Diseases of the oral mucosa. Allergies in the tongue and mouth - signs and treatment Allergy of the oral mucosa treatment

One of the problems that a person faces throughout his life is allergic reactions... These can be allergic reactions of an immediate or delayed type - this classification is given due to the time of development of symptoms.

In addition to those forms of manifestations of allergic reactions that seize the entire body as a whole, such as anaphylactic shock, one of the most formidable and life-threatening reactions for a person, local manifestations of allergies that can occur on the skin of the face, whole body, mucous membrane oral cavity and so on.

Allergic reactions in and around the mouth are common and cause serious concern.

To begin with, one should understand the fact that allergy itself is an inadequate response of the body to an irritant adequate in its strength. It develops against the background of preliminary sensitization - increasing the sensitivity of the whole organism as a whole.

It is in such conditions that sometimes an irritant of ordinary strength, whether it be pollen of plants, hair of domestic animals, food products, medicinal substances and much more, turn into a stumbling block and cause such a violent surge of reactions from the body, significantly worsening the quality of life of patients suffering from this problem.

Causes of the reaction in the mouth and on the skin

Among the reasons for the occurrence will be distinguished:

• The influence of food allergens (eating strawberries, chocolate, citrus fruits, milk, herbal tea, etc., if you are allergic to any of the listed products);
• The influence of drugs - as a result of their side effects, allergic manifestations can develop in the oral cavity;
• Toxic effects (for example, during treatment at the dentist, prosthetics are used - in some cases, dental defects are replaced with a prosthesis. It itself is most often made of plastic, for which you need to maintain a certain proportion. In case of incorrect mixing, the so-called residual monomer remains, which can cause contact, allergic prosthetic stomatitis.Some people may be allergic to plastic - in such cases, the doctor can do everything right, but the material for the prosthesis should be replaced with another, hypoallergenic);
• Autoimmune processes (systemic lupus erythematosus, Behcet's syndrome, etc.).

Symptoms and Signs

The main symptomatology will be itching, there may be a rash, burning of the skin of the face, if a process occurs in the facial area. If the oral cavity is exposed to the pathological process, itching, burning of the oral mucosa, dry mouth will also be present.

In the case of toxic stomatitis, there will be a limited area of \u200b\u200bhyperemia (redness) at the site of the prosthesis. If the cause was autoimmune processes - a specific butterfly rash in the paranasal region in the case of systemic lupus erythematosus, etc. In the event of generalized allergic manifestations, such as with urticaria, there will be a rash in the form of blisters, similar to a mosquito bite, accompanied by severe itching.

Features in children

In young children, allergies around the mouth and in the immediate oral cavity are characterized by more pronounced clinical symptoms. In such cases, you should not delay treatment and try to eliminate the allergen as soon as possible. In adolescent children, symptoms are similar to those in adults.

Features in adults

In adults, the age aspect is also important: in elderly people, due to a decrease in the body's resistance, a greater susceptibility to the occurrence of diseases, more often than in young or mature people, an allergy occurs in the perioral region and oral cavity. They almost always use full removable dentures, which also increases their incidence of this pathology.

Treatment and prevention

In this case, the main therapeutic measures include:

1. If possible, complete elimination of the allergen.
2. Hyposensitizing therapy (taking antihistamines) - at the moment, the best are considered antiallergic drugs of the 4th generation, which do not have such a side effect as depression of the central nervous system - Desloratadine, Cetirizine in tablet forms. Diphenhydramine will not badly recommend itself in severe cases with its intravenous administration.
3. Antiseptics with an anesthetic component of action (as a local symptomatic treatment)
4. In severe forms, hormonal treatment with corticosteroids.

Prevention is supervision by an allergist, which will allow you to find out what can cause this disease, careful collection of anamnesis by the doctor before treatment with certain medications, prosthetics, maximum elimination of potential allergens.

If once you are faced with such a problem as an allergy of this localization, to prevent its recurrence, you need to visit the allergy center, make allergy tests and find out what caused this condition. Depending on the test results, the allergist will prescribe a treatment regimen for you and give you recommendations that will help you cope with this problem.

Allergy - increased sensitivity of the body to various substances associated with a change in its reactivity. The peculiarity of allergic reactions is their variety clinical forms and flow options.

They are classified into two large groups: immediate-type reactions and delayed-type reactions.

Allergic reactions of immediate type

ž Immediate reactions include anaphylactic shock, Quincke's edema. They develop literally within a few minutes after a specific AH (allergen) enters the body. Quincke's edema (angioedema) is characterized by its specific manifestation in the facial area in particular.

Angioneurotic edema (Quincke's edema)

It occurs as a result of the action of food allergens, various medications used internally, when applied topically. Localized accumulation of a large amount of exudate in the connective tissue, most often in the lips, eyelids, mucous membrane of the tongue and larynx. Edema appears quickly, has an elastic consistency; tissues in the area of \u200b\u200bedema are tense; lasts from several hours to two days and disappears without a trace, leaving no changes. Angioedema of the face or lips alone is often observed as an isolated manifestation of drug allergy. It should be differentiated from: edema of the lip with Melkersson-Rosenthal syndrome, Meija's trofedema and other macrocheilitis.

Quincke's edema, with manifestation on the upper lip:

With manifestation on the lower lip:

Delayed allergic reactions

Contact and toxicoallergic drug stomatitis

They are the most common form of oral mucosa lesions in allergies. They can occur when using any medication.

Complaints: burning, itching, dry mouth, pain when eating. The general condition of patients, as a rule, is not disturbed.

Objectively: hyperemia and edema of the oral mucosa are noted, teeth imprints clearly appear on the lateral surfaces of the tongue and cheeks along the line of closing of the teeth. The tongue is hyperemic, bright red. The papillae can be hypertrophied or atrophied. At the same time, catarrhal gingivitis can occur.

