Stomatitis in children: symptoms and treatment, causes and types

Mouth pain is most often caused by infection, allergies, or injury. A sore throat can easily be confused with pain in the mouth.

THE DOCTOR'S CONSULTATION

Contact your doctor if your child:

refuses to drink for a long time due to pain in the mouth
he has a mouth ulcer that has not healed for more than a week
swelling of the gums, lips, palate

ATTENTION!

Pain in the mouth can lead to a child refusing to drink for a long time, and this is dangerous due to the risk of dehydration.

ASK YOURSELF A QUESTION	POSSIBLE REASON	WHAT TO DO
Is your baby breastfed and has small sores on your tongue?	Incorrect attachment during breastfeeding	Ulcers are formed from pressure from the nipple when the baby is not latched onto the breast incorrectly and go away when proper latching is established. Try changing your feeding position. You can contact a lactation consultant for help in establishing proper feeding. If inflammation or other symptoms occur, contact your child's doctor .
Has your child's drooling increased? Does he keep his finger(s) in his mouth all the time? Is he 4-8 months old?	Teeth cutting	If these symptoms are accompanied by signs of illness (fever, loss of appetite, etc.), call your child's doctor for an examination. The appearance of teeth alone cannot cause a high temperature. Some children find it easier if they are given special rubber rings to chew on; others like to live cool objects (see Toothache)
Is your baby hungry but refusing to nurse? Are there white spots on the tongue and inside of the cheeks? Did he take antibiotics?	Thrush	This is a fungal disease and can be caused by taking antibiotics. Consult your child's doctor . A good remedy is to treat your mouth with a soda solution. Sometimes it is necessary to take antifungal agents.
Is your older child complaining of pain when swallowing?	Viral or bacterial (streptococcal) infection	Take your child to the pediatrician . He will prescribe the necessary treatment
Do you have small, painful sores on your tongue and inside your cheeks?	Ulcerative stomatitis	Take your child to the pediatrician. He will prescribe the necessary treatment
Painful yellowish spots or blisters on the tongue, gums, inner cheeks, swelling and redness of the oral mucosa? Enlarged cervical lymph nodes, “cold” on the lip? Are your lips bright red, swollen, painful? Temperature 37.5-39 C? Loss of appetite, headache, drooling?	Herpetic or other viral infection	Call a doctor and follow all his instructions. A sick child should have separate dishes; isolation is required. Paracetamol will help with pain and fever. Give non-carbonated, non-acidic drinks (water, milk, milkshakes); broths
Are your lips dry and bright red? Are there peeling and cracks in the corners of your mouth?	Seizures (cheilitis); may be caused by B vitamin deficiency or food allergies	Talk to your child's doctor . Use hygienic lipstick, baby cream, especially in cold weather
Does your child have a constant sore on the tip or edge of his tongue or one sore on the inside of his cheek?	Biting with a tooth	Contact your dentist
Does your child have sores on his tongue or on the inside of his cheek? Is he taking any medication, such as an anticonvulsant or an antibiotic?	Possible side effects of the medication	Show your child to the pediatrician - he will recommend what to do

FOR INFORMATION

"Geographical" language

A healthy tongue is pink in color, its upper surface is covered with papillae surrounded by taste endings. Sometimes parents notice with concern that the child’s tongue is covered with bright red spots with white borders and resembles a map. The spots are painful and appear and disappear. This inflammation of the tongue is the so-called harmless migratory glossitis. It does not require treatment. The reason is not known for certain.

Causes of stomatitis

The imperfection of local and general defenses of the child’s body makes the mucous membranes of the oral cavity vulnerable to adverse factors. And the healthy curiosity characteristic of every child has made stomatitis one of the most common diseases among children. Sometimes, for the development of an illness, it is enough to taste any less than sterile object. The main causes of the disease include the following:

insufficiently good oral hygiene;
minor injuries - cheek biting, scratch, etc.;
burns, including chemical burns;
exposure to pathogens from unwashed hands or dirty toys.

Dentists focus on stomatitis associated with biting the inside of the cheek.
This is often associated with recent dental treatment under local anesthesia. For some time after the procedure, there is reduced sensitivity in the area of the lip or cheek, so you need to eat food after treatment very carefully and only after you have waited for the recommended period of time - usually from 1 to 2 hours. The likelihood of developing stomatitis for these reasons increases after infectious diseases, previous interventions, hypothermia and other factors that contribute to a decrease in protective forces.

