damm DD, Allen CA, Bouquot JE. (2002). Oral & maxillofacial pathology (2nd ed.). Philadelphia: W.B. Saunders. pp. 141, 142. ISBN 0721690033.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ Janam, P (2012 Jan). "Plasma cell gingivitis associated with cheilitis: A diagnostic dilemma!". Journal of Indian Society of Periodontology. 16 (1): 115–9. PMC 3357019. PMID 22628976.
{{cite journal}}: Check date values in:|date=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Kerr, DA (1971 Sep). "Idiopathic gingivostomatitis. Cheilitis, glossitis, gingivitis syndrome; atypical gingivostomatitis, plasma-cell gingivitis, plasmacytosis of gingiva". Oral surgery, oral medicine, and oral pathology. 32 (3): 402–23. PMID 5285187.
{{cite journal}}: Check date values in:|date=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Kanerva, L. (1 December 1999). "Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates". Allergy. 54 (12): 1316–1321. doi:10.1034/j.1398-9995.1999.00074.x.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Neville BW, Damm DD, Allen CM, Bouquot JE. (2002). Oral & maxillofacial pathology (2nd ed.). Philadelphia: W.B. Saunders. pp. 253–284. ISBN 0721690033.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ Brocklehurst, P (2012 Sep 12). "Systemic interventions for recurrent aphthous stomatitis (mouth ulcers)". The Cochrane database of systematic reviews. 9: CD005411. PMID 22972085.
{{cite journal}}: Check date values in:|date=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Zadik Y, Drucker S, Pallmon S (2011). "Migratory stomatitis (ectopic geographic tongue) on the floor of the mouth" (PDF). J Am Acad Dermatol. 65 (2): 459–60. doi:10.1016/j.jaad.2010.04.016. PMID 21763590.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link)