Allergic stomatitis is one of the most common pathologies of the oral cavity. The disease most often is characterized by severe and therapy lends itself with difficulty. The main manifestations of stomatitis allergic Genesis are numerous erosions, ulcers, swelling and redness of the mucous membranes. While eating patients often experience pain and burning. One of the characteristic clinical manifestations of becomes increased secretion of saliva – hypersalivation. Often suffers from the General condition of the patient
Causes of allergic stomatitis
Allergic stomatitis is considered as a pathological symptom, which develops on the background of drug, contact or microbial Allergy. Pathology may be one of the local signs of somatic diseases of infectious or autoimmune origin. Stomatitis can occur in the form of gingivitis, cheilitis, glossitis, etc.
The main reason of arising problems is the conflict of the immune system of the patient to external factors-allergens with subsequent formation of immunopathological reactions (hypersensitivity and hyperarchi).
The development of this variety of stomatitis caused by either penetration into the human body a foreign antigen, either its regular (periodic) and direct contact with the soft tissue of the oral cavity. In the first case the reaction is considered as a system. The patient may respond to pharmacological agents, plants, food, etc. In the second case we are talking about local factors such as hygiene items (toothpaste, rinses). An allergen can be a drug lozenges or chewing gum. Often, dentists have to face a hypersensitivity reaction to orthopedic structures (partial and full removable dentures).
The plastic from which they are created, often contains in its composition compounds that trigger an inappropriate response of the immune system. Some of the body reacts to acrylic fillings, a variety of materials, braces and even metal structures, including containing gold, platinum, palladium and Nickel.
Have a certain value chronic infections dental caries, chronic tonsillitis. Chronic Allergy pathogenic microflora and products of metabolism often plays the role of a provoking factor in the development of allergic stomatitis.
At risk are patients with the following somatic diseases:
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Especially hard changes in the oral cavity compared to other diseases with an allergic component, including asthma.
In some cases, the disease is only one of the manifestations of systemic pathologies, such as SLE, hemorrhagic diathesis and scleroderma.
Classification of allergic stomatitis
Currently used in clinical practice several classifications.
The type of clinical course consider the following:
- catarrhal (most common and is characterized by a relatively light current);
- erosive (which can be a consequence of the bullous);
According to the etiological factors are distinguished:
The type and nature of the reaction stomatitis are of immediate and delayed type. The immediate reaction, as a rule, in parallel, developing angioedema. If you have a slow type of interaction signs of mucosal lesions occur sometimes only 7-10 days after contact with a sensitizing factor.
Clinical manifestations are diverse and depend on the type of pathology.
Pretty typical symptoms of catarrhal forms are:
- constant feeling of dry mouth;
- taste disturbance;
- the feeling of itching and burning;
- pain while eating.
In the course of the examination revealed redness and swelling of the mucosa, a characteristic “painted” language and small petechial hemorrhages.
For bullous varieties typical of the formation of multiple bubbles of various sizes, filled with clear content. After they opened in their place are erosion, quickly covered with a layer of fibrin. The appearance of ulcers of different sizes leads to pain when speaking and eating. On the background of the bullous and erosive forms are often observed in anorexia (loss of appetite), malaise, and hyperthermia within subfebrile values.
For inflammation of the oral cavity, developed on the background of Lyme disease, characterized by the appearance of circular red spots on body and fever. Bleeding vesicles and erosions in the mouth appear some days later.
The most serious and intractable kind of allergic stomatitis – ulcerative-necrotic. During objective examination revealed a marked redness of the mucosa and ulceration, covered with dirty-gray patina of fibrin. Determined by numerous small foci of necrosis tissue necrosis. The patient feels sharp pain when eating; he rises up, the temperature appears and drooling. Pathology is accompanied by intense headache and a sharp increase in the submandibular lymph nodes.
For syndrome Stevens-Jones is characterized by severe reactions to pharmacological agents. This form of the disease is accompanied by hyperthermia and intense joint pain. Vesicles appear not only in the oral cavity, but the skin (including the genitals).
There are a number of common clinical manifestations from the nervous system, characteristic of most varieties of disease. They include sleep disturbances (problems falling asleep in the evening and sleepiness during the day), unexplained mood swings and kantserofobiey (fear of cancer).
Survey necessarily involves gathering detailed allergic history. The doctor must find out whether there were similar symptoms in blood relatives (especially parents). The technician then tries to identify the substance that causes a hypersensitivity reaction. The inspection is carried out carefully, since changes can have unpredictable localization. Compulsory part of study of the patient is the laboratory testing of saliva, skin tests, and elimination tests.
During the initial examination, the doctor draws attention to the degree of hyperemia of the mucosa, the degree of moisture, the presence of defects (vesicles and erosions) and petechial rashes. In addition, define the number and degree of viscosity of the discharge of saliva.
In a survey it is important to find out what drugs and how long taken by the patient in recent times. One of the possible etiological factors is long (especially uncontrolled) antibiotic therapy.
The examination determined the presence of fillings, dentures and braces, as well as the degree of their deterioration. It also includes the presence of at least a single carious teeth.
Laboratory tests in diagnosis include the biochemical and chemico-spectral analysis of saliva and examination of scraping for fungus of the genus Candida.
The sample with the exposition involves a temporary elimination of the denture with the observation of the dynamics of the process. If symptoms abate, cause I believe in braces. Provocative test is to return a structure with the definition of development of pathological reactions.
Additionally apply a skin Allergy test with different antigens.
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Great importance is differential diagnosis herpes lesions, candidiasis, changes in the mucosa in leukemia and AIDS. Picture of allergic stomatitis is sometimes reminiscent of the clinic of hypovitaminosis (vitamin b and ascorbic acid).
Treatment allergic stomatitis
The solution to the problems associated with the disease, became a joint task of dentists, immunologists, allergists, dermatologists, and in some case, and rheumatologists.
The treatment is based on pathology – a complete cessation of contact with the alleged precipitating factor, medication, antihistamine drugs and symptomatic therapy, involving treatment with antiseptics and drugs to regenerate damaged tissues.
The patient must strictly follow a diet with intermittent exclusion from the diet of those or other products. It should abandon the usual hygiene items.
Among the most effective antihistamine drugs are currently Hloropiramin, Dimetindene Maleate, Suprastin and loratadine. In pharmacological therapy have shown the appointment of vitamins (group In, ascorbic and nicotinic acids). For local treatment are used anesthetics, antibacterial agents, corticosteroid hormones and herbal remedies for tissue healing (sea buckthorn oil).
If the cause of the disease is recognized as poor or worn out dental designs, be sure they are replaced.
With early detection and early combined therapy with the disease usually manages to cope at an early stage. The average course of therapy catarrhal form takes less than 2 weeks. In more advanced cases, to a complete clinical recovery takes months.
Prevention of allergic disease
Measures to prevent illness include daily quality care of the oral cavity. Tooth decay and gingivitis (inflammation of gums) need timely treatment. A dentist is required to visit at least 1 time in 6 months. Solid dental deposits require professional removal. Worn orthopedic construction shall be timely replacement or adjustment.
With burdened allergic anamnesis in the manufacture of dentures, you should use only hypoallergenic materials.
Latin Alexander, dentist, medical columnist