II. Definitions
- Stomatitis
- Inflammation of the mouth and lips
- Broader term that includes Oral Mucositis
- Mucositis
- Painful inflammation and ulceration of the Gastrointestinal Tract
- Typically caused by Chemotherapy or Radiation Therapy
III. Causes: Stomatitis
-
Vitamin Deficiency (typically associated with recurrent Aphthous Ulcers)
- Iron Deficiency Anemia
- Vitamin B1 Deficiency (Thiamine deficiency)
- Vitamin B2 Deficiency (Riboflavin deficiency)
- Vitamin B6 Deficiency (Pyridoxine deficiency)
- Vitamin B9 Deficiency (Folic Acid Deficiency)
- Vitamin B12 Deficiency (Cobalamin Deficiency)
- Specific lesions
- Angular Stomatitis
- Aphthous Stomatitis
- Herpes Gingivostomatitis
- Involves Tongue and Hard Palate
- Nicotinic Stomatitis
- Acute Necrotizing Ulcerative Gingivitis (Vincent's Stomatitis)
- Reactive Infectious Mucocutaneous Eruption (RIME)
- Follows respiratory tract infections
- Local Trauma or reaction
- Ill-fitting dentures
- Contact Dermatitis
- Mouth Chemical Burn Causes
- Oral Mucositis associated with high dose Chemotherapy or head/neck Radiation Therapy
- Often involves Buccal mucosa
- May be complicated by Oral Candidiasis (Thrush) or Herpes Gingivostomatitis
- Allergic Contact Stomatitis (Delayed-Type Hypersensitivity) Causes
- Chlorhexidine Gluconate (Peridex)
- Topical Corticosteroids
- Budesonide (Rhinocort)
IV. Management
- See Oral Ulcer
- See Pharyngitis Symptomatic Treatment
- Evaluate for complications of mucositis and poor oral intake (esp. Chemotherapy and Radiation Therapy related)
- Severe Dehydration
- Electrolyte abnormalities (e.g. Hyponatremia, Hypokalemia)
- Failure to Thrive
- Secondary Oral Infections
- Antifungal rinses may be used prophylactically
- Bleeding lesions
- Keep Platelet Count >20,000
- Apply local pressure
- Topical Tranexamic Acid (TXA)
- Treat specific causes
- Symptomatic management
- General measures
- Consider debriding with soft ToothBrush
- Saline rinses
- Prepare one teaspoon salt in 32 ounces water
- Some recipes recommend adding bicarbonate
- Topical over-the-counter agents
- Amphojel (coats lesions)
- Zilactin (forms film over the lesion)
- Topical prescription agents (expensive)
- Episil (viscous gel)
- Mugard (oral rinse)
- Gelclair (viscous gel)
- Consider topical combination agents
- Viscous Lidocaine
- Exercise caution in dosing and toxicity
- Magic Mouthwash
- Typically compounded (e.g. Lidocaine, Benadryl, Maalox, with or without a Corticosteroid and/or Antibiotic)
- First Mouthwash BLM (commercially prepared)
- Viscous Lidocaine
- Avoid unhelpful or harmful agents
- Avoid Sucralfate (ineffective)
- Avoid Chlorhexidine (ineffective)
- Avoid Alcohol-based rinses (may exacerbate pain)
- Avoid Hydrogen Peroxide (may delay healing)
- Other agents used in Chemotherapy and Radiation Therapy induced mucositis
- Doxepin 0.5% solution
- Morphine 2% mouthwash preparation
- Keratinocyte growth factor preparation
- Systemic Analgesics
- General measures
V. References
- Negrin in Drews (2014) Oral Toxicity Associated with Chemotherapy, UpToDate, accessed online 11/05/2014
- Swaminathan and Dibbs in Herbert (2020) EM:Rap 20(8): 2
- (2014) Presc Lett 21(11): 64
- Nolan (1991) J Oral Pathol Med 20(8):389-91 [PubMed]
- Sun (2014) J Oral Pathol Med [PubMed]
- Thongprasom (2001) Southeast Asian J Trop Med Public Health 32(3):643-7 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Definition (CHV) | inflammation of the mucous tissue of the mouth |
| Definition (CHV) | inflammation of the mucous tissue of the mouth |
| Definition (NCI_NCI-GLOSS) | Inflammation or irritation of the mucous membranes in the mouth. |
| Definition (NCI) | Inflammation of the oral mucosa due to local or systemic factors. |
| Definition (NCI_CTCAE) | A disorder characterized by inflammation of the oral mucosal. |
| Definition (CSP) | inflammation of the oral mucosa due to local or systemic factors. |
| Definition (MSH) | INFLAMMATION of the soft tissues of the MOUTH, such as MUCOSA; PALATE; GINGIVA; and LIP. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D013280 |
| ICD10 | K12.1 |
| SnomedCT | 95361005, 61170000, 155660009, 196527002 |
| English | Stomatitides, STOMATITIS, Stomatitis, stomatitis, stomatitis (diagnosis), Mucositis oral, Oral Mucositis, Stomatitis NOS, Stomatitis [Disease/Finding], Oral mucositis, oral mucositis, Stomatitis NOS (disorder), Inflammation of oral mucosa, Inflammatory condition of oral mucous membrane, Stomatitis (disorder), Stomatitis, NOS |
| French | STOMATITE, Mucite orale, Stomatite |
| Portuguese | ESTOMATITE, Mucosite oral, Estomatite |
| Spanish | ESTOMATITIS, Mucositis oral, mucositis bucal, afección inflamatoria de la membrana mucosa bucal, Stomatitis NOS, estomatitis, SAI, estomatitis, SAI (trastorno), estomatitis (trastorno), estomatitis, Estomatitis |
| German | STOMATITIS, Mukositis oral, Stomatitis |
| Dutch | mucositis oraal, stomatitis, Stomatitis |
| Italian | Mucosite orale, Stomatite |
| Japanese | 口腔粘膜炎, ｺｳｸｳﾈﾝﾏｸｴﾝ, ｺｳｺｳﾈﾝﾏｸｴﾝ, ｺｳﾅｲｴﾝ, 口腔炎, 口内炎 |
| Swedish | Muninflammation |
| Czech | stomatitida, Stomatitida, Zánět ústní sliznice, zánět sliznice dutiny ústní |
| Finnish | Suutulehdus |
| Russian | STOMATIT, СТОМАТИТ |
| Croatian | Not Translated[Stomatitis] |
| Polish | Zapalenie jamy ustnej, Zapalenie błony śluzowej jamy ustnej |
| Hungarian | Oralis mucositis, Stomatitis |
| Norwegian | Munnhulebetennelse, Stomatitt |
Ontology: Pharyngeal mucositis (C1699324)
| Definition (NCI) | An inflammatory process affecting the mucous membrane of the pharynx. |
| Definition (NCI_CTCAE) | A disorder characterized by an inflammation involving the mucous membrane of the pharynx. |
| Concepts | Disease or Syndrome (T047) |
| Dutch | mucositis van keelholte |
| French | Inflammation de la muqueuse pharyngée |
| German | Mukositis des Pharynx |
| Italian | Mucosite faringea |
| Portuguese | Mucosite faríngea |
| Spanish | Mucositis faríngea |
| Japanese | 咽頭粘膜炎, ｲﾝﾄｳﾈﾝﾏｸｴﾝ |
| Czech | Mukozitida hltanu |
| English | Pharyngeal Mucositis, Pharyngeal mucositis |
| Hungarian | Pharyngealis mucositis |
