Treatment of stomatitis in children - when to go to the doctor

Stomatitis in a child is a very common phenomenon caused by an inflammatory process of the oral mucosa, which also occurs in newborns. We can say that raising a child and not knowing what stomatitis looks like in children is almost impossible. Quite often, the symptoms of the disease initially resemble those of a respiratory infection with a characteristic fever, stuffy nose and poor appetite. But after a short time, parents notice the appearance of blisters and ulcers on the gums, cheeks and inner lips, which can be caused by various pathogens. The child behaves anxiously, capriciously, sleeps poorly... Even for an adult, it is very difficult to endure the painful sensations that arise from stomatitis, not to mention children, who cannot always clearly explain what is tormenting them. Parents, of course, are concerned about the question of what causes stomatitis in children and whether the occurrence of such a disease can be prevented. Let's try to understand this thoroughly.

Causes of stomatitis

In children, as in adults, stomatitis can be caused by viruses, fungi, bacteria, allergies and injuries. About six months after birth, the child loses the immunity received from the mother, the protective power of the immune system changes, and the child’s body becomes more susceptible to infections. The oral mucosa in children is more delicate and easier to injure; children also more often “bite” their cheeks after dental treatment due to a temporary loss of sensitivity after anesthesia, which causes traumatic stomatitis.

Children are not always motivated to brush their teeth, so poor hygiene can also cause stomatitis.

With the following diseases, stomatitis is observed in children much more often: chronic tonsillitis, diabetes mellitus, heart defects, chronic hepatitis.

Causes

The most common reasons:

• Presence of infectious diseases.
• Genetic predisposition.
• Increased sensitivity of the mucous membrane.
• Weak immunity.
• Lack of zinc or iron.
• Lack of vitamins.
• Injuries to the oral mucosa.
• Diseases of the gastrointestinal tract.
• Burn of the mucous membrane.
• Allergy to any food product or hygiene product.
• Caries.
• Dry mouth.
• Using the wrong toothbrush.
• Pulpitis.
• Nervous exhaustion.
• Malocclusion.

Classification of HRAS (chronic recurrent aphthous stomatitis)

All types of stomatitis occur in children, but the most common are: herpetic, candidal and traumatic stomatitis.

Treatment methods

Due to the fact that the etiology of each type of stomatitis is different, the approaches to treatment are also different. For example, a fungus needs to be fought with an antifungal drug, herpes with an antiherpes drug, allergies with an antihistamine, etc. Therefore, the main task of a doctor is to diagnose stomatitis, identify the cause of the disease and prescribe appropriate treatment. Therapy is carried out in two directions: relief of general symptoms and local effects on mucosal lesions. As a rule, the doctor prescribes medications and antiseptic treatment of the oral cavity in the form of applications and rinses.

Acute herpetic stomatitis

It occurs most often, and mainly affects children from 10 months to 3 years.3 The appearance of rashes is preceded by inflammation of the lymph nodes.

With a mild form

In acute herpetic stomatitis, the temperature rises to 37-37.5°C, the general condition is satisfactory, slight swelling and redness may occur on the gums, then up to six blisters appear, which burst with the formation of painful aphthae surrounded by a red rim.
Afta is a round-shaped erosion. Aphthae may merge together. The rash appears once, and after 1-2 days the erosion gradually heals.

Moderate form

Acute herpetic stomatitis is characterized by deterioration of the child’s well-being, weakness, and headache. The child is capricious, has no appetite, the lymph nodes are enlarged and painful, the temperature rises to 38-39°C, the symptoms resemble ARVI. The oral mucosa is swollen, reddened, rashes appear (bubbles, then erosions) of 10-15 pieces, and often there are rashes on the face. Salivation increases, and gingivitis appears (inflammation of the gums, accompanied by bleeding). The rash may appear several times, i.e. after the old ones heal, new ones appear. Healing of erosions takes up to 4-5 days. Bleeding gums and swollen lymph nodes persist for some time after the erosions have healed.

Severe form

It begins as an acute respiratory viral infection, there is pain in the muscles, joints, tachycardia and bradycardia (increased and slow heartbeat), and nosebleeds may even be observed. In this form, the temperature is high up to 40°C, gingivitis is pronounced, the mucous membrane is bright red, swollen, the child’s lips are dry, the mucous membrane of the eyes is swollen, reddened. The rashes constantly appear again, their number can reach 100. Rashes often appear around the mouth, on the eyelids, on the mucous membranes of the eyes, between the fingers, on the earlobes. Simple gingivitis turns into ulcerative (a more severe form of gum inflammation, with the formation of ulcers), salivation increases, and bad breath appears. Recovery is long and hospitalization is often required.

