Stomatitis in children is a concept that unites a group of diseases accompanied by inflammation of the oral mucosa. This is the most common diagnosis in pediatric dentistry, occurring even in newborns and in children under 1 year.
The sores that appear in the mouth often cause unpleasant taste sensations, and as a result children often refuse to eat. But with the development of stomatitis, there are not only difficulties with eating, the lymph nodes sometimes increase, the child may have a fever or general lethargy and deterioration of well-being.
The urgency of the problem in childhood is due to the high prevalence and contagiousness of the disease. As a result of imperfections of local and general immunity, infants and preschool children are most vulnerable to stomatitis.
What is stomatitis?
Stomatitis is the common name for various inflammatory processes in the mucous membrane of the child’s mouth. According to statistics, children with stomatitis suffer from year to five years. Children up to the year are still fairly well protected by antibodies derived from breast milk, and rarely face stomatitis, children over five can already boast of their own well-established immunity.
The disease is provoked by two main conditions:
- Low immune protection of the child's body.
- The features of the structure of the mucous.
The mucous membrane in children is very thin and easily injured. The cracks formed are often infected, because the saliva of a child, especially before the age of one year, does not yet possess the bactericidal properties that the saliva of an adult. So, during inflammation forms stomatitis.
Symptoms of stomatitis in children
When stomatitis in children, the main symptom of the disease is damage to the mucous membrane of the mouth in the form of the appearance of a light gray plaque that can go into erosion and aphthae (ulcers).
Depending on the lesion and the degree of spread of the disease, there are several types of stomatitis:
- Herpetic stomatitis is the most common type of disease that can manifest itself in both children and adults. With this type of disease, there is an active irritation of the mucous membranes in the mouth, which gradually turns into small bubbles with liquid. The acute form is accompanied by high fever, which is difficult to bring down with antipyretic drugs, dizziness, nausea, chills and other symptoms of ARVI can be observed.
- Fungal stomatitis Called the fungus of the genus Candida. Most of the children up to one year old suffer from this type of stomatitis due to breast milk feeding. Milk is a breeding ground for the growth of fungi. Therefore, such stomatitis is also called "thrush". It is characterized by the appearance of persistent white bloom in the baby's mouth. Do not confuse it with the usual bloom after feeding.
- Aphthous stomatitis in children is manifested on the mucous membrane of the mouth in the form of aft sizes from 5 to 10 mm on the inner sides of the lips and cheeks, the outer and inner side of the tongue. Unlike herpes stomatitis, with aphthous in the mouth, only one ulcer is formed, in rare cases two or three.
- Allergic stomatitis manifests itself in the form of redness of the gums, tongue. Subsequently, the microbial flora may join and cause bacterial, fungal or viral stomatitis. The temperature may be normal, and may increase. If the pathogenic flora has not joined, then such stomatitis is not contagious.
- Bacterial stomatitis. This type of disease is characteristic of children of different ages and occurs due to mechanical or thermal injury to the oral cavity, as well as in violation of the rules of personal hygiene, in the period of teething in babies, etc.
How to treat stomatitis in children directly depends on the type of pathogen that caused inflammation. Most often, the disease develops against the background of a general decline in the child’s immunity. Sometimes the cause of stomatitis in children, especially small ones, is the usual trauma to the mouth, because the kids are constantly pulling various objects in their mouths.
Stomatitis in children: photos
What does stomatitis look like in children’s mouth, in the photo the initial and other stages.
Clinically, ulcers resemble ulcers with herpetic stomatitis. But there are differences, the afta is an erosion of a round or oval shape with smooth edges and a smooth bottom, the bottom of the aphthae is colored bright red. The main location of such ulcers on the mucous membrane of the lips and cheeks.
As the disease progresses, the haptah changes and becomes covered with a cloudy film. After the film breaks through, a secondary infection may join, which may complicate the course of the disease. The condition of the child changes, drowsiness, whims, lack of appetite, and often refusal to eat appear. Body temperature rarely increases, but can be kept within 38º.