What are the main causes of swelling with pain?

The main cause is inflammatory processes of periodontal tissues, which are caused by a number of pathological conditions.

Advanced caries, bad habits, ignoring hygiene rules or poor-quality root canal filling. In most cases, swelling of the cheek is preceded by pain localized on the side of the affected tooth. The source of inflammation is located in the root area and after a few days a flux can form, which without treatment transforms into an abscess.

Very often, swelling of the cheek occurs due to disruption of the eruption of wisdom teeth. In this case, purulent inflammation is caused by the formation of a pocket (hood) between the gum and the dental unit itself. In addition, due to lack of space in the jaw arch, molars can occupy an unphysiological position and injure the buccal mucosa.

Inflammation caused by infection of the socket after the removal of a molar very often leads not only to swelling of the cheek, but also to more serious consequences.

A dental cyst is characterized by asymptomatic formation over a long period of time; when it increases to 5-7 mm, the neoplasm presses on the bone. The pathology is characterized by acute throbbing pain, accompanied by swelling and redness of the gums, as well as deterioration of the general condition.

The danger of inflammatory processes in the oral cavity lies in the close proximity of pathogenic swelling to the tissues of the face and brain. If left untreated, there is a high risk of phlegmon and abscess formation, which in extreme situations can lead to death.

Types of stomatitis

The treatment regimen for stomatitis in children is based on the type of disease. There are several types of stomatitis:

bacterial;
viral, including herpes;
fungal;
aphthous;
angular;
allergic;
traumatic.

All types of stomatitis occur in children, but the most common among children under 3 years of age are aphthous, candidal, herpetic and allergic. An increase in the incidence of traumatic stomatitis is usually associated with a period of active growth of primary teeth.

It is important to understand that in some cases, stomatitis is combined with other diseases with similar symptoms and is the first sign of more serious diseases. For example, with cheilitis - inflammation of the mucous membrane and red border of the lips, food allergies, etc.

Symptoms

Common symptoms of stomatitis are pain, burning, swelling of the mucous membrane and redness, and bad breath. Salivation also changes - it can be excessive or insufficient, with dry mouth. In some cases, there may be an increase in temperature and enlargement of the submandibular lymph nodes.

The types of stomatitis in children and treatment methods differ, as do the specific manifestations. For example, with aphthous stomatitis, only one large ulceration may appear, but with viral stomatitis, inflammation almost always takes the form of numerous elements or a rash merging into one focus.

Candidal stomatitis is characterized by the formation of a white or yellowish cheesy coating. It is easier to recognize traumatic stomatitis because it is preceded by damage or the source of injury is nearby - a chipped tooth or a rough filling.

“Mom, my mouth hurts!” We talk about stomatitis in children

Is your child being capricious, refusing food, or complaining of pain in the mouth? One of the reasons for this condition may be stomatitis. Alla Aleksandrovna Zmanovskaya, a dentist at Clinic Expert in Irkutsk, told us about the signs of stomatitis in children, methods of diagnosing and treating it.

— Alla Alexandrovna, what is stomatitis?

This is an inflammation of the mucous membrane of any part of the oral cavity - lips, cheeks, tongue, palate, gums.

— Why does stomatitis occur in children?

One of the reasons for the development of stomatitis may be damage to the mucous membrane as a result of mechanical and chemical trauma. There are frequent cases of injury to the mucous membrane by sharp edges of teeth. One type of stomatitis, Bednar's aphthae, develops due to trauma to the oral cavity from a rough pacifier. The availability of household chemicals to a child can cause a chemical burn to the oral cavity.

Viral, bacterial and fungal stomatitis develop against the background of infection with pathogens of ARVI, influenza, herpes, measles, rubella, specific infections (tuberculosis, syphilis, etc.), with weakened immunity, with pathology of certain organs and systems, in particular the gastrointestinal tract , as well as for allergic reactions. Fungal stomatitis can develop due to the use of antibiotics.

