Stomatitis in children: treatment features
Stomatitis in children is manifested by ulcers in the oral cavity, a deterioration in general well-being. Because of the pain, the child can refuse food, becomes moody. You should not delay treatment, you need to diagnose the disease as soon as possible. Therapy will depend on what exactly caused the development of stomatitis. The doctor will help you decide on this issue.
Stomatitis in children is one of the most common diseases in which the mucous membranes of the oral cavity suffer. Symptoms are caused by a tissue infection or an allergic reaction in the body.
There are many types of stomatitis. Therefore, the symptoms of the disease will vary. Common signs include ulceration of mucous tissues in the mouth, the appearance of plaque on them, swelling, cracks and pain in the affected area.
Pediatric dentists face this disease every day. Moreover, cases of stomatitis are recorded even in newborns. With the wrong treatment, stomatitis becomes chronic, while the child remains infectious and can transmit the infection to other people. Stomatitis negatively affects the state of the immune system.
Children more often than adults suffer from stomatitis. First of all, this is due to the low formation of their protective forces. The insufficient level of development of hygiene skills also affects.
Content:
- Disease types
- Causes of occurrence
- Symptoms of stomatitis in children
- Diagnosis of stomatitis in children
- How to treat stomatitis in children?
- Features of the treatment of some forms of stomatitis
- Diet for stomatitis in a child
- Possible complications
- Prevention
Disease types
There are several types of stomatitis that can occur in children:
- Candidal stomatitis. Most often, this type of disease is diagnosed in children from birth to 3 years.
- Herpetic stomatitis. Children get sick with it at the age of 1-3 years.
- Aphthous stomatitis. Most often it is diagnosed in children 7-15 years old.
- Viral, bacterial, or traumatic stomatitis can occur at any age.
Causes of occurrence
Stomatitis can develop for a variety of reasons. Depending on the type of disease, the etiological factors can be very diverse. However, any kind of stomatitis cannot be considered in isolation from the patient's immune system. Immunity is of great importance in terms of the occurrence of pathology. The weaker it is, the higher the likelihood of developing the disease. Moreover, both general and local immunity is important.
It is necessary to take into account the anatomical features of the structure of the mucous membrane of the child's oral cavity. In children, it is delicate and thin, which means that it is easy to injure it. In addition, microbes can easily overcome this barrier. Therefore, stomatitis in childhood is not uncommon.
Candidal stomatitis
Candidal stomatitis develops due to the multiplication of Candida genus fungi in the oral cavity. Such a disease can be diagnosed in a person at any age, but most often it is children of the first year of life that are susceptible to it.
There are several reasons:
- A baby can get the fungus from the mother during birth or while breastfeeding.
- The intake of antibacterial drugs and some other drugs is negatively reflected in the state of the mucous membranes.
- In children of the first year of life, the immune system is especially weak.
- The fungus can enter the body through dirty hands or toys.
- Infection can occur through contact with an infected person.
- In infants, the mucous membranes of the oral cavity do not have the same perfect mechanisms of resistance as in adults.
Read more: Candidal stomatitis - what is it? How is it treated? Symptoms and Effects
Herpetic stomatitis
Herpetic stomatitis develops due to infection with the herpes virus. Its distributor can be both adults and other children. Rashes can appear not only in the mouth, but also on the lips and also on the nose.
Once on the mucous membranes of the child, the herpes virus quickly invades them and begins to multiply. It is capable of being transmitted not only by airborne droplets, but also by household means. Therefore, you can get infected even when using a regular pacifier.
Read more: Herpetic stomatitis
Aphthous stomatitis
Aphthous stomatitis develops against the background of chronic diseases. Health problems such as tonsillitis, caries, hypovitaminosis, gastritis or stomach ulcers, disorders in the functioning of the immune system can provoke the formation of aft. Many scientists are of the opinion that aphthous stomatitis is a consequence of allergic reactions to food. The peak of the exacerbation of the pathology occurs in autumn and spring.
Read more: Aphthous stomatitis
Viral stomatitis
Viral stomatitis develops due to the ingestion of viruses that have the ability to multiply in the mucous membranes of the oral cavity.
The causes of the disease can be as follows:
- Past infections: chickenpox, flu, measles, etc.