Kinds

Today, 8 types of stomatitis can be diagnosed:

• bacterial;
• aphthous - manifests itself when immunity decreases due to gastrointestinal diseases and anemia;
• herpetic – occurs due to the herpes virus;
• viral;
• angular;
• allergic – a reaction to an allergen entering the child’s body;
• traumatic - the cause may be an accidental bite of the lip with teeth or scratches on the gum;
• fungal – infection of the oral cavity by fungi of the genus Candida.

All types of stomatitis can occur in childhood. However, from birth to 3 years, children are especially susceptible to aphthous, candidal, herpetic and allergic types. During the period of active growth of baby teeth, traumatic stomatitis often appears, caused by rupture of the soft tissue of the gums.

Note! Stomatitis does not always occur on its own. Quite often, rashes in the mouth are a sign of other diseases, so before treatment it is necessary to carry out a series of diagnostic measures to discover the exact cause.

Symptoms

The classic clinical picture for diagnosing stomatitis includes the following symptoms:

• swelling of the mucous membrane;
• the appearance of a white or yellowish coating;
• bad breath;
• dryness or excessive salivation;
• enlarged lymph nodes and increased temperature.

Stomatitis in children has similar and different symptoms. Each type of disease has its own differences in manifestations.

With allergic stomatitis, minor ulcerative lesions appear on the palate, gums, cheeks, and lips. They pass as soon as the irritant can be identified and removed. With aphthous, even one spot with a diameter of up to 1 cm may appear in the mouth. Its outer part is covered with a film, the ulcer is yellow, and its edges are inflamed. If stomatitis is herpetic, then the mucous membrane is affected by numerous rashes that merge into one large wound. These are blisters with clear liquid and are extremely painful. Often the herpes virus causes a deterioration in the general condition of the child’s body, accompanied by body aches and high fever.

The most common type of stomatitis in a child’s mouth is candidiasis. Its common name is thrush. 9 out of 10 parents have encountered this phenomenon at least once. It is characterized by the appearance of a white cheesy coating on the tongue, gums, and cheeks of the baby. It is often observed after completing a course of antibacterial therapy or as a consequence of infection of the mother’s nipples by Candida fungus. Candidiasis can also be caused by poor hygiene.

On a note! Regardless of the type of stomatitis, its treatment should be comprehensive and begin immediately after the first signs of damage to the oral cavity are detected!

Treatment options

How to cure stomatitis in a child? It’s worth noting right away that you can’t prescribe medications to your baby yourself. Only the pediatrician makes a diagnosis and makes recommendations for therapy. Attempts to overcome the disease on your own can lead to a worsening of the little patient’s condition. To determine the causative agent of the inflammatory process, a scraping is made and a virological study is carried out.

For stomatitis in children, what treatment will be most effective? Only those therapeutic measures will help that will affect the disease comprehensively, eliminating both the cause and external manifestations.

Medicines

When an accurate diagnosis is established, dentists prescribe medications for the treatment of stomatitis in children. They are conventionally divided into symptomatic and special.

The purpose of the first is to eliminate the symptoms that accompany the disease. For this purpose the following is prescribed:

• vitamin complexes to strengthen the body;
• antiviral drugs that fight viruses;
• antipyretic and anti-inflammatory drugs;
• anesthetic gels;
• ointments and solutions for treating the oral cavity.
• need to drink plenty of fluids
• gentle diet (exclude sour, salty, spicy)

Candidal stomatitis is treated with special pharmaceuticals that contain substances that kill the fungus. Creams suitable for internal use are prescribed. If an allergic type is detected, the pediatrician will add antihistamine drops or tablets to the general list. If the rash is caused by the herpes virus, you cannot do without taking antiviral drugs, as well as local treatment of the mucous membranes with antiherpetic ointment.

Attention! The entire oral cavity needs to be treated, since pathogens are found everywhere on the mucous membrane. They are not visible to the naked eye, but if they remain in the mouth, they will continue to spread and the treatment will be delayed.

Folk remedies

Have you noticed stomatitis in a child and don’t know how to treat it? Drug therapy can be supplemented with the use of traditional medicine. Compositions prepared from natural ingredients are used to treat stomatitis in children over 2 years of age.

The following formulations are suitable for treating mouth ulcers.

Soda and salt

0.5 tsp each Dissolve the components in warm water. Rinse your mouth with the solution 3-4 times a day after meals. Baking soda relieves inflammation and disinfects well. The same composition, only diluted with water to a mushy consistency, can be used to clean off plaque from fungal stomatitis using a finger wrapped in gauze.

Honey and aloe

The leaf of the plant is ground to a puree, and the same amount of natural honey is added to it. Apply to affected areas three times a day.