Differential diagnosis: similar changes in gastrointestinal tract pathology, hypo- and avitaminosis C, B1, B6, B12, endocrine disorders, diabetes mellitus, CVS pathology, fungal infections.

Drug-induced stomatitis, localized on the lower lip:

Medical catarrhal gingivo stomatitis, with localization on the upper lip:

Ulcerative lesions of the oral mucosa

♠ ž Occur against the background of edema and hyperemia in the lips, cheeks, lateral surfaces of the tongue, hard palate.

♠ ž There are erosions of various sizes, painful, covered with fibrinous plaque.

♠ ž Erosion can merge with each other, forming a requested erosive surface.

♠ ž The tongue is coated with bloom, swollen. Gingival interdental papillae are hyperemic, edematous, bleed easily when touched.

♠ ž Submandibular lymph nodes are enlarged, painful. The general condition is disturbed: elevated temperature, malaise, lack of appetite.

♠ ž Differential diagnosis: it is necessary to differentiate from herpetic stomatitis, aphthous stomatitis, pemphigus, erythema multiforme.

Medication erosive stomatitis:

Necrotic ulcerative lesions of the oral mucosa

♠ ž The process can be localized on the hard palate, tongue, cheeks.

♠ ž It can be diffuse, involving not only the oral mucosa, but also the palatine tonsils, the posterior pharyngeal wall, and even the entire gastrointestinal tract.

♠ ž The ulcers are covered with white-gray necrotic decay.

♠ ž Patients complain of severe pain in the mouth, difficulty opening the mouth, pain when swallowing, fever.

♠ ž Differential diagnosis: ulcerative necrotizing stomatitis of Vincent, traumatic and trophic ulcers, specific lesions in syphilis, tuberculosis, as well as ulcerative lesions in blood diseases.

Drug-induced ulcerative-necrotizing stomatitis with localization on the lower surface of the tongue:

Specific allergic manifestations on the mucous membrane, when taking certain medicinal substances

♠ žž Often, as a result of taking a medicinal substance, bubbles or blisters appear on the mucous membrane of the oral cavity, after opening which erosions usually form. Such rashes are observed mainly after taking steptomycin. Similar elements on the tongue, lips may appear after taking sulfonamides, olettrin.

♠ žž Changes in the oral cavity as a result of taking antibiotics of the tetracycline series are characterized by the development of atrophic or hypertrophic glossitis

♠ žž Oral cavity lesions are often accompanied by fungal stomatitis.

Changes in the oral cavity as a result of taking sulfonamides in the form of edema and hyperemia of the upper lip and the area of \u200b\u200bnecrosis on the CO of the tongue:

The reaction of the mucous membrane to oletthrin in the form of erosions on the lateral surfaces of the tongue:

The reaction of the oral mucosa to antibiotics in the form of papillary hypertophy, erosions in the tongue and atrophy of the papillae, after taking tretracycline (tetracycline tongue):

Allergic purpura or Schönlein-Gennukh syndrome

♠ ž Aseptic inflammation of small vessels, caused by the damaging effect of immune complexes.

♠ ž Manifested by hemorrhages, intravascular blood coagulation disorders and microcirculatory disorders.

♠ ž It is characterized by hemorrhagic rashes on the gums and cheeks. language, sky. Petechiae and hemorrhagic spots with a diameter of 3-5mm to 1cm do not protrude above the level of the mucous membrane and do not disappear when pressed with glass.

♠ ž The general condition of patients is disturbed, worried about weakness, malaise.

♠ ž Differential diagnosis: Wergolf's disease, homophilia, vitamin C deficiency.

Schönlein-Genyukh syndrome:

Diagnostics of contact and toxic-allergic drug stomatitis

♠ ž Allergic history.

♠ ž Features clinical course.

♠ ž Specific allergic, skin-allergic tests.

♠ ž Hemogram (eosinophilia, leukocytosis, lymphopenia)

♠ ž Immunological reactions.

Treatment of contact and toxic-allergic drug stomatitis

♠ ž Etiotropic treatment - isolation of the body from the influence of the putative antigen.

♠ ž Pathogenetic treatment - inhibition of lymphocyte proliferation and antibody biosynthesis; inhibition of the antigen-antibody connection; specific desensitization; inactivation of biologically active substances.

♠ ž Symptomatic treatment - influence on secondary manifestations and complications (correction of functional disorders in organs and systems)

♠ ž Specific hyposensitizing therapy is carried out according to special schemes after a thorough allergological examination and determination of the patient's state of sensitization to a certain allergen.

♠ ž Non-specific hyposensitizing therapy includes: calcium preparations, histoglobulin, antihistamines (Peritol, Tavegil), ascorbic acid and ascorutin.

♠ ž In severe cases, corticosteroid medications are prescribed.

♠ ž Local treatment is carried out according to the principle of therapy for catarrhal stomatitis or erosive-necrotic lesions of the oral mucosa: antiseptics with anesthetics, antihistamines and corticosteroids, anti-inflammatory drugs and proteinase inhibitors.

♠ ž Proteolytic enzymes are indicated for necrotic lesions;

♠ ž For restoration - keratoplastic preparations.

Behcet's syndrome

♠ ž Dental-ophthalmogenital syndrome.

♠ ž Etiology: infectious allergy, autoaggression, genetic condition.

♠ ž Usually begins with malaise, which may be accompanied by fever and myalgias.

♠ ž Aphthae appear on the oral mucosa and CO of the external genital organs. There are many aft, they are surrounded by an inflammatory rim of bright red color, have a diameter of up to 10 mm. The aft surface is densely filled with yellow-white fibrinous plaque.

♠ ž They heal without a scar.

♠ ž Damage to the eyes occurs in almost 100% of patients, manifests itself as severe bilateral iridocyclitis with opacity of the vitreous body, which leads to the gradual formation of synechia, overgrowing of the pupil.