- Interaction with persons who are infected with viral stomatitis. It can be spread by airborne droplets and through household items.
- Weak immunity of the child. It will be easy for viruses to enter the child's body.
Bacterial stomatitis
Bacterial stomatitis most often develops in children who often suffer from ARVI, influenza, sore throat, bronchitis, etc. Any pathology undermines the child's immunity, so it is not difficult for bacteria to penetrate into the mucous membranes of the oral cavity and begin to multiply there. The presence of scratches and injuries in the mouth contributes to infection. They can be mechanical in nature, or they can appear during teething.
Traumatic stomatitis
Mechanical damage to the mucous membranes of the oral cavity is one of the most common causes of stomatitis.
Injuries can be obtained in the following way:
- During outdoor games.
- If foreign objects enter your mouth.
- Eating too hot drinks or foods.
- If chemicals are swallowed.
- When biting on the cheek or lips.
- When teething, if the edges are too sharp.
- During the use of braces, if they were installed incorrectly.
Allergic stomatitis
Allergic stomatitis is the result of an allergic reaction of the body to various substances. This can be house dust, plant pollen, animal hair, etc.
Symptoms of stomatitis in children
The symptoms of stomatitis in children are as follows:
- On the mucous membranes of the mouth and on the tongue, bubbles appear, which will be filled with a clear liquid. After 2-3 days, they are opened, inflamed areas remain in their place.
- A rim of inflamed tissue is visible around the ulcer.
- The pink mucous membrane of the mouth becomes red or dark purple.
- Body temperature rises to high levels and can reach febrile values.
- The child suffers from severe intoxication of the body.
- Appetite worsens or is absent altogether.
- The child cannot sleep normally.
- The oral cavity hurts, the pain is especially intense in the place of concentration of ulcerative defects.
- Gums and tongue swell.
- White plaque may form on the affected areas.
- An unpleasant odor comes from the mouth.
- Sometimes salivation increases, and sometimes, on the contrary, the oral cavity dries up.
As you know, stomatitis can have several varieties. Therefore, the above general symptoms do not always occur in a child and not to the full. Depending on the specific form of stomatitis, the clinical picture may be as follows:
- Candidal stomatitis does not lead to an increase in body temperature. In the mouth, areas of inflammation appear, which are overlaid with a white coating. In appearance, it resembles cottage cheese. Removing it is not difficult. Underneath is an inflamed mucous membrane that can bleed. Children report pain, itching, and burning in the mouth. Candidal plaques can appear on the gums, cheeks, lips, and tongue.
- Aphthous stomatitis is characterized by the appearance of ulcers that are round or oval. In diameter, they can reach 10 mm and even more. The aphthae are covered with a gray-white bloom, and a red rim is noticeable around them. The ulcers hurt a lot, but the child's general well-being is not disturbed. Most often, one aphtha appears in the mouth, but with a severe course of the disease, there may be more. In 10-14 days, the ulcers disappear. If there is no treatment, then the disease becomes chronic.
- Herpetic stomatitis. If with this disease the child's body temperature rises, then the maternal antibodies in his body have already stopped circulating. The disease leads to general intoxication and deterioration of health. First, some areas of the mouth turn red and then become covered with blisters. There can be a lot of them (about 20 pieces). The more ulcers, the more intense the symptoms of stomatitis and the worse the child feels. After opening, the bubbles hurt a lot, eroded areas remain in their place. Sometimes the rash appears not only in the mouth, but also on the lips and also on the wings of the nose.
Diagnosis of stomatitis in children
The doctor makes a diagnosis after examining the child. Only a dentist can determine exactly what type of stomatitis a patient develops. There are many inflammatory diseases of the oral cavity, which, with their symptoms, can resemble stomatitis (glossitis, periodontitis, gingivitis). Therefore, it is so important to consult a specialist when signs of infection appear.
If stomatitis has a chronic course, then the child can be sent for additional diagnostic measures, including:
- Research for cytology.
- Virological analyzes.
- Bacterial study of the obtained materials.
- Immunological studies, etc.
If stomatitis develops in a child under one year old, then first it must be shown to the pediatrician. If necessary, he will refer the baby to a narrow specialist. Children over 3 years old can be taken to the dentist immediately.
To clarify the diagnosis, the following studies may be required:
- Blood chemistry.
