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Stomatitis is a general term used to describe any inflammatory process occurring in the oral cavity. These inflammatory process usually involve the mucous membranes of lips and mouth, may be accompanied by formation of ulcers, and can impair a person’s ability to speak, eat, or sleep.

There are two main types of stomatitis:

  1. Canker sores (aphthous ulcers)
  2. Cold sores (fever blisters)


  • Hormonal changes, stress, poor nutrition, reduced immunity, vitamin B12 deficiency, viruses.
  • Foods like chocolates, coffee, potatoes, cheese, nuts etc.
  • Women are known to be more affected by canker sores than men.


  • Herpes virus type 1, so once the person has been exposed to the virus, it’s going to stay in the body, becoming activated by stress, fever, trauma, hormonal disturbance and exposure to sunlight.
  • Denture stomatitis – caused by denture plate irritating the mouth.
  • Nicotine stomatitis – caused by smoking tobacco.
  • Mouth Irritation – caused by wearing braces, chewing tobacco, sharp edges of teeth, burns by hot foods and drinks, hypersensitivity to certain foods or medicines, gum disease can also be a factor.
  • Drug-Induced – by taking antibiotics, medicines for rheumatoid arthritis and epilepsy also have effects on mouth, chemotherapy, and radiotherapy for cancer treatment.
Risk factors

Some principal predisposing factors of stomatitis include:

  • Poor nutrition,
  • Stress,
  • Lack of sleep,
  • Sudden weight loss,
  • Weakened immune system,
  • Lack of vitamin B12,
  • Lack of folic acid.

Canker sores

  • These are pale yellow ulcers with a red outline, appearing inside the mouth usually on cheeks, inside lips and tongue.
  • The canker sores are painful, usually last 5 to 10 days, are not associated with fever and give a burning sensation in affected areas of mouth especially on eating spicy and sour food.

Cold sores

  • caused by herpes virus type 1, mostly occurring around lips, rarely appear inside the mouth and later form a scab.
  • The cold sores are associated with tingling, tenderness and burning before the sores appear. They are painful, with flu like symptoms and are gone within 10 days, but leave scabs for few days.

The site and appearance of both types of stomatitis is the main feature that helps us in diagnosing.

  • Canker sores (mouth ulcers) occur inside the mouth and are non-fluid filled
  • Cold sores occur outside the mouth mostly around the lips and are fluid-filled. In some cases, diagnosis depends upon culture or biopsy, with the application of immunofluorescence to the specimen.

To formulate a diagnosis, it is extremely important to know the etiology of stomatitis. A detailed medical history, examination of the lesions, and some investigations to rule out diseases that cause immunosuppression can prove vital in establishing a diagnosis. Duration, severity, location, and condition of the lesions play an important role in diagnosis.


The treatment for canker sores is mostly symptomatic:

  • Analgesic gel for relief.
  • Medicated mouthwash.
  • A topical corticosteroid such as applied on the sores.
  • Suckle ice-pops to help with burning sensaiton.
  • Dietary modifications – avoid spicy, hot and sour foods.
  • Take milk and lots of water to flush out any drug affects causing ulcers.
  • Dental treatment like repair of ill-fitting or sharp-edged dentures and broken teeth.
  • Treatment of systemic disease like Crohn’s disease that may cause mouth sores.

For Cold sores guard the sores from infection and relieve pain and discomfort. Try these:

  • Pain relievers like Tylenol and ibuprofen.
  • Blistex and Campho-phenique offer some relief to canker and cold sores if applied when the sore first appears.
When to consult a doctor?
A dentist must be immediately consulted to relieve dental associated pain and resulting sores. If you get canker sores often, then you must ask your physician for testing you for iron and vitamin B12 deficiency. As for fever blisters, if the symptoms don’t go away with recommended treatment, see your doctor.

Available Medicine for Stomatitis