♠ ž In some cases, a rash appears on the skin of the body and limbs due to erythema nodosum.

♠ ž The most serious complication is damage to the nervous system, which proceeds as meningoencephalitis.

♠ ž Other symptoms of Behcet's syndrome: the most common are recurrent epididymitis, gastrointestinal tract involvement, deep ulcers prone to perforation and bleeding, vasculitis.

Treatment of Behcet's syndrome

There are currently no generally accepted methods of treatment. Corticosteroids do not have a significant effect on the course of the disease, although they can reduce the manifestation of some clinical symptoms. In some cases, colchicine and levamisole are used - which is effective only in relation to mucocutaneous manifestations of the syndrome. Prescribe broad-spectrum antibiotics, plasma transfusion, gamaglobulin.

Behcet's syndrome:

Exudative erythema multiforme

♠ ž Disease of an allergic nature with an acute cyclic course, prone to relapse, manifested by polymorphism of skin rashes and oral mucosa.

♠ ž Develops mainly after taking medications (sulfonamides, anti-inflammatory drugs, antibiotics) or under the influence of household allergens.

♠ ž It is manifested by various morphological elements: spots, papules, blisters, vesicles and blisters.

♠ ž The skin, mucous membrane of the oral cavity can be affected in isolation, but their combined lesion also occurs.

♠ ž Infectious-allergic form of PEE - begins as an acute infection... Maculopapular rashes appear on the skin, lips, edematous and hyperemic oral mucosa. In the first stages, bubbles and vesicles appear, discharged by serous or serous-hemorrhagic exudate. Elements can be observed for 2-3 days. The blisters rupture and empty and in their place numerous erosions are formed, covered with a yellow-gray fibrinous coating (burn effect).

♠ ž Toxic-allergic form of MEE - occurs as an increased sensitivity to medications when they are taken or in contact with them. Relapse rates depend on exposure to the allergen. When this form МЭЭ, ОПР is an obligatory place of lesion elements rash. The rashes are completely identical as in the previous form, but more common, and the process is fixed here. Complications of this form are conjunctivitis and keratitis.

♠ ž When diagnosing PEE, in addition to anamnesis and clinical examination methods, it is necessary to do a blood test, conduct a cytological examination of material from the affected areas.

♠ ž Differential diagnosis: herpetic stomatitis, pemphigus, Duhring's disease, secondary syphilis.

MEE. Erosion and crusts on the red border of the lips and facial skin:

MEE. Bubbles on the gums and mucous membrane of the lower lip:

MEE. Erosions on the mucous membrane of the lips, covered with fibrinous plaque:

MEE. Erosions covered with a fibrinous film on the lips:

MEE. Extensive erosions, covered with a fibrinous film, on the lower surface of the tongue:

Cockades:

Treatment of exudative erythema multiforme

♠ Provides for the identification and elimination of the sensitization factor.

♠ For the treatment of an infectious-allergic form, specific desensitization with microbial allergens is performed.

♠ Severe disease is a direct indication for corticosteroids. Lysozyme course.

♠ Local treatment is carried out, adhering to the principles of therapy of ulcerative-necrotic processes of OOPR - irrigation with antiseptic solutions, solutions that increase immunobiological resistance, drugs that break down necrotic tissues and fibrinous plaque.

♠ A feature of the treatment of PEE is the use of drugs that have a local antiallergic effect (diphenhydramine, thymalin) - in the form of applications or aerosol.

Stevens Johnson Syndrome

♠ Ectodermosis with localization near the physiological holes.

♠ The disease is a failure of a super-severe form of exudative erythema multiforme, which proceeds with significant disturbances in the general condition of patients.

♠ Develops as a drug lesion. During development, it can transform into Lyell's syndrome. It can be caused by non-steroidal anti-inflammatory drugs.

♠ The main changes occur in the integumentary epithelium. They are manifested by spongiosis, ballooning dystrophy, in the papillary layer of the lamina propria - the phenomenon of edema and infiltration.

♠ Clinic: the disease often begins with a high body temperature, is accompanied by cystic and erosive elements of the lesion, severe eye damage with the appearance of vesicles and erosions on the conjunctiva.

♠ A permanent sign of the syndrome is a generalized lesion of the oral mucosa, accompanied by the appearance of widespread erosions covered with a white membranous coating.

♠ With generalized lesions, vulvoaginitis develops.

♠ The skin rash is characterized by polymorphism.

♠ Papules on the skin often sink in the center, reminiscent of "cockades"

♠ On the red border of the lips, tongue, soft and hard palate, bubbles form with serous-hemorrhagic exudate, after emptying which appear extensive painful erosion and foci covered with massive purulent-hemorrhagic crusts.

♠ The development of pneumonia, enceffalomyelitis with a lethal outcome is possible.

Allergic stomatitis is a disease of the oral cavity. The course is often severe, the patient experiences noticeable discomfort due to swollen, irritated tissues of the palate and tongue. Negative reactions develop during the immunological conflict of the body with allergens that enter the mouth from the outside or from the inside.

What to do if a child has allergic stomatitis? Which doctor will help eliminate negative signs? What treatments are effective for oral tissue damage?

Answers in the article.

The reasons for the development of the disease

A negative reaction develops after contact of the oral mucosa with various allergens. External agents are plant pollen, mold spores.

Often, allergic stomatitis develops in the following cases:

• negative reaction to installed crowns, fillings, prostheses, especially those made from cheap, low-quality materials;
• in children - an acute response to certain types of food;
• irritation of the tissues of the oral cavity with a decrease in immunity against the background of a course of treatment with sulfonamides or antibacterial drugs;
• neglected caries, bleeding gums, inflammatory processes, accompanied by the reproduction of pathogenic microorganisms;
• as a complication of Lyme disease, recurrent aphthous stomatitis, systemic lupus erythematosus, hemorrhagic diathesis, Stevens-Johnson syndrome.