- General analysis of urine and feces.
- Mouth swab.
- Cytological, virological and bacteriological research.
- Assessment of the state of the immune system.
How to treat stomatitis in children?
In order for the treatment to give the desired result, you need to know the cause of the stomatitis. The choice of drug is determined by the form of the disease. Therapy should be comprehensive, the patient is shown both local and systemic treatment. The dose of medicines and the frequency of their administration is determined by the doctor.
Tasks that face a specialist:
- Elimination of the cause of stomatitis.
- Relief of inflammation.
- Elimination of pain.
- Acceleration of healing of mucous membranes.
General rules that must be followed when treating stomatitis in children:
- Isolate the sick child from the children's team. At home, he must eat from a separate dish, use his own towel, etc.
- Oral hygiene must be of high quality. This will avoid the attachment of a secondary infection. A baby's mouth is treated with xylitol wipes or another antiseptic that the doctor has recommended. Older children should rinse their mouths before and after meals with disinfectants.
- In order not to injure the mucous membranes, you need to use a soft bristled brush.
- All teats and bottles must be disinfected. The mother should keep her breasts clean.
- To reduce painful sensations, you need to use sprays with an analgesic effect.
- From the child's menu, acidic foods should be excluded, which will irritate the mucous membranes of the oral cavity. The same applies to spices, spicy dishes, conservation. Food should be warm, but not hot or cold. If the pain is intense, then the food is offered to the child only in a grated form.
- The menu should contain foods rich in nutrients, minerals and vitamins. Carbohydrate foods, sweets and baked goods are banned.
Drug treatment allows you to eliminate pain, relieve inflammation and accelerate tissue regeneration processes.
Pain relievers
Children are very sensitive to pain, which is why it is so important to supervise this symptom so as not to make the child suffer. Doctors prescribe systemic and local pain relievers.
Oral preparations:
- Ibuprofen. This drug relieves pain, has anti-inflammatory and antipyretic effects. The dose is calculated based on the weight of the child (10 mg per kg of weight). The drug is taken 3 times a day. The course should not last more than 5 days. Ibuprofen is given to children over 3 months of age.
- Paracetamol. This drug helps to lower body temperature and quickly relieves pain. It is offered to small children in the form of syrup or in the form of candles. If the child is older, pills can be used. The dose is calculated based on body weight (15 mg per kg of body weight). For bitches, the drug can be taken no more than 4 times.
Topical pain relievers:
- Holisal. This gel not only anesthetizes the oral cavity, but also disinfects it, and also helps relieve inflammation. The mucous membranes are treated 4 times a day before or after meals. Apply the gel before a night's rest. Doctors recommend using Cholisal for children over 9 months old.
- Kamistad. The gel contains chamomile extract and lidocaine, which allows sanitizing the affected area, as well as relieving pain. Use the drug 4 times a day, rubbing it into the inflamed areas.
- Calgel. This drug not only destroys the microbial flora, but also anesthetizes the oral cavity well. Apply it 6 times a day.
Antiseptic and anti-inflammatory drugs
The use of antiseptic drugs allows not only to destroy the pathogenic flora, but also to remove the inflammatory reaction. Rinse your mouth with such means, or apply them only to the affected areas. Antiseptics are widely used to treat stomatitis at home.
Anti-inflammatory drugs:
- Spray Hexoral. They are treated with the oral cavity after eating 2 times a day. The effect lasts for 12 hours.
- Ingalipt. The spray has anti-inflammatory, disinfecting and analgesic effects. It is applied to the affected area 4 times a day.
- Chlorophyllipt. The spray disinfects the oral cavity, destroys pathogenic flora and accelerates regenerative processes. It is used 4 times a day.
- Lugol. This spray contains iodine, therefore, it should not be applied to the mucous membranes more often 2 times a day.
- Metrogyl Denta. The areas of inflammation are treated with the gel 3 times a day.
- Miramistin. The drug is used 3 times a day. It is a good antiseptic and can destroy most of the pathogenic flora.
To better disinfect the oral cavity, you need to rinse it regularly. The child should repeat this procedure every 3 hours. The rinsing time is 1 minute. If the child has not yet learned how to rinse his mouth, then you need to lay him on his side and rinse the oral cavity with a syringe, or with a syringe without a needle.