Chamomile with honey

Dried flowers are brewed in the proportion of 1 tbsp. for 250 ml of boiling water. Add 2 tsp to the cooled broth. honey Rinse your mouth with warm liquid 2-3 times a day.

Rinses can be prepared from other ingredients:

• sage;
• rosehip;
• St. John's wort;
• oak bark;
• flaxseeds;
• yarrow;
• calendula;
• propolis tinctures.

Lotions of essential oils help a lot.

Important! Folk remedies can only be used after consulting a pediatrician!

How to prevent stomatitis

To reduce the risk of getting an infection in your mouth, you should:

• regularly wash toys, hands, pacifiers, bottles;
• carry out wet cleaning and ventilate the room where the baby spends his leisure time;
• strengthen the immune system: strengthen the child, give vitamins, maintain proper sleep and wakefulness;
• provide a balanced diet;
• fight the bad habit of biting nails or other objects (pencils, pens, rulers);
• Make an appointment with the dentist twice a year for a routine examination.

Any disease should be treated in a timely manner, otherwise negative consequences cannot be avoided. Carefully examine the child’s oral cavity at the first complaints. When stomatitis occurs in infants, the first symptoms include behavioral changes, crying, and refusal of the breast or bottle. Children aged 1 year and older will be able to independently point out to their parents the source of discomfort. Get treated promptly and be healthy!

Enteroviral vesicular stomatitis (arm - leg - mouth)

Caused by enteroviruses. It also occurs in adults, but in 95.7% of cases children are affected.6 It is characterized by seasonal occurrence (summer - autumn) and group incidence.4 It is observed mainly in children under 10 years of age. Vesicular stomatitis is contagious, so it is recommended to use separate utensils and hygiene products. Characteristics for this disease: temperature 37.5-38, weakness, headache, muscle pain, rash on the palms, soles, as well as blisters on the hard palate and pharynx, which then turn into erosions that are almost not painful.

Acute pseudomembranous candidal stomatitis (thrush)

Acute pseudomembranous candidal stomatitis (thrush) occurs:

• Light shape
• Medium-heavy forms
• Severe form

The main symptom of the disease is a white or yellow coating.

With a mild form

The plaque is located in islands, most often on the tongue and cheeks. Children are restless, sleep poorly, and suck the breast sluggishly. Older children may complain of a burning sensation. The plaque is easily removed; underneath there is a bright red mucous membrane. The disease lasts no longer than 7 days.5

Moderate form

The plaque is located on the cheeks, tongue, hard palate, and mucous membranes of the lips. Under the plaque, erosions form, which sometimes bleed. The plaque is more difficult to remove. Lymph nodes are sometimes enlarged and painful. The duration of the disease is 10-15 days, there are relapses.

Moderate form

The plaque is dirty gray, almost cannot be removed, and is located on the tongue, cheeks, soft palate, tonsils, pharynx, and mucous membranes of the lips. Cheilitis appears in the corners of the mouth - inflammation of the lips. The oral mucosa is dry and inflamed. The child’s health is impaired, the child refuses to eat, and the temperature rises. Lesions in the genital area, neck folds, and between the fingers are also common. The disease is long-term, with frequent relapses.

What happens if stomatitis is not treated?

Some parents do not take their child’s stomatitis seriously, they say, “it will go away on its own.” Such an attitude towards the baby’s health can lead to serious consequences. Without treatment, the infection can spread to the skin of the face. There is also a high risk of secondary infection. And this already threatens general intoxication of the body, damage to the nervous system, etc., even death. Therefore, doctors strongly recommend that if symptoms of the disease are detected, show the child to a specialist in order to avoid negative health consequences.

Bacterial stomatitis in children

Necrotizing ulcerative stomatitis is more common in weakened children and is caused by fusobacteria and spirochetes. May be a sign of periodontal disease (progressive destruction of periodontal tissue). It is characterized by the appearance of painful ulcers, weakness, gingivitis (inflammation of the gums), enlarged and painful lymph nodes, difficulty eating, speaking, and bad breath.

Often, erosions in traumatic stomatitis can become infected through dirty hands, toys and other objects, then bacterial stomatitis develops, so it is important to pay attention to antiseptic treatment.

Traumatic stomatitis in children

A specific form of traumatic stomatitis in children is Bednar's aphthae . This is a traumatic erosion of the oral mucosa. In children, unlike adults, the mucosal epithelium consists not of four layers, but of two, so it is easily injured. The cause may be early teething, a rough nipple from the mother, or a long nipple on the bottle. Erosion is most often located in the middle of the palate or opposite the cutting edge of the teeth. The child begins to refuse food, cries, and sleeps poorly.

