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Inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. The word "stomatitis" literally means inflammation of the mouth. The inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene, poorly fitted dentures, or from mouth burns from hot food or drinks, or by conditions that affect the entire body, such as medications, allergic reactions, or infections.


Stomatitis is an inflammation of the lining of any of the soft-tissue structures of the mouth. Stomatitis is usually a painful condition, associated with redness, swelling, and occasional bleeding from the affected area. Bad breath (halitosis) may also accompany the condition. Stomatitis affects all age groups, from the infant to the elderly.

Causes and symptoms

A number of factors can cause stomatitis; it is a fairly common problem in the general adult population in North America. Poorly fitted oral appliances, cheek biting, or jagged teeth can persistently irritate the oral structures. Chronic mouth breathing due to plugged nasal airways can cause dryness of the mouth tissues, which in turn leads to irritation. Drinking beverages that are too hot can burn the mouth, leading to irritation and pain. Diseases, such as herpetic infections (the common cold sore), gonorrhea, measles, leukemia, AIDS, and lack of vitamin C can present with oral signs. Other systemic diseases associated with stomatitis include inflammatory bowel disease (IBD) and Behçet's syndrome, an inflammatory multisystem disorder of unknown cause.
Aphthous stomatitis, also known as recurrent aphthous ulcers (RAU) or canker sores, is a specific type of stomatitis that presents with shallow, painful ulcers that are usually located on the lips, cheeks, gums, or roof or floor of the mouth. These ulcers can range from pinpoint size to up to 1 in (2.5 cm) or more in diameter. Though the causes of canker sores are unknown, nutritional deficiencies, especially of vitamin B12, folate, or iron is suspected. Generalized or contact stomatitis can result from excessive use of alcohol, spices, hot food, or tobacco products. Sensitivity to mouthwashes, toothpastes, and lipstick can irritate the lining of the mouth. Exposure to heavy metals, such as mercury, lead, or bismuth can cause stomatitis. Thrush, a fungal infection, is a type of stomatitis.


Diagnosis of stomatitis can be difficult. A patient's history may disclose a dietary deficiency, a systemic disease, or contact with materials causing an allergic reaction. A physical examination is done to evaluate the oral lesions and other skin problems. Blood tests may be done to determine if any infection is present. Scrapings of the lining of the mouth may be sent to the laboratory for microscopic evaluation, or cultures of the mouth may be done to determine if an infectious agent may be the cause of the problem.


The treatment of stomatitis is based on the problem causing it. Local cleansing and good oral hygiene are fundamental. Sharp-edged foods such as peanuts, tacos, and potato chips should be avoided. A soft-bristled toothbrush should be used, and the teeth and gums should be brushed carefully; the patient should avoid banging the toothbrush into the gums. Local factors, such as ill-fitting dental appliances or sharp teeth, can be corrected by a dentist. An infectious cause can usually be treated with medication. Systemic problems, such as AIDS, leukemia, and anemia are treated by the appropriate medical specialist. Minor mouth burns from hot beverages or hot foods will usually resolve on their own in a week or so. Chronic problems with aphthous stomatitis are treated by first correcting any vitamin B12, iron, or folate deficiencies. If those therapies are unsuccessful, medication can be prescribed which can be applied to each aphthous ulcer with a cotton-tipped applicator. This therapy is successful with a limited number of patients. More recently, low-power treatment with a carbon dioxide laser has been found to relieve the discomfort of recurrent aphthae. Major outbreaks of aphthous stomatitis can be treated with tetracycline antibiotics or corticosteroids. Valacyclovir has been shown to be effective in treating stomatitis caused by herpesviruses.
Patients may also be given topical anesthetics (usually a 2% lidocaine gel) to relieve pain and a protective paste (Orabase) or a coating agent like Kaopectate to protect eroded areas from further irritation from dentures, braces, or teeth.