Sprays are used to irrigate the oral cavity, but it is recommended to use them after the child reaches one year of age. In babies, sprays can provoke laryngospasm and an attack of suffocation. Therefore, children under one year old should apply ointment to ulcers, and preliminary antiseptic treatment should be carried out using a gauze swab dipped in a suitable solution.
Drugs that can be used for mouthwash:
- Pure Stomatidin. They rinse their mouth 4 times a day. The drug can be used by children over 4 years old.
- Iodinol. Children over 2 years old are diluted with 10 ml of the drug in 100 ml of water. Rinse your mouth with the drug 5 times a day. The course of treatment should not last longer than 5 days.
- Chlorhexidine. In undiluted form, the solution is used for rinsing the mouth in children over 5 years old. The procedure is carried out 4 times a day. For children from 7 months to 5 years old, the solution must be diluted in equal proportions with water. This drug copes well with pathogenic flora and quickly relieves inflammation.
- Furacilin. In a pharmacy, you can buy a ready-made solution, or make it yourself at home. For this, the drug tablet is diluted in 0.5 ml of water. Use the drug 4 times a day. It is used for very young children.
- Stomatofit. This drug is plant-based. It is used to rinse the mouth 4 times a day. For 100 ml of water, take 20 ml of the product.
Ready-made in the pharmacy, you can buy drugs such as Ingafitol, Rotokan, Evkanorm.
Vitamin and regenerating agents
After the main manifestations of the disease have been arrested, drugs with wound healing properties can be used. Also during this period vitamins are prescribed. Such treatment allows you to accelerate tissue regeneration, restore the affected areas and accelerate metabolic processes in them. Preparations can have a different form of release (ointments, gels, oils, solutions).
More often than others, such means are prescribed as:
- Aekol (oil solution of vitamin A, E, K, provitamin A). The drug is applied to the affected area by wetting a gauze swab with it. Processing is carried out once every 2 days. Treatment should continue until the affected tissues are completely restored.
- Vinylin. This drug not only helps to restore mucous membranes, but also has an antiseptic effect. It is applied to the ulcer defect with a cotton swab after meals and before bedtime. Treatment continues until complete recovery. The drug can be used in children over a year old.
- Solcoseryl. The paste accelerates tissue healing. She is treated with a previously cleaned oral cavity.
- Sea buckthorn oil. This product is of plant origin, but has a pronounced regenerating effect. The oil is applied to the affected areas of the mucous membranes using a cotton swab.
- Peach and linseed oil, rosehip oil (Carotolin), Kalanchoe juice. These oils can also be used to speed up the regeneration of affected areas.
Video: Dr. Kamorovsky "Stomatitis in a child - how to recognize and how to treat?"
Features of the treatment of some forms of stomatitis
Different forms of stomatitis require different approaches to treatment. It is necessary to use drugs that will directly affect the cause of the disease.
Candidal stomatitis
Fungi of the genus Candida, which cause the development of candidal stomatitis, are not able to multiply in an alkaline environment. Therefore, to treat the disease, alkalinization of the oral cavity is required. Children should clean their mouth with a baking soda solution. One teaspoon is required for a glass of water. Rinse your mouth with this tool 2 times a day.
If the disease does not recede, then drugs such as:
- Candide with clotrimazole. The drug is applied to the area of inflammation 3 times a day. Treatment should continue for 7-10 days. You should not stop therapy after a visible improvement, as there is a high risk of recurrence of the disease.
- Nystatin. This drug allows you to quickly destroy the fungal flora in the oral cavity. One tablet of the drug must be dissolved in water and the resulting composition should be applied to the inflamed areas. You can use Nystatin in gel form. The oral cavity is treated 2 times a day.
- Fluconazole (Fucis). The drug is available in tablet form. The daily dose for a child is 12 mg / kg of body weight. The duration of the course is determined by the doctor.
Herpetic stomatitis
Herpetic stomatitis develops due to the multiplication of the herpes virus in the body. Therefore, its treatment requires drugs that are active against this microbe. The doctor may prescribe to the child such means as:
- Oxolinic ointment. It is detrimental to the herpes simplex virus. Apply it to the area of inflammation 1-2 times a day.
