Ulcerative stomatitis: symptoms, treatment in adults and children

Ulcerative stomatitis, Vincent stomatitis, is a disease of dental profile, characterized by the appearance in the mouth of the patient small necrotic ulcers. The disease has infectious-inflammatory nature, it occurs mainly in childhood. In healthy children, the disease almost never occurs. Vincent’s stomatitis is a secondary character, as a consequence of the underlying disease and any associated changes in the child’s body. After elimination of reasons that caused the ulcers and appropriate treatment, the symptoms of ulcerative-necrotic process completely disappears.

The origin of the disease

Direct the causative agent of ulcerative stomatitis is considered to be a symbiosis of two microorganisms, Vincent spirochetes and fusiform bacilli. Bacteria are opportunistic and normally exist in the mouth in small amounts. In healthy people, they can be found in deep periodontal pockets.
Under the influence of certain factors of conditionally pathogenic microflora begins to actively proliferate, suppressing other types of microorganisms and occupying a leading position. The disease occurs only in the presence of the entrance gate infection – injuries of the mucous membrane of the gums.
Factors contributing to the development of stomatitis Vincent:

  1. Lack of vitamins;
  2. The decrease in the level of immune protection;
  3. Malnutrition;
  4. Chronic and acute intoxication;
  5. Lesions of the mucous membrane of the mouth chemical or mechanical agents, burns, frostbite, and other processes that lead to tissue damage;
  6. Disturbance of microcirculation of blood in the region of the mucous membranes of the mouth;
  7. The lack of adequate hygiene of the oral cavity.

Diseases in which the probability of occurrence of features of ulcerative stomatitis is especially great:

  1. Allergic reactions;
  2. Anemia;
  3. Hypovitaminosis «C»;
  4. Leukemia;
  5. Gastrointestinal disease related to malabsorption of nutrients;
  6. Injuries in the mouth;
  7. Disorders in the peripheral nervous system;
  8. Dry mucous membranes;
  9. Catarrhal stomatitis.

Ulcerative stomatitis often develops in the spring, on the background of reducing the concentration of vitamins and exacerbation of chronic diseases (if any). Depending on the form of the disease can occur with varying degrees of intensity.

Clinical picture and diagnosis

The clinical picture of ulcerative stomatitis varies depending on the stage of the disease. To begin the process characteristic swelling and redness of the gums, burning sensation when eating or speaking. Slight bleeding of mucous membranes. In General, the symptoms of the initial stages of disease similar to that of catarrhal stomatitis. In the future, patients develop the following symptoms:

  1. In the mouth there are isolated ulcers of small size, covered with gray bloom and is surrounded by a cushion of infiltration;
  2. Bad breath;
  3. Severe bleeding of the gums;
  4. A purulent discharge is discharge from the periodontal pockets;
  5. Soreness on palpation of the gums and meal.
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Stomatitis Vincent also leads to the appearance of General symptoms:

  • Body temperature is 37-38C;
  • Deterioration in General health;
  • Weakness;
  • Headache;
  • Muscle pain;
  • Fatigue;
  • Moodiness;
  • Passivity;
  • Drowsiness;
  • Swollen lymph nodes.

In severe stomatitis in patients, there is nausea, vomiting, abdominal pain. While ulcers can reach the jaw bone. Associated superinfection. There is a risk of systemic complications, pyemia, sepsis.


Diagnosis is based on history, visible signs of disease and data of laboratory examination. As a rule, the ulcer-necrotic stomatitis take the following types of tests:

  1. General analysis of blood: nonspecific signs of inflammation (increased ESR, leukocytosis);
  2. Immunogram (signs of immunodeficiency);
  3. Sowing smear from the mucous membrane (the presence of characteristic JANS microflora).

In the absence of visible factors that triggered the onset of the disease, conducted a comprehensive examination of the patient so as to treat stomatitis is possible only after correction of comorbidities. Patient is prescribed a consultation with a cardiologist, internist, gastroenterologist, immunologist, hematologist. Appoint additional examination in a biochemical blood test, coagulogram, determining the acid-alkaline environment and the amount of electrolytes.

The treatment of stomatitis Vincent

To treat ulcerative stomatitis is required in accordance with the degree of severity of the disease. Can apply local and General methods of treatment.

Local treatment

In the absence of General symptoms and a normal feeling of the patient, therapy confined to local impact:

Anesthesia. Anesthesia is provided an application method using a solution of benzocaine or lidocaine. The first is preferable as it is not irritating to the wound.
Sanitation inflamed areas. For the rehabilitation of the inflamed areas are used antiseptic solutions and antimicrobial agents: chlorhexidine, metronidazole, potassium permanganate, dioxidine, Miramistin. Ulcer is cleaned with a sterile gauze swab soaked with antiseptic. Forcibly remove areas of necrosis are not allowed.
Accelerated rejection of necrotic areas. The goal is achieved through the use of proteolytic enzymes such as chymotrypsin and trypsin. To do this, superimposed on ulcer swab soaked in the respective solution. Applique is held for several hours, during which the swab several times dipped in the drug solution.
Rehabilitation treatment. After cleansing of ulcers from necrotic sites assigned to remedial therapy. Treatment requires the use of the ointment «solcoseryl», promoting rapid granulation and healing of wounds. As local anti-microbial agents can be used «levomekol» and other compositions appropriate purpose.
The sanitation of the oral cavity. Treatment in adults and children includes rehabilitation of the oral cavity. Tartar is removed, the sharp areas of the teeth that can injure the cheek or tongue, grind. Cure tooth decay, remove teeth that cannot be restored. These events are held only after recovery. In the active phase of ulcerative-necrotic stomatitis of such dental procedures is unacceptable.
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General treatment