— Tell us about the existing types of stomatitis in children and their differences

There are acute and chronic forms of this pathological process. Depending on the elements of tissue damage, catarrhal, ulcerative and aphthous stomatitis are distinguished. They differ from each other both in symptoms and severity, and in treatment tactics.

Acute herpetic stomatitis is a common type of disease in children aged 6 months to 3 years. During this period, children lose antibodies received from the mother while the fetus is in the womb, and their own immunity is not yet ready for an adequate response. With age, there is a decrease in the incidence of this form of stomatitis due to the development of acquired immunity after suffering various forms of herpetic infection.

Infants and children who have undergone long-term antibiotic therapy often develop candidal stomatitis.

— What are the symptoms of stomatitis in children?

Parents may notice rashes on the oral mucosa - blisters, spots, ulcers, erosions, and feel bad breath. Young children become more capricious and refuse foods that especially irritate the inflamed mucous membrane (sour, salty). An older child usually points to the place where it hurts. With more severe stomatitis in children, body temperature may increase. Detection of these signs is a good reason to immediately contact a pediatric dentist.

— What is the diagnosis of stomatitis in children based on?

To make a diagnosis, we first talk with the adults accompanying the child - we find out the complaints, clarify when and how the disease began, how long it has lasted, and what chronic pathologies the child suffers from. Then we move on to examining the oral cavity, recording all changes in the mucous membrane and teeth. An external examination of the maxillofacial area is also carried out. In severe cases of some types of stomatitis in children, rashes on the lips and enlarged regional lymph nodes can be detected.

— What methods of treating stomatitis in children are currently relevant?

Depending on the severity of the disease, local or complex treatment is used. For example, in the case of the development of stomatitis as a result of mechanical damage, it is sufficient to eliminate the action of the causative factor (avoid the use of rough nipples, grind off sharp edges of teeth, etc.), antiseptic treatment of the oral cavity and the use of drugs for regeneration of the mucous membrane against the background of complete sanitation and elimination of the damaging factor a. For chemical burns, depending on the severity, hospitalization is indicated.

For viral, bacterial and fungal stomatitis of moderate and severe severity, in addition to local treatment, antiviral, antifungal or antibacterial therapy is additionally prescribed.

For any form of stomatitis, children should limit their consumption of coarse, hard, irritating foods.

Based on how long it takes for a child’s stomatitis to go away, we can draw a conclusion about the effectiveness of the treatment used and, if necessary, adjust it. Any form of stomatitis is cured within one to two weeks. However, it should be remembered that a feature of stomatitis in an HIV-infected child is that its course, even with appropriate treatment, is delayed for more than 2 weeks.

— Alla Alexandrovna, is it possible to prevent the development of stomatitis?

Can. The main method of prevention is sanitation of the oral cavity, which involves treatment of all teeth affected by caries and its complications, regular thorough oral hygiene, disinfection of premises, household items, and toys.

If a child often has stomatitis, you should consult a dentist and pediatrician, who, if necessary, will prescribe a comprehensive examination. It is important that children receive a nutritious, balanced diet and spend a lot of time outdoors. Hardening the body and playing sports also help the body resist infections.

If you suspect or detect signs of stomatitis in a child, I recommend that you contact a pediatric dentist. By eliminating possible causes and choosing the right therapy, the doctor will be able to prevent oral inflammation from becoming chronic.

For reference:

Zmanovskaya Alla Alexandrovna

In 2015 she graduated from the Faculty of Dentistry of Irkutsk State Medical University.

In 2016, she completed her internship at the Federal State Budgetary Educational Institution ISMU in the specialty “General Dentistry”.

In 2016, she underwent professional retraining at the Federal State Budgetary Educational Institution ISMU in the specialty “Therapeutic Dentistry”, in 2022 – in the specialty “Pediatric Dentistry”.

Dentist-therapist, pediatric dentist at “Clinic Expert” Irkutsk. Receives at the address: Irkutsk st. Kozhova, 9a

Diagnostic features

A dentist can detect stomatitis during the first visual examination. But in controversial cases, laboratory tests may be required. Thus, bacterial inflammation may require identification of the causative agent of the disease and its sensitivity to antibiotics. A scraping and/or virological study will help determine the cause of the disease and prescribe appropriate treatment.

