Oral Mucosa diseases

стоматит и глоссит

The mucosa of mouth cavity is always affected by different provocatives-chemical, mechanical, thermal, many microbes and toxic materials. Besides the mouth cavity is a sensitive indicator that shows the functions of internal organs and signals operatively when something is wrong with one of the organs.  If one of the defensive factors has weakened, there arises risk of development of inflammatory lesion of mucosa. The most widespread types are stomatitis and glossitis.


The reasons of mucous diseases of mouth cavity might be:


-    The trauma of oral tissues (chemical, thermal, etc.) that causes traumatic erosion, ulcer, leukoplasia or leukokeratosis (keratinization of mucosa that later may lead to pernicious degeneration)
-    Infection diseases affecting the mucosa as a result of penetration of viruses, microbes, fungi.   
-    More often the reasons of pathologic changes of mucosa are the disorders of different organ-systems in the organism: allergy, diseases of cardiovascular system, gastrointestinal tract, endocrine, blood, skin, tuberculosis, AIDS, etc.
Sometimes to find the reason of mucosa pathology is rather difficult: in that case one needs great experience, high professionalism, ability not only to gather much information but also skills to render and make conclusions on it. 

In ‘Aregak’ dental clinic the experienced doctor-dentists are able to diagnose the existing oral mucosa diseases of concrete patient; they find the reasons and accordingly prescribe appropriate treatment.

Main clinical manifestations

Main clinical manifestations

All inflammatory diseases of mucosa are called identically-stomatitis. If the pathologic process is on the tongue, it is called glossitis, if on the gingiva-gingivitis, if on the lips-cheilitis. When the mucosa starts thickening, calcifies and starts to peel then special type of the illness is existent-leukoplakia.   
The common symptom of stomatitis is the appearance of niduses of reddening, acnes, erosions or ulcers, incrustation. Those niduses often appear on the buccal mucosa, on the oral cavity floor, palate, on the tip of the tongue. Sometimes enlargement of lymphatic nodes placed near the erosions and ulcers is detected, in other cases the body temperature raises. The average of duration of the illness is 7-14 days. Stomatitis may be repeated if the immunity is law, there are feeding disorders, hypovitaminosis, infection diseases; moreover, the exacerbations happen often in the spring and autumn.    

The diagnosis of the diseases of oral mucosa

The diagnosis of oral mucosa diseases is done by detailed clinical examination of the patient that allows the dentist to detect the degree of pathologic process and its prevalence, the reaction of the organism towards the inflammation. It is very important to find the real reason of the illness (trauma, infection, allergy, pathology of inner organs, hypovitaminosis, etc.) for the productivity of the treatment and the prevention of later exacerbation depend on it.   

The principle of the therapy of oral mucosa diseases


The etiotropic and pathogenic therapy set to eliminate the reasons of the diseases (in case of infection stomatitis, glossitis, chelitis-antibacterial, antivirus therapy, in case of hypovitaminosis-vitamin therapy, treatment of the main illness because of which the oral mucosa diseases generated).
Local therapy set to eliminate the local traumatic factors, the main symptoms of the disease and to recover quickly the existing erosions and ulcers.  
General recovering therapy that stimulates the protective forces of the organism.   
Turning to dentist in case of first symptoms of oral mucosa diseases is the guarantee of quick recovery.

Стоматит

Stomatitis

Stomatitis is the general name given to the diseases of oral mucosa. The following pathology develops, as a rule, because of general and local reduction of immunity. According the causes of generation the following types of stomatitis are differentiated:
- Chronically repeated aphthous stomatitis
-    Herpetic
-    Ulcero-necrotic
-    Oral moniliasis

Chronic aphthous stomatitis manifests itself either on the lips, on bucca, on palate or on the tongue mucosa in the form of sore aphthа.  The main causative agents are microbes and viruses. The illness is generated when the balance of vitamins B1 and B12 in the organism is disturbed. It is often observed in case of chronic diseases of the liver and gastrointestinal tract.