This type of stomatitis is provoked by yeast-like fungi of the genus Candida, which enter the child’s body through household items, the birth canal. Fungi multiply under favorable conditions (trauma to the mucous membranes, taking antibiotics) and cause illness.
Usually candidal stomatitis at the first stage is not accompanied by obvious symptoms. The child experiences dry mouth, mild itching and burning. Infants up to 12 months may be more often applied to the chest to compensate for the feeling of dry mouth, and older children, from 2–3 years old, on the contrary, refuse to eat.
Children from 5-6 years complain of bad taste and smell from the mouth. On external examination of the oral cavity, you can notice a grayish or yellowish coating on the mucosa. It has some similarities with sour milk droplets or curds.
As the condition worsens, the mucosa quickly becomes more and more covered with white bloom, and if the form is running, the mucous is almost completely covered with such bloom, and also the "stuck" in the mouth.
Herpes stomatitis in children appears when infected with the herpes simplex virus. The source of infection is both children and adults who have herpes on the lips and on the nose. The virus, which is vulnerable to any ailment, the mucous membrane of the child’s mouth, especially the newborn, is transmitted immediately. The virus can be picked up not only by airborne droplets, but also through everyday objects. Even the usual dummy can become a source of infection.
The disease develops very quickly, the incubation period is up to five days and the disease is mild, moderate and very severe.
- In the mild form, symptoms of intoxication are absent, at first there is an increase in temperature up to 37.5º. The oral mucosa becomes bright red, bubbles are formed, which is called the vesicle stage. Then they begin to burst, erosion of the oral mucosa occurs - this is the second stage of stomatitis. The rash becomes a marble color when the disease begins to decline.
- The moderate and severe form of the disease is manifested in the symptoms of intoxication of the child’s body. Before a rash occurs, the baby’s general condition worsens, there are manifestations of weakness, drowsiness, the child does not want to eat food. At first, parents may think that this is a cold or an ordinary cold. The lymph nodes are enlarged, the temperature rises to 38º. When the rash begins to appear, the temperature reaches 38 - 39º, possibly nausea and vomiting. It can sprinkle not only the oral cavity, but also the surrounding tissues of the face. In addition, there is obstruction of the saliva, the gums are inflamed.
Every tenth child suffering from herpetic stomatitis can develop into a chronic stage and periodically relapses can occur. Most often occurs in children aged 1.5 to 3 years.
How to treat stomatitis in children
It is clear that the question of how to cure stomatitis in a child is of great concern to all parents. First of all, you should contact your dentist. He will make an accurate diagnosis, determining the nature of the occurrence of the disease, and only then appropriate therapy will be prescribed. The task of any parent is to strictly follow all the instructions of a specialist, because children, especially small ones, will not be treated.
In any form of stomatitis, it is important to follow a diet that excludes the ingestion of annoying foods; after each use, rinse the mouth cavity with decoctions of herbs or antiseptics until the signs of the disease disappear (babies irrigate the mouth cavity from a can).
Principles of treatment of stomatitis in children can be reflected as follows:
- Anesthesia. This can be a very convenient drug Lidochlor gel, which begins almost immediately after applying cheeks and gums to the surface, and its duration is 15 minutes. Also for anesthesia with stomatitis apply a three-five percent anesthetic emulsion.
- Treatment not only of the affected areas, but also of healthy tissues (to prevent damage) with a pharmacological drug that affects the underlying cause of the disease (antiviral, antibacterial, antifungal, antiseptic).
Further, the treatment of inflammation of the oral mucosa depends on its type and origin.
Treatment of fungal stomatitis
To prevent the reproduction of fungus in the mouth, it is necessary to create an alkaline environment in the mouth. For this purpose, antiseptic solutions are used, which can be easily prepared at home. It:
- Soda solution (2-3 tsp. Per 250 ml).
- Boric acid solution.
It is necessary to process the oral cavity 2-6 times a day. At the same time, drugs are carefully applied to the cheeks and gums, since there are clusters of harmful microorganisms.