Alternative treatment

Alternate treatment of stomatitis mainly involves prevention of the problem. Patients with such dental appliances as dentures should visit their dentist on a regular basis. Patients with systemic diseases or chronic medical problems need to ask their health care provider what types of oral problems they can expect from their particular disease. These patients must also contact their medical clinic at the first sign of problems. Common sense needs to be exercised when consuming hot foods or drinks. Use of tobacco products should be discouraged. Alcohol should be used in moderation. Mouthwashes and toothpastes known to the patient to cause problems should be avoided.
Botanical medicine can assist in resolving stomatitis. One herb, calendula (Calendula officinalis), in tincture form (an alcohol-based herbal extract) and diluted for a mouth rinse, can be quite effective in treating aphthous stomatitis and other manifestations of stomatitis.
More recently, a group of researchers in Brazil have reported that an extract made from the leaves of Trichilia glabra, a plant found in South America, is effective in killing several viruses that cause stomatitis.


The prognosis for the resolution of stomatitis is based on the cause of the problem. Many local factors can be modified, treated, or avoided. Infectious causes of stomatitis can usually be managed with medication, or, if the problem is being caused by a certain drug, by changing the offending agent.


Stomatitis caused by local irritants can be prevented by good oral hygiene, regular dental checkups, and good dietary habits. Problems with stomatitis caused by systemic disease can be minimized by good oral hygiene and closely following the medical therapy prescribed by the patient's health care provider.



Beers, Mark H., MD, and Robert Berkow, MD., editors. "Disorders of the Oral Region." In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.


Cella, M., D. A. Riva, F. C. Coulombie, and S. E. Mersich. "Virucidal Activity Presence in Trichilia glabra Leaves." Revista Argentina de microbiologia 36 (July-September 2004): 136-138.
Miller, C. S., L. L. Cunningham, J. E. Lindroth, and S. A. Avdiushko. "The Efficacy of Valacyclovir in Preventing Recurrent Herpes Simplex Virus Infections Associated with Dental Procedures." Journal of the American Dental Association 135 (September 2004): 1311-1318.
Mirowski, Ginat W., DMD, MD, and Christy L. Nebesio. "Aphthous Stomatitis." eMedicine September 24, 2004.
Sciubba, James J., DMD, PhD. "Denture Stomatitis." eMedicine June 11, 2002.
Shulman, J. D., M. M. Beach, and F. Rivera-Hidalgo. "The Prevalence of Oral Mucosal Lesions in U.S. Adults: Data from the Third National Health and Nutrition Examination Survey, 1988–1994." Journal of the American Dental Association 135 (September 2004): 1279-1286.
Wohlschlaeger, A. "Prevention and Treatment of Mucositis: A Guide for Nurses." Journal of Pediatric Oncology Nursing 21 (September-October 2004): 281-287.


American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500.
American Medical Association. 515 N. State St., Chicago, IL 60612. (312) 464-5000.

Key terms

Aphthous stomatitis — A specific type of stomatitis presenting with shallow, painful ulcers. Also known as canker sores.
Stomatitis — Inflammation of the lining of the mouth, gums, or tongue.
Thrush — A form of stomatitis caused by Candida fungi and characterized by cream-colored or bluish patches on the tongue, mouth, or pharynx.


 [sto″mah-ti´tis] (pl. stomati´tides)
inflammation of the mucosa of the mouth; it may be caused by any of numerous diseases of the mouth or it may accompany another disease. Both gingivitis and glossitis are forms of stomatitis.