The causative agent herpetic stomatitis is the ordinary herpes virus. Most often it occurs to children 1-3 years. In that case at the beginning of the disease the child has common symptoms of general intoxication:   

-    general malaise,
-    high temperature,
-    enlargement of lymphatic nodes,
-    nausea and vomiting  
-    diarrhea.

Then on the oral mucosa and on the edges of the lips acnes appear in places of which erosions appear quickly with typical irregular edges. After nearly 8-10 days the illness is cured.

To ulcero-necrotic stomatitis the necrosis of gingiva is typical. The inflammation usually starts from inter-dental papillae and the mucosa surrounding, especially buccal mucosa. Then sore and easily bleeding ulcers appear that join quickly and form rather big ulcers of mucosa. As a result active necrotic lesion is started; there is odor of rotting in the mouth.    
This kind of lesion is detected in case of insufficient oral hygiene especially to people of 17-30 years.
The ulcero-necrotic stomatitis may be accompanied by flu, quinsy, ARD, blood diseases, AIDS, tuberculosis, and raise rather unpleasant and serious complications. In case of such lesion of mucosa besides the rash symptoms of intoxication are also possible: high temperature, general malaise, enlargement of lymphatic nodes and pain.       

Oral moniliasis is a rater widespread disease of oral mucosa the causative agent of which is the fungi called Candida. In this case there is dryness, burning in the mouth cavity; white incrustation is formed (while cleaning it the mucosa is bleeding).

The treatment of stomatitis

In case of first symptoms of each kind of stomatitis it is necessary to turn to dentist. No self-treatment should be done. First the doctor will put diagnosis then he will start treatment.  To prevent stomatitis one must keep always private oral hygiene and, of course, be attentive towards his own health.

Stomatitis depending on clinical manifestation may be catarrhal, ulcer and aphthous.

Catarrhal stomatitis is one of the most frequently accruing lesions. The reasons of its generation are the local factors-when the oral hygiene is not kept, the dental diseases, oral dysbacteriosis. The illnesses of gastrointestinal tract such as gastritis, duodenitis, colitis, helminthiasis can also cause stomatitis. In case of catarrhal stomatitis the oral mucosa swells, hyperemia is detected; it can be covered with white or yellow incrustation. Hypersalivatation is also detected. Gingiva bleeding and fetid odor in the mouth are also possible. Кандидозный стоматит

The treatment of catarrhal stomatitis is the elimination of local causes-cleaning of dental tartars, teeth healing. The mucosa is disinfected chlorhexidine liquor of 0.05 % and 0.1%. In a day one must polish the mouth cavity with tincture of chamomile, marigold and keep special diet. Generally after 5-10 days stomatitis is cured. But if the phenomena do not eliminate then the general reasons should be revealed that might be illnesses of gastrointestinal tract or helminthiasis. In this case local and general therapies are combined.     

The ulcer stomatitis is a more severe disease than the catarrhal; it can either develop itself or be the complication of catarrhal stomatitis. The ulcer stomatitis is often generated to the people having stomach ulcer illness or chronic enteritis, as well as in case of cardiovascular, blood, infection diseases and intoxications. Unlike catarrhal stomatitis that infects the superficial layer of the mucosa, the ulcer stomatitis infects the whole mucosa.   
The primary symptoms of catarrhal and ulcer stomatitis are similar, but later in case of ulcer stomatitis high temperature, malaise, headache, enlargement of lymphatic nodes and pain are detected. The patient feels strong pain while eating. These symptoms, of course, make the patient to turn to doctor. 

Aphthous stomatitis shows itself by generating one or several aphthas on the oral mucosa. The aphthas are oval or round, in the size of lentil grain, with clear red lines with gray-yellow incrustation in the middle.
The gastrointestinal illnesses, allergic reactions, virus infections, rheumatism may cause aphthous stomatitis. The disease starts with general malaise, high temperature and pain in the mouth cavity in the places of aphthas. To treat this illness one must turn to doctor immediately.    