Another treatment for stomatitis is the Candide solution. Its active substance destroys the walls of the cells of the fungus. Course treatment is carried out for 10 days. When the first signs of improvement appear, in no case should the treatment be abandoned, otherwise, as in the case of taking antibiotics, the resistance of the pathogen to the drug is formed.
In rare cases, "Diflucan" can be used, it is prescribed to children in adolescence, the doctor prescribes the dosage.
Herpetic stomatitis: treatment
As with fungal stomatitis, acidic foods, especially citrus fruits, canned foods, salty and spicy foods are excluded from the diet. For herpes stomatitis in children, the treatment includes local procedures and the use of general therapeutic agents:
The main way to treat stomatitis in a child is to take special antiviral drugs (acyclovir, viferon in candles, viferon ointment). The disease is based on the herpes virus, from which it is impossible to get rid of it forever, but it is possible to suppress its activity through well-planned treatment. Immunostimulants are also recommended, because a weakened immunity allows the disease to progress.
For rinsing optimal use of the solution "Miramistin". Rinse the mouth should be 3-4 times a day for 1 minute (by the way, after a short time after rinsing, you can immediately make the application Viferon-gel, unless of course you use the gel, and not candles). Miramistin in small children can be applied as follows: moisten a gauze swab and treat the oral cavity, or spray the oral cavity from the nozzle-sprayer (included).
During illness, the child needs a half-bed mode. Give up walks and outdoor games. Remember that stomatitis is an infectious disease characterized by high contagiousness (can be transmitted to others, especially to weakened children and the elderly). Give a sick child a separate towel, your cutlery, try to reduce his contact with other family members.
It is very important to correctly distinguish herpetic stomatitis from aphthous, because they are treated with completely different drugs. Therefore, it is desirable to treat stomatitis not independently, but referring to a pediatric dentist!
Treatment of aphthous stomatitis in children
With aphthous stomatitis in a child, treatment is aimed at accelerating the healing of aft and pain relief. Still widely used is an aqueous solution of methylene blue, or in common vernacular - blue. Sores are treated with a cotton swab dipped in a solution, at least 3 times a day, preferably 5-6 times.
Also, treatment should take into account the possible cause of the disease, since There are a lot of reasons and they all require a different approach to treatment. Therefore, immediately after you have found afta in a child, it is necessary to immediately exclude allergenic foods (honey, strawberries, chocolate, nuts, citrus fruits ...) from the diet, and also exclude spicy, spicy, coarse foods from the diet.
Selection of antiseptic, antimicrobial agents is often carried out by trial and error, because the flow of any inflammatory process individually, who help the spray Lugol, spray Hexoral, or rinsing with Yodinol, Miramistin, who really helps Viniline or methylene blue dye - Blue. Rotokan - antiseptic with a healing effect (for rinsing the mouth) has proven itself well.
Treatment of bacterial stomatitis
A one-year-old child’s mucous membranes are thin and easily injured, and there are still not enough enzymes in saliva to protect the body from external “enemies”. Therefore, when you have stomatitis, you should often rinse your mouth with solutions of chamomile, chlorhexidine, furatsilina, manganese, soda, strong tea, or any other antiseptic.
The main treatment for bacterial stomatitis is chlorophyllipt (solution), oxolinic ointment. When the wounds begin to heal, they can be smeared with rosehip oil, propolis, aloe or kalanchoe juice, a solution of vitamin A, and solcoseryl.
Treatment of stomatitis in children: Dr. Komarovsky
Famous pediatrician Dr. Komarovsky will tell you how to treat stomatitis in a child, depending on its type, and what can be done at home.
The main way to prevent stomatitis is to observe the rules of hygiene. It is necessary to ensure that small children do not lick dirty objects, hands.
It has been observed that breastfed babies are less likely to suffer from all forms of stomatitis. The elders need to explain how important it is to wash their hands, brush their teeth and not take toys in kindergarten.
Hardening, food with a minimum amount of sugar and frequent exposure to fresh air will help strengthen the immune system, the child will not get sick, even if the infection falls into the oral cavity.