Causes. The causes of stomatitis vary widely, from a mild local irritant to a vitamin deficiency or infection by a possibly dangerous disease-producing organism. Inflammation may arise from actual injury to the inside of the mouth, as from cheek-biting, jagged teeth, tartar accumulations, and badly fitting dentures. Irritating substances, including alcohol, and tobacco, may also cause stomatitis. Other causes are infectious bacteria, such as streptococci and gonococci or those causing necrotizing ulcerative stomatitis, diphtheria, and tuberculosis; the fungus causing thrush; or the viruses causing herpes simplex and measles. Extreme vitamin deficiencies can result in mouth inflammation, as can certain blood disorders. Poisoning with heavy metals, such as lead or mercury, can also cause stomatitis.
Symptoms. There is generally swelling and redness of the tissues of the mouth, which may become quite sore, particularly during eating. The mouth may have an unpleasant odor. In some types of stomatitis the mouth becomes dry, but in others there is excessive salivation. Ulcerations may appear, and, in extreme cases, gangrene (gangrenous stomatitis).

Other forms of stomatitis may occasionally cause more severe symptoms, including chills, fever, and headache. Sometimes bleeding or white patches in the mouth can be seen. In thrush, the symptoms themselves may be slight (white spots in the mouth resembling milk curds) but the disease may give rise to serious infections elsewhere in the body. In some cases, stomatitis causes inflammation of the parotid glands.

Stomatitis resulting from certain diseases presents special identifying symptoms. Syphilitic stomatitis produces painful ulcers in the mouth; in scarlet fever the tongue first has a strawberry color, which then deepens to a raspberry hue; in measles, Koplik's spots appear.
Treatment and Prevention. The treatment varies according to the cause. When the inflammation is caused by anemia, vitamin deficiency, or any infection of the body, both the underlying disease and the stomatitis are treated. Antibiotics often are effective against the infection and prevent its spreading to the parotid glands. Severe stomatitis can be a side effect of chemotherapy and radiation to the head and neck as treatment for cancer. Measures to alleviate the inflammation and promote healing include increasing fluid intake and using artificial saliva to minimize dryness and help buffer acidity in the mouth, avoiding liquids and foods that are chemically irritating or extremely hot, and frequent and consistent mouth care.

With proper care, many cases of stomatitis can be prevented. Cleanliness is essential, especially of the mouth, teeth, dentures, and feeding utensils. Infants may acquire mouth infection from the mother's oral flora, dirty bottles, or the mother's nipples. In the case of a prolonged fever or of any severe general illness, dryness of the mouth should be avoided by ingestion of increased amounts of fluids.
angular stomatitis superficial erosions and fissuring at the angles of the mouth; it may occur in riboflavin deficiency and in pellagra or result from overclosure of the jaws in denture wearers. Called also perlèche.
aphthous stomatitis recurrent aphthous stomatitis.
denture stomatitis inflammation of the oral mucosa seen in some patients with new dentures or with old, ill-fitting ones, caused by Candida albicans; characterized by redness, swelling, and pain of mucosa that is in contact with the denture. Called also chronic atrophic candidiasis and denture sore mouth.
gangrenous stomatitis see noma.
herpetic stomatitis herpes simplex involving the oral mucosa and lips, characterized by the formation of yellowish vesicles that rupture and produce ragged painful ulcers covered by a gray membrane and surrounded by an erythematous halo.
stomatitis medicamento´sa stomatitis due to an allergic reaction to drugs ingested, absorbed through the skin or mucosa, or given by hypodermic injection. Principal symptoms include vesicles, erosion, ulcers, erythema, purpura, angioedema, burning, and itching.
recurrent aphthous stomatitis a recurrent disease of unknown etiology, characterized by one or more small round or oval ulcer(s) on the oral mucosa, covered by a grayish fibrinous exudate and surrounded by a bright red halo. The lesions usually persist for 7 to 14 days and then heal without scarring. Called also aphthae, aphthous stomatitis, and canker sore.


Inflammation of the mucous membrane of the mouth.
[stomat- + G. -itis, inflammation]


/sto·ma·ti·tis/ (sto″mah-ti´tis) pl. stomati´tides   Generalized inflammation of the oral mucosa.
angular stomatitis  perlèche.
aphthous stomatitis  recurrent aphthous s.
gangrenous stomatitis  see noma.
herpetic stomatitis  an acute infection of the oral mucosa with vesicle formation, due to the herpes simplex virus.
mycotic stomatitis  thrush.
recurrent aphthous stomatitis  a recurrent stomatitis of unknown etiology characterized by the appearance of small ulcers on the oral mucosa, covered by a grayish exudate and surrounded by a bright red halo; they heal without scarring in 7 to 14 days.
ulcerative stomatitis  stomatitis with shallow ulcers on the cheeks, tongue, and lips.
Vincent's stomatitis  necrotizing ulcerative gingivitis.