According to international classification diseases, negative reaction in the oral cavity is highlighted in a special section.

Allergic stomatitis code according to ICD 10 - K12 "Stomatitis and other related lesions" and subsection K12.1 "Other forms of stomatitis".

Learn about the use of bay leaves in traditional medicine for the treatment of allergic diseases.

Read about the first signs and symptoms of a child's gluten allergy at this location.

First signs and symptoms

The disease has general and local symptoms.

Even with a mild form of allergic stomatitis, the patient experiences discomfort during hygiene procedures in the oral cavity, eating, in advanced cases it is difficult to speak due to inflamed, swollen tissues.

Local signs:

• soreness, redness of the affected areas;
• an unpleasant odor is heard from the mouth (persists even after brushing your teeth);
• swelling of the tongue, lips, palate, pharynx, cheeks;
• excessive salivation.

If you are allergic to medicines in the oral cavity, additional symptoms arise:

• fluid-filled blisters form on the mucous membranes in the mouth;
• tissues turn red;
• pain is felt.

When tick-borne borreliosis appears:

• blisters on the mucous membranes;
• redness;
• bleeding wounds and erosion.

Common signs:

• the disease often develops rapidly;
• body temperature often rises (especially with allergies to antibiotics);
• bubbles, blisters are formed in severe form, not only in the mouth, but also on the skin, mucous membranes of the eyes, genitals;
• with Lyme disease, red spots with a border around the edges appear on various parts of the body;
• pain syndrome is pronounced;
• sometimes joint pain occurs.

Diagnostics

In case of damage to the mucous membranes and tongue, it is important to consult a dentist in time.

The doctor will examine the oral cavity, clarify the clinical picture, and listen to the patient's complaints. An analysis of background diseases is carried out, the doctor identifies the strength and nature of negative symptoms.

If you suspect an allergic stomatitis, a comprehensive diagnosis is carried out:

• • checking structures: prostheses, braces, fillings;
  • general clinical studies of urine and blood;
  • condition monitoring immunogram immune system;
  • determination of the level of acidity and composition of saliva;
  • identification of the activity of enzymes contained in saliva;
  • leukopenic test;
  • provocative tests with ...

    The reasons for the development of the disease

    Both adults and children are susceptible to such an unpleasant disease as allergies. And especially unpleasant is the type of disease in which allergic reactions are observed in the oral cavity. This type of allergy is not only extremely painful, but also quite dangerous for the patient's health.

    Symptoms

    Not all inflammatory processes in the oral cavity are associated with allergies. They can also be caused by various bacteria and viruses, autoimmune diseases - systemic lupus erythematosus and pemphigus vulgaris, as well as exudative erythema multiforme.

    In addition, oral edema can be observed as a particular manifestation of generalized angioedema.

    By localization, inflammation is divided into:

    • cheilitis - the area of \u200b\u200bthe lips and mucous membrane near the mouth,
    • glossitis - tongue
    • gingivitis - gums,
    • stomatitis - the mucous membrane of the oral cavity,
    • palatinitis - soft or hard palate
    • papillitis - papillae of the gums.

    In terms of severity and characteristic symptoms, allergic stomatitis can be divided into:

    • catarrhal,
    • catarrhal-hemorrhagic,
    • bullous,
    • ulcerative necrotic,
    • erosive.

    The catarrhal type of allergic stomatitis is characterized by mild symptoms.

    Patients usually complain of dry mouth, soreness when eating. The disease is also accompanied by burning and itching. With a hemorrhagic form, small specks of hemorrhage on the mucous membrane are visible on examination. The bullous form is characterized by the formation of blisters with exudate. When they are destroyed, erosion can form. With ulcerative necrotic stomatitis, painful ulcers form on the surface of the mucous membrane with areas of necrosis.

    This type of stomatitis is the most severe, it can be accompanied by severe pain, damage to the lymph nodes and signs of general intoxication of the body.

    How to distinguish allergic reactions from inflammatory processes of infectious origin? First of all, you need to pay attention to symptoms such as dry mucous membranes and tongue. This feature is typical for allergic processes. With a bacterial infection, there is usually increased salivation or it remains within the normal range. Bad breath is also common in bacterial infections, while in allergic stomatitis, it is absent.

    On the other hand, allergic stomatitis is characterized by a change in taste or the presence of an unpleasant taste in the mouth, which usually does not occur with bacterial stomatitis.

    Other symptoms of allergic stomatitis also include small rashes in the mouth, the formation of small vesicles (vesicles), and in severe forms, ulcers and areas of necrosis. The patient feels severe itching in the mouth, and sometimes severe pain. The process of eating and chewing it is also difficult or even impossible due to severe pain syndrome.

    In the absence of treatment, massive necrotic lesions of the oral mucosa, the addition of a bacterial infection are possible, which will significantly complicate the treatment.

    In children, allergic stomatitis is usually much more severe than in adults, it has a more acute onset and is often accompanied by intoxication of the body.

    This is due to the child's weaker immune system and higher metabolic rate. Moreover, the disease can often be diagnosed only at the stage of development of complications. Often stomatitis in children is accompanied by an increase ...

    First signs and symptoms

    Allergic stomatitis: what is this ailment and how to deal with it

    Stomatitis is the name of a group of diseases of the oral mucosa of an infectious, inflammatory or allergic nature.

    This term is also called local manifestations of immune, skin and other diseases.

    Stomatitis is quite common in both children and adults. The mucous membrane of the bottom of the mouth, cheeks, palate is affected in isolation or is accompanied by glossitis (inflammation of the tongue), gingivitis (inflammation of the gums), and sometimes cheilitis (inflammation of the lips).

    Stomatitis develops independently or is a manifestation of other pathological processes.