If a combination of several ailments with a similar picture is suspected, as well as if the child’s general well-being deteriorates, laboratory tests of blood and urine and consultations with other specialists may be prescribed.

Sometimes stomatitis can be the first manifestation of systemic diseases, general somatic pathology, for example, diabetes mellitus or malignant neoplasms. Therefore, a timely visit to the doctor is extremely important.

Swelling and gumboils after milk tooth extraction

The surgical dental procedure is quite traumatic. When a baby tooth is extracted, tissue and blood vessels are torn. The child does not feel pain under anesthesia, but almost always experiences stress. Therefore, common consequences include a slight rise in temperature, swelling after the removal of a baby tooth, a small bruise in the projection of the extracted unit, the whims and bad mood of the baby.

In the case of edema, parents should monitor closely. Within normal limits, swelling persists and even increases in the first three days after removal. After this, the swelling should subside. But in some cases the situation begins to worsen. Improper healing, infection or pathology is indicated by:

high temperature - more than 38 degrees;
gumboil - a very swollen cheek after a child’s tooth was removed, as well as when the swelling went down to the throat;
bleeding - repeated or continuous;
pain - severe, difficult to relieve with medications;
numbness of the gums - in the area of the socket of the extracted tooth;
vomiting, diarrhea, abdominal pain.

Any of the listed symptoms indicates the need to consult a doctor and take urgent measures to eliminate the ailment.

Features of treatment

As is often the case with diseases that are at the intersection of several areas of medicine, inflammatory lesions of the oral mucosa are one of the least studied areas of dentistry. Therefore, several specialists can be involved in the treatment of stomatitis in children in the mouth: pediatrician, dentist, dermatologist, immunologist-allergist, otolaryngologist, etc. This is especially convenient when you go to a multidisciplinary clinic.

Self-medication of stomatitis is unacceptable, and although it is now easy to find ready-made treatment regimens and folk recipes, it is important not to experiment with the baby’s health.

Conservative treatment is mainly used, which involves treating the underlying cause of the disease. Your doctor may prescribe the following medications:

antibacterial drugs (systemic and local in the form of ointments): for bacterial inflammation;
antiviral agents for herpes and other types of viral stomatitis;
antifungal drugs for fungal diseases;
antihistamines - both for allergic origin of stomatitis, and as part of complex therapy to reduce swelling and itching;
symptomatic drugs - anti-inflammatory, analgesic, antipyretic.

Treatment of candidal stomatitis in infants should be carried out with caution. At the same time, it is important to pay attention to your health; sometimes the cause of such a disease can be insufficient breast hygiene during lactation.

Often, only local remedies are sufficient, but make sure that the entire oral cavity is treated with the rinse - inflammatory agents can be found on the entire surface of the mucous membranes. Healing applications can be used to a limited extent, only on areas of inflammation.

Treatment of stomatitis of any kind in children involves strict adherence to a diet. The diet should be gentle, it is important to avoid salty, spicy, sour foods and drinks, serve the child warm meals, and limit the consumption of sweets.

If traumatic stomatitis occurs, the doctor will prescribe medications to speed up healing. However, it is very important to prevent re-injury. If it was caused by sharp edges of a tooth or filling, this cause should be eliminated. The doctor will suggest grinding off the filling or replacing it, and will also choose the appropriate option for restoring the shape of the crown in case of chips and cracks.

Prevention of stomatitis

You can reduce the risk of developing stomatitis using the following recommendations:

regular washing of toys, bottles, pacifiers, breast hygiene if the baby is breastfed;
general strengthening activities: walks, wet cleaning, a balanced diet, moderate hardening, adherence to a daily routine;
fighting bad habits of biting nails, pencils, etc.;
regular dental examinations and timely interventions in case of dental injuries.

The dentists of the Family Doctor clinic treat and prevent stomatitis in children.
Advanced equipment allows us to quickly and accurately assess the condition of the oral cavity and perform the necessary studies in a short time. We practice modern approaches to the treatment of inflammatory diseases of the oral cavity and adhere to an individual approach to each small patient. Consultations with a pediatric dentist are available by appointment. To make an appointment, call the single contact center or fill out a special online appointment form with a pediatric dentist on the website, or you can also visit the clinic’s reception in person.