Leukoplakia is the chronic lesion of oral mucosa which causes keratinization of epithelium (hyperkeratosis). It is detected generally to men older 40 years and is placed on the buccal mucosa, in the corners of mouth, in the lateral zones of the tongue.
The causes of leukoplakia might be the mechanical traumas of the mucosa from the retractors of dental prosthesis, from too hot or cold food and so on. This illness often does not have expressed symptoms, but the patient may have the feeling of light itching and burning. But the disease is dangerous as it can change into a pernicious degeneration, thus it is necessary to turn to a doctor-oncologist.       

Glossitis
Глоссит
Glossitis is the inflammation of the tongue tissues. It can be both superficial and deep. More often glossitis is a symptom of some other illness of the organism, but it may be an independent disease as well.
The main reasons of the development of glossitis are dental caries, tartars, the traumas of tongue and mouth cavity, smoking, alcoholism, insufficient oral hygiene, the lesion with salts of hard metals, scalding, too hot food, hot spices, allergies and so on. 

Superficial glossitis might be a symptom of gastrointestinal tract, infection diseases. It shows itself by incrustation, swell on the tongue, thickening and limitation of mobility. The tongue gets bright red color, feeling of burning on the tongue raises, it is painful, the taste feeling is lost and hypersalivation is detected.     

The treatment of superficial glossitis is performed by local anesthesia and with antibacterial means. Multivitamin complexes, antihistamines are prescribed. Great role has the oral cavity sanation (the elaboration of the open wound with special materials and extraction of dead tissues, so that nothing would impede the rehabilitation).

In case of deep glossitis it is a bit difficult. The inflammatory lesion takes place in the tongue and an abscess is developed (pus accumulation that generates in case of acute or chronic infection nidus). The deep glossitis may spread over the floor of the mouth and generate inflammation in the zones of chin and isthmus.  In this case a surgical treatment is indicated.   
Besides the above mentioned there are also non-inflammatory types of glossitis, t. e. desquamative glossitis (geographical language).
This type of the illness is detected in case of pregnancy, gastrointestinal tract, blood illnesses, metabolic disorders, in case of some infection diseases, helminthiasis, rheumatism.
In case of desquamative glossitis the epithelium of the tongue surface and lateral parts is expressed by nidus. The alliteration of the niduses of epitheliums being decayed and restored makes the surface of the tongue look like a map. Besides external changes, there is also a feeling of burning and pain.     
The treatment of desquamative glossitis is based on the treatment of the main disease because of which the glossitis is developed.
The glossitis may also be rhombus-like, which is an inborn anomaly; villiferous, which is described by enlargement and keratinization of filamentous papillae; folded, which is an inborn anomaly: on the tongue plaits appear, but is doesn’t cause complaints; atrophic, which is one of the symptoms of anemia which is generated because of the insufficiency of vitamin B12 and folic acid, the tongue becomes bold without any papillae; interstitial, this type is developed in case of the syphilis, the tongue scleroses and its mobility is limited.

ворсинчатый глоссит географический язык Глоссит

The prevention of glossitis demands sufficient oral and dental hygiene, regular visits to dentist, healthy food.
ГлосситThe treatment of oral mucosa diseases mainly is done by elimination of provocative reasons. Oral cavity sanation is done, the acute angles of teeth are flattened, the dental prosthesis is chosen correctly. The patient is prescribed healthy diet; the patient quits smoking and doesn’t eat too hot and spicy food.
To treat stomatitis the dental tartars are extracted and the ill teeth are treated. Antiseptic means are prescribed to polish oral cavity, the tincture of chamomile and marigold among them. If the stomatitis is not recovered in 5-10 days it means there is gastrointestinal tract disease or helminthiasis. In this case the general therapy course is chosen.



In ‘Aregak’ dental clinic diagnosis and treatment of oral mucosa diseases are done. These illnesses are quite diverse and often make the patient suffer. For that reason they should be diagnosed and treated on time. Besides the diagnosis of oral mucosa diseases would allow to determine the state of inner organs which is very important as it does not demand laboratorial methods.