Chronic recurrent aphthous stomatitis: treatment in children

Chronic recurrent aphthous stomatitis — an inflammatory condition of the mucous membrane of the oral cavity, with a characteristic formation of aft, long course of disease and frequent exacerbation. AFTA is a soft and painful defect in the surface epithelium. Most often, the disease affects children of preschool age and people 20 to 40 years.

The causes of the disease

The most probable reasons for the occurrence of chronic recurrent aphthous stomatitis include:

  1. viral infection (herpes, cytomegalovirus);
  2. bacterial infection;
  3. allergic reactions;
  4. genetic predisposition;
  5. beriberi;
  6. immunodeficiency;
  7. injury to the shell of the mouth;
  8. stress;
  9. mental disorders;
  10. bad ecology;
  11. failures of the gastrointestinal tract;
  12. pathology of the blood;
  13. use for oral hygiene means with the content of sodium lauryl sulfate.

When injected into the human body with a weakened immune system of the virus or the bacteria develops first acute Aptos. Further, if there is no necessary treatment, any factor able to trigger the recurrence of chronic stomatitis.


Chronic aphthous stomatitis manifested certain characteristics:

  • the increase in body temperature during moderate and severe stages of the sores;
  • General malaise;
  • before the rash the child experiences a burning sensation of the mucous membranes, it’s cranky, not eating and not sleeping;
  • in severe stage, the increase in regional lymph nodes;
  • the appearance of one or multiple painful ulcers covered with bloom;
  • unpleasant smell from the mouth.

The clinical development of aphthous stomatitis

The original aphthous stomatitis appears round patch of pink or white hue. The item turns into aftu for no more than 5 hours. AFTA is localized on the erythematous patch and covered fibrioznoy coating, which, by scraping, it is impossible to remove, and with a strong influence of pathological bleeding surface.

Aphthae located on a transitional fold on the sides of the tongue, on the surface of the mucous membranes of the lips and cheeks. Defective formation may also be detected on the mucous membranes of the stomach and intestines, the reproductive system, and conjunctiva. Gradually with the aggravation of the disease amount of aft increases and the recovery period increased to 4 weeks.

With a strong necronom the development of the canker area increases the amount of plaque and appears infiltration.

Classification of the disease

There are several ways of classifying chronic aphthous stomatitis.
Depending on the severity of the disease manifests in three forms:

A mild form of aphthous stomatitis. It is determined by the presence of a single aft a little painful with the presence of fibrinous plaque. For this form of symptoms of diseases of the digestive tract (frequent constipation, flatulence).
Moderate form. In this form there is swelling of the mucous membranes and pale. In the front part of the oral cavity is present up to 3 aft, covered with fibrinous coating and painful when touched. There is an increase, mobility and tenderness of the regional lymph nodes. Change aphthae is 5-10 days and is associated with the resistance of the organism. In moderate form of the disease are manifested symptoms of diseases of the gastrointestinal tract (constipation, pain in the navel, symptoms of flatulence, decreased appetite).
A severe form. Aphthous stomatitis is caused by many AFL localized on entire oral mucosa. The disease occurs without interruption or frequent recidive. In the initial stages of the disease can increase the body temperature to 38 degrees, to appear malaise, headaches, apathetic condition, and weakness. While eating, during conversation, and even in repose, there is a strong soreness in the mouth. This form is characterized by the manifestation of chronic Hypo — and hyperacidity gastritis, diseases of the biliary system, dysbiosis, constipation, diarrhea, flatulence.
READ  Abscess of the throat: what it is, photos, symptoms, treatment

Classification of chronic aphthous stomatitis on clinical characteristics:

  • Fibrinous form. She is characterized by the appearance of aft is less than 5, epitelizirutmi for 7-10 days.
  • Necrotic. Is the primary process destruction of the epithelium and the formation of plaque necrotic.
  • Glandular stomatitis. Initially there is a loss of the epithelial layer of the duct of the minor salivary gland and decrease in its functional activity.
  • Deforming form. Characterized by the formation of ugly scars in place of the pathological entities that affect relief, the shape and location of the mucosa.

Chronic recurrent aphthous stomatitis has been classified by morphological principles and patterns of development of pathology on:

  1. The typical form. The most common type. Characterized by the appearance of aft Mikulich. The General condition is satisfactory. The number of aft to 3. They are not painful and are located on a transitional fold and lateral surfaces of the tongue. Aft healing occurs within 10 days.
  2. Scar or ulcerative stomatitis. Is determined by the presence of large, deep and painful aft of Setten with jagged edges. Healing forms a scar. The formation of a new epithelium is completed all the way to the 25th day. Overall health is deteriorating, there is a strong headache, malaise, apathy, weakness, rise in body temperature to 38 degrees.
  3. Deforming form. Typical all the signs of scar forms of chronic recurrent aphthous stomatitis, but with a more deep destructive changes of the connective base. In areas of healed ulcers formed deep and tight scars that alter the mucosa of the soft palate, arches, tip of the tongue and its lateral surface, the corners of the mouth. Health is deteriorating. There are migraines, lethargy, fever up to 39 degrees. Scarring occurs for 1.5–2 months.
  4. Lichenoid form. Aphthous stomatitis this expression looks similar to the red flat depriving. The mucous membrane there are areas of hyperemia, bordered by a barely noticeable white cushions giperplazirovannah epithelium. Over time, the mucosa is covered by erosion and appear isolated aphthae.
  5. Fibrinous form. Typical focal hyperemia, on the site where for several hours there without effusion of fibrin films. Such a process often has a backlash and spills over into the subsequent stage.
  6. Glandular form. Minor salivary glands and excretory ducts are working with disabilities. The transformation of pathology in aphthous and ulcerative stage of disease.
READ  What to do after removal of wisdom tooth: rinse your mouth than

Diagnosis of the disease

If you have symptoms of chronic canker sores should consult a specialist: adult — to the dentist or the therapist, the child — to the pediatrician. The doctor conducts questioning and examination. Then a cervical smear is taken from the surface of aft for laboratory research biomaterial. Depending on the results of the analysis to be diagnosed and assigned a treatment regimen.

In the diagnosis it is important not to confuse the CRAS with other, similar major symptoms, diseases. These include:

  • chronic recurrent herpetic stomatitis;
  • mnogoformna exudative erythema;
  • traumatic erosion and chronic ulcers;
  • secondary syphilis;
  • stomatitis medication nature;
  • ulcerative-necrotic gingivo-stomatitis Vincent;
  • Aptos Bednar;
  • syndrome Behceta.


Treatment of chronic aphthous stomatitis is not a simple task. Therapy depends on the results of a comprehensive immunological survey. Required is the identification and elimination of co-morbidities and precipitating causes.

In that case, if the survey does not give complete information about the causes of disease, is a common immunomodulatory treatment. Children assigned Imudon, adults — infusion of Echinacea, Amiksin, Interferon.

Always therapy in the complex. For all patients equally requires the following activities:

  1. The reorganization of the chronic sites of infection.
  2. Sanitation of the oral cavity. It includes regular professional oral hygiene.
  3. Conduct pain procedures on the oral mucosa.
  4. The treatment of the oral cavity with the use of physiological antiseptics. You can conduct oral baths or rinses.
  5. Blockade of the elements of the pathology of the type of infiltration anaesthesia, increasing the rate of formation of epithelium in aphthous lesions.
  6. The use applications of the collagen films with a variety of therapeutic components. As drugs use with corticosteroids, anestetiki. The film is attached to after the rain and has anti-inflammatory and antiallergic effect for 45 minutes and then dissolves.

Chronic recurrent aphthous stomatitis treated together with the local impact has a total therapy:

  • Destiladeros treatment. Accepted tavegil, diazolin, diphenhydramine fenkarol, suprastin. Introduces intravenous sodium thiosulfate.
  • Intramuscular histaglobulina or gistaglobina. When ingested drug components in the body of the patient induces the production of antibodies antihistaminic and enhance the ability of blood serum to inactivate free histamine.
  • Vitamin, stimulates the regeneration of the damage of the mucous membranes of the oral cavity.
  • In severe cases, appointed by a corticosteroid drug.
  • The appointment of sedatives and tranquilizers.
  • Is plasmapheresis, which reduces the cooldown of the epithelium, helps to increase duration of remission and improve overall health.
  • Intramuscular glargine. The drug has the analytical action that optimizes epithelialization of ulcers and erosions. The drug is more effective in combination with local treatment.
  • Physical therapy (radiation helium-neon laser).
READ  Child teeth grinding during sleep causes how to treat bruxism in children

During treatment need to diet, which should be anti-allergic and rich in vitamins. Definitely an exception from the diet sharp, spicy, sweet, rich and gross food, and also alcoholic beverages. Not to drink hot and cold drinks. In the menu should include dairy products, mashed potatoes, porridge, fresh juices and fruit.

Prognosis and prevention


Upon detection of chronic aphthous stomatitis in a mild form in the initial stages the prognosis is often favorable. But a full recovery when the disease is in the chronic form is not achieved. The maximum result is the lengthening of periods of remission.
To prevent the development of chronic canker sores, you can, if you follow the rules:

  1. Systematic and regular visits to the dentist. With an average form of the disease — 2 times a year, with heavy — 3 times.
  2. A complete and thorough survey of manifestations of symptoms.
  3. Sanitation of the oral cavity not less than 2 times a year.
  4. A set of actions aimed at preventing relapse. It includes medication, physiotherapy and health resort treatment.
  5. A balanced vitamin-rich diet.
  6. Tempering procedures, exercise and maintaining a healthy lifestyle.

To prevent the development of chronic diseases, you need to take responsibility for your body and the manifestation of any alarming symptoms, consult a doctor. The correct way of life and prevention of diseases are key to good health.