    General characteristics of the disease

    Allergic stomatitis is a disease of the oral mucosa, which is based on complex immunological processes.

    Typical signs of the disease are hyperemia, swelling, bleeding wounds, erosive and ulcerative formations. Patients cannot eat normally because of pain and discomfort, indicating a deterioration in well-being in general.

    The reason for such stomatitis is the ingress of an allergen into the body or direct contact of the traumatic element with the oral mucosa.

    Allergies can be triggered by plant pollen, medicines, and certain foods, resulting in a complex immune response. Stomatitis is one of the manifestations of this reaction.

    Local exposure to a provoking factor (oral hygiene products, cough drops, dentures) irritates the mucous membrane, which again leads to illness.

    Contact stomatitis is associated with high sensitivity to dental treatments:

    • means for local anesthesia;
    • filling material;
    • braces;
    • orthodontic plates;
    • crowns;
    • metal and other prostheses.

    

    Acrylic implants, which contain residual monomers and dyes, are more likely to cause allergies.

    When staging a metal structure, an allergy develops to the alloy used (for example, nickel, chromium, platinum). The course and outcome of the disease also depend on the presence of plastics and other components in the orthodontic construction.

    It has been established that persons suffering from chronic diseases of the gastrointestinal tract (dysbiosis, pancreatitis, cholecystitis, colitis, gastritis and others), as well as endocrine disorders (diabetes mellitus, increased thyroid function, menopause) are susceptible to the disease.

    Due to various kinds of disorders, the listed diseases lead to a modification of the body's reactivity and sensitization to allergens of dental prostheses.

    In such patients, the neurological status changes.

    

    Carcinophobia (fear of cancer), neurasthenia, prosopalgia (pain in the facial area) appear, which is why people turn not to a dentist, but to a neurologist and other specialists.

    As practice shows, severe hypersensitivity reactions develop in persons with a burdened allergic history (vasomotor rhinitis, various forms of eczema, urticaria, angioedema, etc.). Most often they occur with drug allergies (30% of cases), food (30%), asthma and other pathologies.

    An important place in the mechanism of development of allergenic stomatitis is played by carious teeth, chronic tonsillitis, as well as the accumulation of various microorganisms in the area of \u200b\u200bprostheses.

    Allergic stomatitis can pass in isolation or be part of systemic disorders:

    • systemic lupus erythematosus;
    • vasculitis;
    • scleroderma;
    • diathesis;
    • toxic epidermal necrolysis;
    • reiter's disease;
    • exudative, malignant erythema and others.

    The following types of allergic stomatitis are distinguished:

    • catarrhal (simple);
    • bullous;
    • catarrhal-hemorrhagic;
    • erosive;
    • ulcerative.

    A type of the disease is anaphylactic stomatitis, which is the appearance of multiple aftokas and erythema in the mouth.

    It develops as a result of the use of any drugs.

    Intraoral fixed ...

    

    Allergic stomatitis

    The changes caused by the pathological process on the lips and tongue are difficult for the patient to miss. Allergic reactions in this area can manifest themselves in various ways, from edema to the appearance of rashes; some of them can be very painful. Mouth allergies often occur in childhood, although the possibility of development in an adult cannot be ruled out.

    The reasons

    The defeat of the lips, extending to the mucous membrane and the red border, is called cheilitis, and the pathological process localized in the area of \u200b\u200bthe tongue is called glossitis.

    

    Both cheilitis and glossitis are more often distinguished as symptoms of various diseases and are considered as an independent pathology in very rare cases. Allergy to lips and tongue occurs:

    1. In case of hypersensitivity to chemicals, which include components of dental materials (metal alloys, ceramics, cements, etc.), decorative cosmetics, oral care products (toothpastes, rinses), office supplies (pencils, pens with the habit of holding in your mouth), candy, and chewing gum.

    Also, the etiological factor may be the use of musical instruments, when working with which contact with the lips is required to create sound.

  • With increased sensitivity to sunlight.
  • In patients with atopic dermatitis, eczema, chronic stomatitis.

The types of lesions of the lips and tongue of an allergic nature can be presented in the list:

• • • contact cheilitis;
    • contact glossitis;
    • actinic cheilitis;
    • atopic cheilitis;
    • eczematous cheilitis.

The area of \u200b\u200bthe lips and tongue is also involved in the pathological process with Quincke's edema, chronic aphthous stomatitis.

Symptoms

Contact allergic cheilitis is caused by a delayed-type reaction and is recorded mainly in women; lip allergy symptoms include:

• • • severe itching;
    • severe swelling;
    • redness;
    • burning sensation on the lips;
    • the appearance of small bubbles;
    • erosion after the opening of the bubbles;
    • peeling.

The disease worsens after repeated contact with the allergen.

With a widespread lesion, patients complain of soreness, which increases during eating, talking. Allergic contact glossitis, or allergy in the tongue, in many cases is combined with cheilitis; the tongue turns red, the papillae are atrophied when viewed, gustatory sensitivity may be impaired.

Actinic cheilitis is understood as inflammation of the tissue on the lips, caused by the influence of sunlight. The exudative form is manifested by the presence of a rash on the lips in the form of bubbles, after which erosion and crusts are found, painful when in contact with food, with pressure, with lip movement.

There is also swelling and redness, itching of varying intensity. Patients suffering from the dry form of actinic cheilitis complain of severe dryness and burning sensation on the lips, the appearance of peeling - gray, whitish scales. Redness is observed on the lips, erosion may appear.

Atopic cheilitis is a pathology that occurs most often in children who have been diagnosed with atopic dermatitis.

Changes are most pronounced in the area of \u200b\u200bthe corners of the mouth and are manifested by itching, pain when opening the mouth, a feeling of tightness, dryness and flaking, cracks that bleed when damaged.

Allergies around the mouth can be complicated by the addition of a bacterial, viral or fungal infection.

