Stomatitis
Encyclopedia
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 from hot food or drinks, toxic plants, or by conditions that affect the entire body, such as medications, allergic reactions, radiation therapy, or infections.
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 (Cyanocobalamine).
When it also involves an inflammation of the gingiva
, it is called gingivostomatitis
.
It may also be seen in ariboflavinosis (riboflavin deficiency) or neutropenia
.
in the corners 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).
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 an relatively uncommon form of the geographic tongue
condition, that, in opposed to migratory stomatitis, is confined to the dorsal and lateral aspects of the tongue
mucosa only.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the mucous lining of any of the structures in the mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
, which may involve the cheeks, gums, tongue
Tongue
The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...
, lips, throat
Throat
In vertebrate anatomy, the throat is the anterior part of the neck, in front of the vertebral column. It consists of the pharynx and larynx...
, and roof or floor of the mouth. The inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene
Oral hygiene
Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities , gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened...
, dietary protein deficiency, poorly fitted dentures
Dentures
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental...
, or from mouth burns from hot food or drinks, toxic plants, or by conditions that affect the entire body, such as medications, allergic reactions, radiation therapy, or infections.
Pathophysiology
Severe iron deficiency anemiaIron deficiency anemia
Iron-deficiency anemia is a common anemia that occurs when iron loss occurs, and/or the dietary intake or absorption of iron is insufficient...
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 (Cyanocobalamine).
When it also involves an inflammation of the gingiva
Gingiva
The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
, it is called gingivostomatitis
Gingivostomatitis
Gingivostomatitis is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva. Herpetic gingivostomatitis is often the initial presentation during the first herpes simplex infection. It is of greater severity than herpes labialis which is often the subsequent...
.
It may also be seen in ariboflavinosis (riboflavin deficiency) or neutropenia
Neutropenia
Neutropenia, from Latin prefix neutro- and Greek suffix -πενία , is a granulocyte disorder characterized by an abnormally low number of neutrophils, the most important type of white blood cell...
.
Angular stomatitis
Irritation and fissuringFissure
In anatomy, a fissure is a groove, natural division, deep furrow, elongated cleft, or tear in various parts of the body.-Brain:...
in the corners of the lips is termed angular stomatitis or angular cheilitis
Angular cheilitis
Angular cheilitis is an inflammatory lesion at the labial commissure, or corner of the mouth, and often occurs bilaterally. The condition manifests as deep cracks or splits...
. In children a frequent cause is repeated lip-licking and in adults it may be a sign of underlying iron deficiency anemia
Iron deficiency anemia
Iron-deficiency anemia is a common anemia that occurs when iron loss occurs, and/or the dietary intake or absorption of iron is insufficient...
, or vitamin B deficiencies (e.g. B2-riboflavin
Riboflavin
Riboflavin, also known as vitamin B2 or additive E101, is an easily absorbed micronutrient with a key role in maintaining health in humans and animals. It is the central component of the cofactors FAD and FMN, and is therefore required by all flavoproteins. As such, vitamin B2 is required for a...
, B9-folate or B12
Vitamin B12
Vitamin B12, vitamin B12 or vitamin B-12, also called cobalamin, is a water-soluble vitamin with a key role in the normal functioning of the brain and nervous system, and for the formation of blood. It is one of the eight B vitamins...
-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 stomatitisMigratory stomatitis
Migratory stomatitis is a benign condition on the oral soft tissue. This condition has two forms: the common form, which is consisted from red lesions with white borders on the tongue only. This form is called geographic tongue...
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 an relatively uncommon form of the geographic tongue
Geographic tongue
Geographic tongue, an inflammatory condition of the tongue affecting approximately 2% of the population, is characterized by discolored regions of taste buds or sometimes even cracks in the tongue...
condition, that, in opposed to migratory stomatitis, is confined to the dorsal and lateral aspects of the tongue
Tongue
The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...
mucosa only.
See also
- CheilitisCheilitisCheilitis is a medical condition involving inflammation of the lip.It is associated with many conditions, including megaloblastic anemia from vitamin B12 deficiency, iron deficiency anemia and oral candidiasis. It can also be a symptom of allergies, such as allergy to Balsam of Peru...
- Pyostomatitis vegetansPyostomatitis vegetansPyostomatitis vegetans is an inflammatory stomatitis and most often seen in association with inflammatory bowel disease, namely ulcerative colitis and Crohn's disease.- See also :* Cheilitis* Cheilitis granulomatosa* Skin lesion...
- Aphthous ulcerAphthous ulcerAn aphthous ulcer , also known as a canker sore, is a type of mouth ulcer which presents as a painful open sore inside the mouth or upper throat characterized by a break in the mucous membrane. Its cause is unknown, but they are not contagious...
- Bovine papular stomatitisBovine papular stomatitisBovine papular stomatitis is a disease caused by a virus of the family Poxviridae and the genus Parapoxvirus. It occurs worldwide in cattle. Symptoms include reddish, raised, sometimes ulcerative lesions on the lips, muzzle, and in the mouth. It usually occurs before the age of two years. ...