Inflammation of the mucous tissue of the mouth.


Etymology: Gk, stoma + itis, inflammation
any inflammatory condition of the mouth. It may result from infection by bacteria, viruses, or fungi; from exposure to certain chemicals or drugs; from vitamin deficiency; or from a systemic inflammatory disease. Kinds of stomatitis include aphthous stomatitis, pseudomembranous stomatitis, thrush, and Vincent's infection. See also candidiasis.


Acute necrotizing ulcerative gingivitis; stomatitis, see there, aka trench mouth. See Herpetic stomatitis.


Inflammation of the mucous membrane of the mouth; characterized by small ulcers covered by a grayish exudate and surrounded by a longer red halo. It may be caused by mechanical or chemical trauma; may be classified as primary (i.e., aphthous stomatitis) or secondary.
[stomat- + G. -itis, inflammation]


(sto-ma-tit'is) [ stomato- + -itis]
Enlarge picture
STOMATITIS: As caused by herpes simplex virus
Inflammation of the mouth (including the lips, tongue, and mucous membranes). See: illustration; noma; thrush


Stomatitis may be associated with viral infections, chemical irritation, radiation therapy, mouth breathing, paralysis of nerves supplying the oral area, chemotherapy that damages or destroys the mucous membranes, adverse reactions to other medicines, or acute sun damage to the lips. The nasal and oral mucosa are esp. vulnerable to trauma from dental appliances, nasal cannula, nasotracheal tubes, or catheters administering nutrients. These areas may also be damaged during surgery when an endotracheal tube is in place.


Symptoms include oral pain, esp. when eating or drinking, bad breath, or difficulty in swallowing. Findings include oral ulcers, friability of the mucous membranes, swollen cervical lymph nodes, and sometimes fever.

Patient care

Treatment depends on the cause but is often symptomatic. The mucous membranes should be kept moist and clear of tenacious secretions. Care of the teeth and gingival tissues should be comprehensive and include flossing. The pain of stomatitis may be alleviated by systemic analgesics or application of anesthetic preparations to painful lesions. It is important for patients with dentures to clean their dentures thoroughly. Dentures should be removed from unconscious or stuporous patient. See: toothbrushing

aphthous stomatitis

Aphthous ulcer.

corrosive stomatitis

Stomatitis resulting from intentional or accidental exposure to corrosive substances.

denture stomatitis

Stomatitis on the oral mucosa covered by full or partial dentures, most commonly seen on the palate although the inflammation may also be seen overlying the mandible.

Patient care

Although most patients are asymptomatic (the finding is noticed by dental professionals during oral examination, rather than by the patient), the condition should be treated to prevent progression to more serious oral diseases. Removal of plaque from dentures (as by brushing them carefully), removal of dentures at night, and sanitizing dentures regularly (as with an overnight soak in a chlorhexidine solution) all prevent the condition from occurring. Antifungal medications are used if fungi are isolated on culture swabs.