Acute eczematous cheilitis is characterized by:

• • redness and swelling of the lips;
  • intense itching;
  • the presence of a rash in the form of ...

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Allergy belongs to the field of immunopathology. The pathophysiological essence of an allergic reaction is the antigen-antibody reaction. The mucous membrane of the mouth and the red border of the lips are often affected by allergic diseases of a local and systemic nature.

Epidemiology

The prevalence of allergic diseases is high. Different nosological forms have different frequency of occurrence.

Classification

Along with truly allergic diseases (Quincke's edema, Lyell's disease, allergic stomatitis, cheilitis and glossitis, medical stomatitis, cheilitis and glossitis), separate nosological forms (exudative erythema multiforme, chronic recurrent aphthous stomatitis, etc.) are distinguished, the etiology of which has not been fully determined. ... This chapter will focus on these diseases.

Etiology and pathogenesis

Chronic recurrent aphthous stomatitis

The etiology is not fully understood. In the pathogenesis of the disease, the main role belongs to autoimmune processes. The presence in the body of foci of chronic infection (periodontitis, chronic periodontitis, chronic tonsillitis, colitis, etc.) is also important. Most often, middle-aged and older people with gastrointestinal diseases are affected.

Exudative erythema multiforme

The etiology is not fully understood. There are two forms of the disease. The idiopathic (or true) form has an infectious-allergic nature (sensitization to bacterial allergens). The symptomatic form has a toxic-allergic nature (hyperergic reaction to drugs). Mostly young and middle-aged men are ill. At the heart of true allergic diseases is the antigen-antibody reaction.

Clinical signs and symptoms

Chronic recurrent aphthous stomatitis (HRAS) is characterized by the appearance on the unchanged mucous membrane of the lips, transitional folds, lateral surface of the tongue, cheeks from one to five aft. Elements of the lesion are practically not found on the mucous membrane of the hard palate and rarely appear on the gums. The appearance of aft is sometimes preceded by a burning sensation on the mucous membrane. Aphthae epithelialize on their own after 7-10 days without leaving scars.

A severe form of HRAS is Setton's syndrome (scarring form). The disease lasts 2-4 weeks; after epithelialization, scars are formed. Another severe form of HRAS, Behcet's syndrome, is characterized by the appearance of aft on the cornea of \u200b\u200bthe eyes and genitals, along with lesions of the oral mucosa.

Exudative erythema multiforme (MEE) is characterized by one-stage polymorphism of lesion elements (spots, blisters, blisters, erosion, ulcers, aphthae, etc.). The disease begins suddenly: malaise, fever (in severe cases - up to 38 C), headache, pain in muscles and joints. Cockades appear on the skin. On the mucous membrane of the oral cavity, against the background of limited or diffuse hyperemia and edema, subepithelial bubbles of various sizes appear, which quickly open, and in their place painful erosion is formed, covered with fibrinous bloom. The red border of the lips is covered with thick hemorrhagic crusts. The addition of fusospirochetosis significantly complicates the course of the disease. The period of exacerbation lasts 2-4 weeks, erosion epithelializes after 7-12 days without scars.

Symptomatic PEE recurs only in case of repeated contact with the allergen drug.

Stevens-Johnson syndrome is a specific severe form of MEE, which is characterized by a severe general condition of the patient and is accompanied by extensive lesions of the mucous membranes of the mouth, eyes, nose and genitals.

The diagnosis is made on the basis of examination data and anamnesis.

Additional survey methods include:general clinical analysis of blood, consultations of specialists in gastroenterology, allergology, skin-allergic, histamine tests, identification of foci of chronic infection.

Differential diagnosis

HRAS is differentiated from chronic herpetic stomatitis, ulcerative necrotizing stomatitis of Vincent, traumatic erosion, secondary papular syphilis. MEE should be differentiated from drug allergy, pemphigus, pemphigoid, acute herpetic stomatitis, secondary syphilis, HIV infection. Treatment is aimed at eliminating the symptoms of the disease, preventing the addition of a secondary infection and indirectly affecting the links of pathogenesis. The treatment of HRAS and MEE should be continued in the interrecurrent period with specialists in gastroenterology and allergology. For application anesthesia to numb the mucous membrane before eating, local anesthetics are used:

Benzocaine / glycerin topically 5/20 g before each meal, until clinical improvement or
Lidocaine, 2.5–5% ointment or 10% aerosol, topically before each meal, until clinical improvement.

For pain relief before meals in benzocaine solution, olive oil or peach oil can be used instead of glycerin. Antiseptics and antimicrobial drugs are used to treat the oral cavity and elements of mucosal lesions and prevent their infection. Processing is carried out with loose cotton swabs dipped in a warm antiseptic solution; oral baths are also used:

Hydrogen peroxide, 1% solution, topically 1-2 p / day, until clinical improvement or
Potassium permanganate, 0.02% solution, topically 1-2 p / day, until clinical improvement or
Sanguinarine / chelerythrine, 1% solution, topically 1-2 times a day, until clinical improvement or
Chlorhexidine, 0.06% solution, topically 1-2 times a day, until clinical improvement or
Ethacridine, 0.05% solution, topically 1-2 times a day, until clinical improvement.

For oral baths, you can use herbal astringent drugs:
St. John's wort herb, tincture 1: 5 in 40% alcohol, topically 30-40 drops per 1/2 glass of water 3-4 r / day, until clinical improvement or
Chamomile flowers, infusion, topically 3-4 r / day, until clinical improvement or
Sage leaves, tab. for resorption or infusion, topically 3-4 r / day, until clinical improvement.

To cleanse the surface of erosions and ulcers, proteolytic enzymes are used, which are applied to the lesion element:
Trypsin 5 mg (in isotonic sodium chloride solution) topically 1-2 r / day, until clinical improvement or
Chymotrypsin 5 mg (in isotonic sodium chloride solution) locally 1-2 r / day, until clinical improvement.