Traumatic stomatitis also occurs in children when wearing braces. Erosions have uneven edges, are painful, and are usually located on the mucous membrane of the cheeks and lips, less often on the tongue.

Caring for a child with stomatitis

The participation of parents in treatment and proper care of the child is not just important - they are decisive. With stomatitis, it is necessary to strictly follow the treatment plan, which is often very labor-intensive, so the result depends on parental care and control. The oral cavity is a kind of epicenter of pain, so it is not surprising that the child will be capricious a lot. Therefore, it is important for parents to be patient and persistent.

Nutritional Features

Most mothers and fathers are concerned about the question of how to feed a child with stomatitis. Firstly, it is necessary to eat only soft, warm and mushy foods, for example, in the form of purees. The main thing is that the food is high in calories and not heavy, because the child’s immunity is already weakened. After eating, be sure to rinse your mouth so as not to provoke the development of stomatitis and not to add any additional infection. If a child is ill, the diet should include the exclusion of spicy, sour, sweet foods and citrus fruits.

Pain relief and care

For stomatitis in children, pain relief is necessary. It is carried out with the help of various medications in order to avoid food refusal and poor sleep. In addition, for stomatitis in children, proper treatment of the oral cavity is very important. A doctor should recommend what to treat and rinse a child’s mouth with.

Drug-induced stomatitis

Occurs when there is an allergy to a drug. Often, allergies can occur to antibacterial, antimicrobial drugs, vaccines, iodine. The mucous membrane is red, swollen, the lips and tongue also often swell, blisters appear, which burst, leaving erosion. The gums are inflamed and bleed when touched. General manifestations are possible, such as urticaria, nausea, vomiting. In severe cases, anaphylactic shock occurs (an emergency condition manifested by decreased blood pressure, shortness of breath, fainting, suffocation), Quincke's edema (an atypical reaction of the body, manifested by rapid and severe swelling)

Both conditions are extremely dangerous and require immediate action and calling an ambulance!

Prevention of stomatitis in children

In children's groups, infections spread especially quickly. Therefore, if a child is infected with the herpes virus, he needs to stay at home until he recovers. Children who have been in contact with sick people should use antiviral ointments for 5 days.

If a pregnant woman has herpes or candidiasis, she should treat it before giving birth. If you have the herpes virus during the period of illness, you should use separate utensils, do not kiss children, and wear a mask.

Kindergartens and other preschool institutions must be cleaned and objects, including toys, must be treated with disinfectants.

To avoid allergic reactions, you should seek help from an allergist to identify existing allergies.

It is worth preventing a decrease in immunity; hardening works especially well in childhood. It is worth limiting your intake of fast carbohydrates, because... they create a favorable environment for the development of candidiasis. An important point is the proper nutrition of the child; regular intake of vitamins, especially vitamin C, is essential.

Tantum® Propolis

For children over 14 years of age , you can use Tantum® Propolis lozenges; they contain a lot of vitamin C, which will strengthen the immune system, and propolis has an anti-inflammatory effect, preventing the occurrence of infections.7
Find out more

Prevention of Bednar's aft is preparing the breasts for feeding, using special creams to soften the skin, prevent cracks, and it is also worth choosing the right bottle. In case of injury due to braces, you need to use orthodontic wax; here it is important to prevent the wounds from becoming infected, so it is better to treat them with antiseptic solutions and sprays.

Tantum® Verde spray will relieve pain at the site of injury and its antiseptic effect will prevent infection.8,9

Treatment

Each type of stomatitis is treated differently depending on the cause that caused it. You should not prescribe medications yourself. Taking antibiotics for herpetic stomatitis caused by a virus will not help. But there will be wonderful prerequisites for the development of fungal stomatitis. Rinsing with antibacterial solutions for fungal stomatitis will only worsen its course. The fungus must be treated with antifungal drugs. To prescribe effective treatment, it is best to consult a specialist . Dentists in Minsk will be able to correctly diagnose and prescribe effective treatment.

At home, before going to the doctor, you can alleviate the condition by following these recommendations:

• Gently brush your teeth with a soft-bristled brush;
• exclusion from the diet of hot, sour and salty foods;
• if health worsens and the temperature rises, the child should be given plenty of water and, if necessary, given an antipyretic (in this case, a visit to the doctor should take place as soon as possible).

As a rule, doctors recommend special ointments and solutions for children, as well as medications to reduce fever or relieve pain. After each meal, be sure to rinse your mouth with water. It is important to treat children's teeth promptly.

You should not rely on folk remedies: remember, some herbal infusions and decoctions can cause a negative effect and also contribute to the development of an allergic reaction in children. Do not aggravate the situation, seek help from your dentist.