Synonym: chronic atrophic candidiasis

diphtheritic stomatitis

Stomatitis caused by infection with Corynebacterium diphtheriae.
See: diphtheria

herpetic stomatitis

Stomatitis seen with primary infection with herpes simplex virus.

major aphthous stomatitis

Stomatitis in which large recurring or migrating painful ulcers appear within the oral cavity (on the gingiva and soft palate) and sometimes on the lips.

membranous stomatitis

Stomatitis accompanied by the formation of a false or adventitious membrane.

mercurial stomatitis

Stomatitiss seen in those exposed to elemental mercury or mercury vapors.

mycotic stomatitis


nicotine stomatitis

, stomatitis nicotina
Fissuring and the formation of hyperkeratotic papules on the palate, usually caused by habitual pipe smoking. It is a form of precancer.

simple stomatitis

Stomatitis occurring in patches on the mucous membranes.

traumatic stomatitis

Stomatitis resulting from mechanical injury as from ill-fitting dentures, sharp jagged teeth, or biting the cheek.

ulcerative stomatitis

Necrotizing ulcerative gingivitis.

vesicular stomatitis

Aphthous ulcer.

Vincent stomatitis

Necrotizing ulcerative gingivitis.


Inflammation or ulceration of the mouth.


Inflammation of mucous membrane of mouth.
[stomat- + G. -itis, inflammation]

stomatitis (stō´mətī´tis),

n inflammation of the soft tissues of the oral cavity occurring as a result of mechanical, chemical, thermal, bacterial, viral, electrical, or radiation injury or reactions to allergens or as secondary manifestations of systemic disease.
stomatitis, acute herpetic,
n (acute herpetic gingivostomatitis), the manifestations of clinically apparent primary herpes simplex characterized by regional lymphadenopathy, sore throat, and high temperature, followed by localized itching and burning, with the formation of small vesicles of an erythematous base that give way to plaques and then painful herpetic ulcers. The gingivae are swollen and erythematous, and they bleed easily. Manifestations subside in 7 to 10 days, and recovery usually occurs within 2 weeks.
stomatitis, aphthous (aphthae, canker sore),
n refers to recurrent ulcers of the oral cavity that are limited to nonkeratinized mucosa and are thought to be immune related.
stomatitis, arsenical
n oral manifestation of arsenic poisoning. The oral mucosa is dry, red, and painful. Ulceration, purpura, and mobility of teeth also may occur.
stomatitis, Atabrine a stomatitis considered by some to be associated with the use of the antimalarial and anthelmintic drug quinacrine hydrochloride (Atabrine) and characterized by oral changes simulating lichen planus.
stomatitis, bismuth,
n a stomatitis resulting from systemic use of bismuth compounds over prolonged periods. Sulfides of bismuth are deposited in the gingival tissue, resulting in bluish-black pigmentation known as a bismuth line. Oral manifestations of bismuth poisoning include gingivostomatitis similar to that of Vincent's infection, a blue-black line on the inner aspect of the gingival sulcus or pigmentation of the buccal mucosa, a sore tongue, metallic taste, and a burning sensation of the oral cavity.
stomatitis, epidemic,
stomatitis, epizootic,
stomatitis, gangrenous (cancrum oris, noma),
n See noma.
stomatitis, gonococcal,
n an inflammation of the oral mucosa caused by gonococci.
stomatitis, herpetic,
n 1. the oral manifestation of primary herpes simplex infection. The term also is used by some for herpetiform ulcers considered to be oral manifestations of secondary or recurrent herpes simplex. See also ulcer, aphthous, recurrent.
2. inflammation of the oral mucosa caused by herpesvirus. See also gingivostomatitis, herpetic.
stomatitis, iodine,
n See iodism.
stomatitis, lead,
n an oral manifestation of lead poisoning. Included are a bluish line along the free gingival margin, pigmentation of the mucosa in contact with the teeth, metallic taste, excessive salivation, and swelling of the salivary glands.
stomatitis medicamentosa
n an allergic response of the oral mucosa to a systemically administered drug. Possible manifestations include asthma, skin rashes, urticaria, pruritus, leukopenia, lymph-adenopathy, thrombocytopenic purpura, and oral lesions (erythema, ulcerative lesions, vesicles, bullae, and angioneurotic edema).
stomatitis, membranous,
n an inflammation of the oral cavity, accompanied by the formation of a pseudomembrane.
stomatitis, mercurial,
n an oral manifestation of mercury poisoning, consisting of hypersalivation, metallic taste, ulceration and necrosis of the gingivae with a tendency to spread posteriorly and to the buccal mucosa and palate, glossodynia, and periodontitis with loosening of the teeth in severe cases of chronic intoxication.
stomatitis, mycotic,
n an infection of the oral mucosa by a fungus, most commonly
C. albicans, which produces moniliasis (thrush). See also moniliasis.
stomatitis, nicotinic,
n an inflammation of the palatal minor salivary ducts caused by irritation by tobacco smoke or hot fluids and characterized by raised small palatal lesions with red centers and white borders. The palatal mucosa usually has a generalized keratosis accompanying the smaller lesions. Also called
stomatitis nicotina.
Enlarge picture
Nicotinic stomatitis.
stomatitis, recurrent,
n recurrent manifestation of herpes simplex involving the lips and labial and buccal mucosa (fever blisters, cold sores). Episodes may result from fever, sunlight, menses, trauma, and gastrointestinal upset. Lesions begin as clear vesicles with an erythematous base that give way to ulcers and superficial crusts if the outer surfaces of the lips and skin are involved.
stomatitis, uremic,
n an oral manifestation of uremia, consisting of varying degrees of erythema, exudation, ulceration, pseudomembrane formation, foul breath, and burning sensations. See also gingivitis, nephritic.
stomatitis venenata
n an inflammation of the oral mucosa as the result of contact allergy. The most common causative agents are volatile oils, iodides, dentifrices, mouthwashes, denture powders, and topical anesthetics. Possible manifestations include erythema, angioneurotic edema, burning sensations, ulcerations, and vesicles.