- Acyclovir. This drug is used when the disease is severe. The dose is 100 mg. The drug is taken 5 times a day. The course of treatment should last 5 days. Intravenous administration of the drug is indicated for infants. Acyclovir ointment or cream is not used in the treatment of young children, as they can increase the inflammatory response.
- Viferon. This drug improves immunity, and also has antiviral activity. For children, Viferon is prescribed in candles or in the form of an ointment, which is applied to the mucous membranes of the oral cavity. Processing must be carried out at least 2 times a day.
Aphthous stomatitis
Aphthous stomatitis often results from diseases of the digestive system. It can occur in response to the development of an allergic reaction in the body. Aphthae can appear in the mouth due to poor personal hygiene. Therefore, in addition to consulting a dentist, you may need the help of a gastroenterologist or allergist. It is important to eliminate the cause of aphthous stomatitis. The rest of the treatment is reduced to eliminating the symptoms of the disease.
Viral stomatitis
Antiviral drugs for viral stomatitis are not always prescribed. The need for their admission is determined by the doctor.
Bacterial stomatitis
If a child has bacterial stomatitis, then he needs antibacterial treatment. The doctor decides which antibiotics to take. It all depends on the age of the child and the symptoms of the disease.
Traumatic stomatitis
Traumatic stomatitis requires the elimination of any factors that can irritate the oral mucosa. First of all, this is the repentance of food. So that the child does not suffer from pain, he is prescribed local or systemic analgesics. Anti-inflammatory and wound healing therapy is required. If a secondary infection joins, then the use of antibiotics is indicated.
Allergic stomatitis
The main thing in the treatment of allergic stomatitis is to identify the allergen and exclude its contact with the child. Drugs that can be used:
- Parlazin. These are antihistamine drops, which are characterized by prolonged action. Children from 3 months to a year old are prescribed 3 drops 2 times a day, and children over a year old - 5 drops a day.
- Suprastin. Children under one year old are prescribed? tablets. After a year they offer? tablets 2 times a day.
Diet for stomatitis in a child
Diet is an integral part of the treatment of stomatitis in a child. The menu should be designed in such a way that food products do not irritate the mucous membranes of the oral cavity or injure them. In addition, the meals should be nutritious and help to increase the child's immunity.
Basic nutritional principles:
- Refusal of sweets.
- Consuming liquid or puréed foods.
- Compliance with the temperature regime. The food should be warm.
- Avoiding spicy, salty, sour and spicy foods.
- Eliminate chocolate and citrus fruits.
- Avoiding solid foods that can cause oral trauma.
- Exclusion from the menu of foods that are a source of chemicals, preservatives and dyes.
- Enrichment of the diet with fortified food.
- Drinking enough water.
Foods that can be eaten:
- Dairy and fermented milk products and drinks that do not contain chemical additives and dyes.
- Acid-free fruits (bananas, watermelon, melon).
- Vegetable juices and vegetables.
- Liquid porridge.
- Homemade ice cream. Cooling the oral cavity helps to eliminate pain and remove swelling from the tissues.
- Tea and herbal teas.
- Low-fat meat and fish.
Possible complications
Complications of stomatitis in children develop only if there was no treatment and the disease became chronic. If a child often suffers from relapses of pathology, then this negatively affects the state of the immune system. He will get sick more often, the body becomes vulnerable to ARVI, flu and other infections.
Viruses, fungi and bacteria that are present in the mouth of a child with stomatitis destroy tooth enamel. Therefore, when the first signs of infection appear, you need to contact your dentist and follow his recommendations.
Prevention
Compliance with preventive measures to prevent the development of stomatitis in a child is complicated by a low level of hygiene skills, as well as a weakness of the immune system. Therefore, it is so important from childhood to teach a child to always wash his hands before eating. The teeth should be brushed at least 2 times a day and done correctly. Vegetables and fruits must be clean.
For the care of the child's oral cavity, the special children's paste Splat, which contains lysozyme, lactoferrin, lactoperoxidase, is well suited. These components help to increase immunity at the local level.
Any diseases of the digestive system must be treated in time. Also, this rule applies to allergic reactions of the body, to dysbiosis, etc.
If possible, you should breastfeed your baby. This will increase the body's resistance to various infections.
The author of the article: Sokolova Praskovya Fedorovna | Pediatrician
Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.