With a hyperergic MEE reaction and to achieve an anti-inflammatory effect, NSAIDs and non-narcotic analgesics are used:
Acetylsalicylic acid inside 0.5-1 g 3-4 r / day, until clinical improvement or
Inside benzydamine (keep the table in the mouth until completely absorbed) 3 mg 3-4 r / day, until clinical improvement, or
0.15% solution for rinsing the mouth every 1-3 hours, or
aerosol for irrigation of the oral cavity 1 dose for every 4 kg of body weight (children under 6 years old), 4 doses (children 6-12 years old), 4-8 doses (children over 12 years old and adults) or
Diclofenac inside 25-50 mg 2-3 r / day (children over 6 years old - 2 mg / kg / day in 3 divided doses), until clinical improvement or

Ketoprofen inside 0.03-0.05 g 3-4 r / day, or rectally 1 supp. 2-3 r / day, or topically (in the form of a rinse solution) 2 r / day, until clinical improvement or
Meloxicam inside 7.5-15 mg 1 r / day, until clinical improvement or
Paracetamol inside 02-0.5 g (adults); 0.1-0.15 g (children 2-5 years old); 0.15-0.25 g (children 6-12 years old) 2-3 r / day, until clinical improvement or
Piroxicam orally 10-30 mg 1 r / day or rectally 20-40 mg 1-2 r / day, until clinical improvement or
Holisal on the affected surface after eating 3-4 r / day, until clinical improvement.

The gel base of choline salicylate / cetalkonium chloride is not washed off with saliva and is firmly fixed on the mucous membrane.

GCS is also used as anti-inflammatory and desensitizing therapy for MEE:
Prednisolone, 0.5% ointment, topically on the affected areas 1-3 r / day, until clinical improvement or
Triamcinolone, 0.1% ointment, topically on the affected areas 2-3 times a day, until clinical improvement or Flumethasone / clioquinol, ointment, topically to the affected areas 2-3 times a day, until clinical improvement or Flumethasone / salicylic acid, ointment, topically on the affected areas 2-3 times a day, until clinical improvement.

In severe cases of MEE, in order to influence the attached pathogenic microflora, antimicrobial drugs are used:
Amoxicillin inside 30 mg / kg in 2-3 doses (children under 10 years of age); 500-1000 mg 3 r / day (children over 10 years old and adults), 5 days or
Amoxicillin / clavulanate orally at the beginning of a meal 20 mg / kg in 3 divided doses (children under 12 years of age); 375-625 mg 3 r / day (children over 12 years old and adults), 5 days or
Ampicillin / oxacillin inside 100 mg / kg in 4-6 doses (children under 12 years old); 0.5 g 4-6 r / day (children over 12 years old and adults), 5-10 days or
Doxycycline inside (children over 8 years old) on the 1st day 0.2 g 2 r / day, then 0.1 g 2 r / day, 5-10 days or
Norfloxacin (children over 15 years old and adults) inside 0.4 g 2 r / day, 7-10 days or
Ciprofloxacin (children over 15 years old and adults) orally before meals 0.125-0.5 g 2 r / day, 5-15 days
±
(in the presence of anaerobic microflora that caused necrotizing ulcerative gingivostomatitis and periodontitis)
Metronidazole inside 0.25 g 3 r / day, 7-10 days.

Amoxicillin in combination with clavulanic acid is considered more effective than monocomponent penicillin antibiotics.

Calcium preparations provide a decrease in tissue permeability, have a decongestant, anti-inflammatory effect:
Calcium gluconate inside 1-3 g 2-3 r / day or 10% solution i / v or i / m 5-10 ml once every 1-2 days, 30 days or
Calcium lactate inside 0.5-1 g 2-3 r / day, 30 days.

Antihistamines are used as antiallergic drugs:
Clemastine inside 0.5 mg (children 6-12 years old); 1 mg (children over 12 years old and adults) 2 r / day, 10-15 days or
Loratadine orally 10 mg (adults); 5 mg (children) 1 r / day, 10-15 days or
Mebhydrolin inside 50-100 mg / day in 1-2 doses (children under 2 years of age); 50-150 mg / day in 1-2 doses (children 2-5 years old); 100-200 mg / day in 1-2 doses (children 5-10 years old); 50-200 mg 1-2 r / day (children over 10 years old and adults), 10-15 days or
Hifenadine inside after eating 0.025 - 0.05 g 3-4 r / day (adults); 0.005 g 2-3 r / day (children under 3 years old); 0.01 g 2 r / day (children 3-7 years old); 0.01 g or 0.015 g 2-3 r / day (children 7-12 years old); 0.025 g 2-3 r / day (children over 12 years old), 10-15 days or
Chloropyramine inside 0.025 g (adults); 8.33 mg (children under 7 years old); 12.5 mg (children 7-14 years old) 2-3 r / day, 10-15 days or
Cetirizine inside 0.01 g (adults and children over 6 years old); 0.005 g (children under 6 years old) 1 r / day, 10-15 days.

For the purpose of non-specific desensitization, human gamma globulin is used:
Human gamma globulin / subcutaneous histamine 1 ml once every 2-4 days, then the dose is gradually increased to 3 ml once every 2-4 days, 8-10 injections.

For detoxification therapy, use:
Sodium thiosulfate, 30% solution, i.v. 10 ml 1 r / day, 10-12 injections.