inflammation of the mucosa of the mouth. It may be caused by one of many diseases of the mouth or it may accompany another disease. Both gingivitis (inflammation of the gums) and glossitis (inflammation of the tongue) are forms of stomatitis as are palatitis (or lampas in horses) and cheilitis (inflammation of lips). The specific identification of stomatitis is an important part of a clinical examination in a food animal because of the need to identify the highly infectious vesicular diseases and bluetongue.

angular stomatitis
superficial erosions and fissuring at the angles (commissures) of the mouth.
catarrhal stomatitis
diffuse erythema of lips, tongue, cheeks; causes some discomfort and unwillingness to eat.
contagious pustular stomatitis
erosive stomatitis
erosive-ulcerative stomatitis
advanced stage of stomatitis characterized by multiple erosions and deeper ulcers; complete anorexia results.
mycotic stomatitis
see mycotic stomatitis.
necrotic stomatitis of calves
see oral necrobacillosis.
papular stomatitis
see bovine papular stomatitis.
stomatitis-pneumoenteritis complex
proliferative stomatitis
a very rare disease of cattle said to be caused by a filterable agent and recorded only in association with such conditions as chlorinated naphthalene poisoning. The lesions are papular and may also occur on the teats.
vesicular stomatitis
stomatitis characterized by vesicular lesions which soon rupture to leave denuded areas which become infected, necrotic, even ulcerative. See also vesicular stomatitis, vesicular exanthema of swine, swine vesicular disease, foot-and-mouth disease.

Patient discussion about stomatitis

Q. aphthous stomatitis can someone please explain me what it is? and what is the best way to treat it?

A. A canker sore (aphthous stomatitis) is an illness that causes small ulcers to appear in the mouth, usually inside the lips, on the cheeks, or on the tongue. What causes aphthous stomatitis (canker sores)?
The exact cause of this disease is not known. There are many factors that are thought to be involved with the development of canker sores, including:

Weakened immune system
Certain allergies may cause the lesions to appear, such as:
Citrus fruits
Viruses and bacteria

The following are the most common symptoms of aphthous stomatitis. However, each child may experience symptoms differently. Symptoms may include:
Ulcers in the mouth, usually inside the lips, on the cheeks, or on the tongue
Ulcers that are covered with a yellow layer and have a red base
For the full article: Hope this helps.

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