The need for shared treatment occurs in severe forms of the disease, accompanied by toxic syndrome. Ulcerative stomatitis require therapy in the following areas:

  1. The fight against pathogen

Patients are assigned a broad-spectrum antibiotics. Medications of choice:

  • Amoxiclav;
  • Augmentin;
  • Ceftriaxone;
  • Doxycycline;
  • Sulbactam.

Large depth of the lesion to the main antibacterial drug is added to a lincomycin, a well penetrating into the bone tissue.

  1. Compensation of vitamin deficiency

Patients with ulcerative stomatitis should receive a multivitamin in injectable or tablet form. Children are often prescribed:

  • Complivit;
  • REVITA;
  • Undevit.

Adult patients often prescribe vitamins in the injections («multivitamin»), characterized by high bioavailability, accurate dosing and rate of absorption.

  1. The decrease in the level of sensitization of the organism

To reduce allergic of alertness of the organism in the treatment of add antihistamines:

  • Tavegil;
  • Suprastin;
  • Fenkarol;
  • Semprex;
  • Zyrtec.

Adults that preserve performance, it is recommended to use the last two drugs listed. They belong to the 2nd and 3rd generation does not have a sedative effect. Children suffering through the disease, it is better to prescribe drugs of the 1st generation, the soothing of the child.

The diet for stomatitis Vincent


Quickly cure stomatitis can only be subject to a proper diet. Patients must not eat spicy, salty, sour, excessively hot or cold foods, marinades, containing a large quantity of vinegar. It is not recommended to eat fresh fruits and berries, bread and dry biscuits, waffles. You should also avoid foods that can cause allergic reactions.
For the period of treatment should abandon alcohol and Smoking. Ethanol not only is an irritant to the mucous membrane of the gums, but also eliminates the effects of antimicrobial drugs, making the treatment useless. Resin included in the composition of tobacco smoke, irritate the areas of inflammation, reduce the intensity of regenerative processes and increase the risk of developing cancer.

Recommended foods with stomatitis is:

  • Dairy products and milk;
  • Soft cheese;
  • The cooked meat;
  • Tea;
  • Gentle cereal;
  • Vegetable juices;
  • Baby food.

After a meal, patients are advised to rinse your mouth decoctions of herbs that have healing and tanning action: oak bark, chamomile, field, flowers lime. This not only helps to clean the oral cavity from food debris, but also to accelerate regenerative processes.

In the absence of necessary medicinal plants mouth rinse boiled and then cooled to 30-40C with water and add a small amount of potassium permanganate.

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Predictions and complications of ulcerous-necrotic stomatitis

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The prognosis in this disease is generally favorable. However, in the absence of necessary treatment of necrotic stomatitis may acquire a chronic course, lead to atrophic changes of the mucosa. In severe cases, the outcome of untreated disease is sepsis. Also ulcerative stomatitis may cause the following complications:

  1. Periodontitis;
  2. Periodontal disease;
  3. Staphylococcal pyoderma of nature;
  4. Exposure and subsequent fracture of the tooth root;
  5. Allergic reactions.

Similar complications arise in the absence of competent antibacterial therapy or ineffectiveness of the used antimicrobials. Therefore, the regimen of antibiotics, initially empirically assigned, shall subsequently be adjusted in accordance with the data of the microbiological analysis and test of the microflora on the sensitivity to certain drugs. No visible clinical effect for 3-4 days is also the indication to change antibiotics.

The course of treatment depends on timely access to medical care and severity of the pathological process. As a rule, against the use of antibiotics and proteolytic enzymes ulcers cleansed and begin to heal already by 8-10 day of the disease. Complete healing takes about three weeks in the absence of precipitating factors.

Prevention

To prevent ulcerative stomatitis symptoms which are visible even in the early stages, you should follow the simple rules:

  • Promptly carry out the oral hygiene, brush your teeth every day;
  • To visit the dentist at the first sign of caries;
  • After eating, rinse your mouth decoctions of chamomile field;
  • An annual preventive examination and to correct existing malfunctions in the body;
  • To avoid injuries in the oral cavity;
  • In the presence of injuries to conduct daily processing antiseptic;
  • Start treatment immediately upon discovery of the signs of incipient disease.
  • To abandon Smoking and drinking alcoholic beverages.

Preventive measures virtually eliminate the development of not only ulcerative Vincent stomatitis, and other inflammatory and infectious diseases of the oral cavity.