What Is Stomatitis?

Stomatitis is inflammation of the mucous membrane lining of the mouth. This means the inner lip, inner cheek, gums, roof of the mouth, or tongue can get inflamed.

Along with inflammation, stomatitis can cause canker sores or cold sores in your mouth. These lesions can both be painful and can sometimes make it difficult for a person to eat, drink, talk, or sleep.

Whether you develop canker sores or cold sores depends on what type of stomatitis you have. There are two main types of stomatitis: aphthous stomatitis and herpetic stomatitis. Aphthous stomatitis can lead to canker sores, while herpetic stomatitis can lead to cold sores.

What Causes Stomatitis? 

The cause of your stomatitis depends on what type of stomatitis you have. 

Aphthous Stomatitis 

Aphthous stomatitis is common, with about 20% of people developing it at some point. Stomatitis is believed to be some sort of immune response. Sometimes, its cause is unknown. Many conditions or situations can trigger this type of stomatitis.

The following can trigger aphthous stomatitis: 

• Stress
• Menstruation
• Allergies or sensitivities, like food or ingredients in toothpaste
• Injury, such as biting your cheek or a jagged tooth cutting your mouth
• Hormonal imbalance
• Nutritional deficiencies, such as a lack of iron, vitamin B12, or folic acid
• Denture usage
• Inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
• Lupus
• Celiac disease
• Behçet disease
• Syphilis
• Chemotherapy
• AIDS 

People who practice good oral care are less likely to develop ulcers from aphthous stomatitis.

While this type of stomatitis can affect anyone, it is more common among females, teens, and young adults.

Herpetic Stomatitis

Herpetic stomatitis is caused by the herpes simplex virus type 1 (HSV-1). (HSV-1 should not be confused with HSV type 2 (HSV-2), a different virus that can be sexually transmitted and causes genital herpes).

Herpetic stomatitis is contagious. While adults can get the infection, it most commonly first develops between the ages of 6 months and 5 years.

HSV-1, the virus that causes this type of stomatitis, spreads through either direct contact or droplets. A person can spread the virus regardless of whether they are showing symptoms. Once someone is infected with HSV-1, cold sores can come and go throughout their life.

Symptoms of Stomatitis

The severity of symptoms can vary widely from person-to-person.

Some of the common symptoms of stomatitis include:

• Pain
• Discomfort
• Burning
• Swelling
• Cracks at the corner of the mouth
• Sores, blisters, or ulcers in the mouth 

Canker Sores (Aphthous Ulcers)

Aphthous stomatitis can cause canker sores, which are medically known as aphthous ulcers. Canker sores are small, shallow ulcers that can appear on your inner lips, cheeks, tongue, and the floor or roof of the mouth. You might experience burning in your mouth a day or two before any sores appear. The sores are round or oval in shape with a gray-white color at the center and a red halo surrounding it.

If you have a less severe case, you may have a few sores that are smaller than 10 millimeters and typically resolve within four to 14 days. More severe cases present with sores that are larger than 10 millimeters, may last for over six weeks, and have a higher risk of scarring.

Canker sores are not contagious, so you can't spread them to other people.

Cold Sores (Herpetic Labialis)

Cold sores that form in the mouth can be a sign of herpetic stomatitis. Other names for cold sores are herpetic labialis, fever blisters, and oral herpes. Cold sores can start out as burning or itching in areas of the mouth and may be accompanied by fever. After 12–24 hours, the blisters form and you may experience swelling, pain, and redness. When the blisters pop, they can form ulcers—open sores that may ooze clear or yellow fluid. In total, it may take about one to two weeks before cold sores heal.

Cold sores in the mouth can usually form on the roof of the mouth. Blisters that affect the inside of the mouth and the gums are signs of herpetic gingivostomatitis. This condition is a combination of herpetic stomatitis and herpetic gingivitis (gum inflammation caused by HSV-1).

Cold sores are contagious, as they are caused by HSV-1. This means you can spread HSV-1 to other people, usually through saliva or direct contact with cold sores.

Treatment Options for Stomatitis 

Treatment depends on what type of stomatitis you have.

Aphthous Stomatitis 

Stomatitis can take anywhere from a few days to a few weeks to clear up. If you have sores, most times they go away on their own. You can apply ointments, creams, or rinses to try to help with any pain, though. These can be over-the-counter products that contain an anesthetic preparation or a coating substance, such as Orajel (benzocaine), Pepto-Bismol (bismuth salicylate), or even honey.

It’s best to stay hydrated and eat a healthful diet. You should also avoid hot, spicy food while you have any sores to prevent irritating the sores.

In more severe cases, if the sores don’t go away on their own or with medication, more advanced treatments, such as laser therapy, may be needed.

Herpetic Stomatitis

Without treatment, herpetic stomatitis usually goes away within 10 days. If you have sores, a healthcare provider might prescribe the antiviral acyclovir to speed up recovery. Brand names of acyclovir include Sitavig and Zovirax.

To help with pain, consider taking Tylenol (acetaminophen) or Advil (ibuprofen). If there is severe pain, your healthcare provider may recommend using viscous lidocaine, a numbing medicine.

Besides medication, you can try sticking to cool drinks that aren’t carbonated or acidic and eating cool, bland, easy-to-swallow foods.

Is Stomatitis Preventable? 

Preventing herpetic stomatitis means doing your best to avoid close contact with people who have cold sores, as the sores carry the virus that causes the stomatitis. Since stomatitis is most commonly picked up in childhood, it’s important to let kids know to avoid anyone with cold sores.

There are many ways you can prevent aphthous stomatitis. This includes:  

• Practicing good oral hygiene
• Avoiding foods or ingredients that cause allergic reactions
• Lessening stressors in your life, when possible
• Supplementing your diet with iron, zinc, or vitamins B1, B2, B6, B12, or C if you are deficient in any of those nutrients
• Eating a gluten-free diet if you have celiac disease

Foods to Avoid

Certain foods may trigger stomatitis. If you experience recurrent stomatitis, you might want to avoid foods that you have found to be connected to stomatitis. This may include:  

• Foods with a high pH, such as oranges and lemons 
• Carbonated drinks
• Hard foods, like toast
• Nuts
• Very spicy foods
• Salty foods 

A Quick Review

Stomatitis is a common condition of the mouth. It is an inflammation of the mucous lining of the mouth that may lead to canker sores or cold sores. Stomatitis can develop for a variety of reasons, including stress, allergies, and HSV-1. If you have herpetic stomatitis, which is a contagious type of stomatitis that is caused by HSV-1, take precautions to prevent spreading it to other people.

Stomatitis can range in severity. Most cases are mild and go away on their own. There are treatments to help with any pain the sores may cause and to promote healing. There are also steps you can take to prevent the development of stomatitis, including avoiding any foods that trigger the condition and practicing good oral hygiene.