After stopping the acute process, drugs are prescribed that stimulate regeneration processes, and vitamins:
Sea buckthorn oil topically on a cleansed area of \u200b\u200bthe affected mucous membrane 1-3 r / day, until clinical improvement or
Solcoseryl, ointment or dental adhesive paste, topically on the cleansed area of \u200b\u200bthe affected mucous membrane 1-3 r / day, until clinical improvement or
Rosehip oil topically on a cleansed area of \u200b\u200bthe affected mucous membrane 1-3 r / day, until clinical improvement
+
Retinol inside 50,000 IU 2 r / day, 20-30 days (used as an anti-inflammatory, immunostimulating agent that improves tissue trophism)
+
Vitamin E inside 50-100 mg 1 r / day, 20-30 days
(used as an active antioxidant to stimulate protein synthesis, reduce capillary permeability)
+
Ascorbic acid inside 50-100 mg 3-5 r / day or 5% solution in / m 1 ml 1 r / day, 20-40 days (used to regulate redox processes, stimulate tissue regeneration, activate phagocytosis and antibody synthesis)
+
Calcium pantothenate inside 0.1 g 2-4 r / day, or 5% solution locally in the form of applications for long-term non-healing erosion 2-4 r / day, or
10% solution in / m 2 ml 1-2 r / day, 20-40 days (used to normalize the metabolism of fatty acids, stimulate the formation of acetylcholine, steroid hormones, utilization of amino acid deamination products)
+
Rutozide inside 0.02-0.05 g 3 r / day, 20-40 days (reduces vascular permeability, protects ascorbic acid from oxidation and together with it inhibits hyaluronidase)
+
Cyanocobalamin inside 0.00005 g 1 r / day, 20-40 days
+
Folic acid inside 0.0008 g 1 r / day, 20-40 days (cyanocobalamin and folic acid are used to activate the processes of hematopoiesis and maturation of erythrocytes, tissue regeneration).

Evaluation of the effectiveness of treatment

Diseases HRAS and MEE are chronic; achieving long-term remission, reducing the frequency of relapses can be considered the result of effective treatment.

Errors and unreasonable assignments

It should be remembered about the possibility of a hyperergic reaction to drugs with MEE. It is not recommended to prescribe drugs that most often cause drug allergies (for example, sulfonamides). With HRAS, the prescription of drugs with immunosuppressive effects (GCS) and antibiotics is unreasonable.

Forecast

The diseases are chronic. With Stevens-Johnson syndrome, the prognosis is extremely poor, possibly fatal.

G.M. Barer, E.V. Zoryan

As an allergy of any etiology, allergic stomatitis occurs in people of different ages. People with weakened immune systems, the elderly, as well as children, tolerate it hard. It is quite difficult to treat allergic stomatitis, the main thing is to correctly determine the cause of the disease and select a set of medicines as soon as possible.

Signs of allergic stomatitis with a photo

There are several forms of allergic stomatitis, each of which has characteristic symptoms. All of them can lead to the development of disturbances in the functioning of the nervous system - the patient becomes irritable, emotionally unstable, sleeps poorly, carcinophobia (fear of getting cancer) may appear.

The most severe is the necrotic ulcerative variety. It is characterized by hyperemia of the mucous membranes of the mouth, the formation of multiple gray-coated ulcers. The latter have necrotic foci. Submandibular lymph nodes increase, salivation increases. The patient's body temperature rises, he complains of headaches and severe discomfort in the mouth, which is aggravated by eating.

If vesicles filled with a transparent liquid appear on the mucous membranes, this indicates a bullous form of stomatitis. Vesicles are vesicles and can be of different sizes. With the development of the disease, they burst, leaving behind erosion with a fibrous coating on their surface. At this stage, the patient notes an increase in pain, which becomes especially intense when chewing food or when talking. Several erosions can merge into a single large wound. Then the patient's condition will deteriorate sharply. Headaches will begin, appetite will decrease, fever is often observed.

There is another form of the pathology under consideration - catarrhal-hemorrhagic or catarrhal. Its main symptom is xerotomy (excessive dryness of the mucous membranes). Another pronounced symptom is the “varnished” tongue. Usually, the patient's teeth imprints are clearly visible on it. You can clearly see how stomatitis manifests itself in the photo to the article. The following signs are also present:

The reasons for the development of the disease

The cause of the development of an allergic form of stomatitis is the effect of an allergen on a person. If an irritant substance has entered the body, then the onset of an inflammatory process can become one of the symptoms of a general allergic reaction. In some cases, the allergen acts directly on the mucous membranes in the mouth, then we will talk about the manifestation of an allergy localized in the oral cavity.

A general allergic reaction, one of the symptoms of which can be stomatitis, develops when the body of a person prone to allergies is exposed to substances that cause his individual intolerance. This can be pollen from plants, bee products, food or, for example, medicines.

The development of the contact form of the disease is possible with local exposure to the allergen. In this case, dentures, mouth rinses, toothpaste, or chewable / lozenge tablets are common causes of stomatitis. Some materials used in dentistry can cause increased sensitivity of the oral mucous membranes:

There are categories of patients who are at risk of developing contact allergic stomatitis. These include people suffering from carious lesions or chronic tonsillitis. There is also a high probability of the occurrence of pathology in persons susceptible to other types of allergies, with functional disorders. endocrine system or diseases of the gastrointestinal tract in a chronic form.

In children, allergic stomatitis often develops when an irritant substance enters the body with dirty hands - for example, after touching a flowering plant, a child may lick his fingers. In some cases, allergic stomatitis can act as a sign of severe pathological processes, which include:

• exudative erythema multiforme;
• behcet's disease;
• stevens-Johnson syndrome;
• lyell's syndrome;
• scleroderma;
• vasculitis;
• systemic lupus erythematosus;
• hemorrhagic diathesis.

Features of the course of the disease in children

It is important to differentiate allergic stomatitis in children from other forms of this pathology, which require a fundamentally different approach to treatment. This can only be done by a qualified specialist. The child's immune system is imperfect, therefore, children suffer the disease much more difficult than adults. In the absence of timely treatment, a secondary infection may join, then the patient's condition will worsen, and the duration of therapy will increase.

On initial stages the development of allergic stomatitis, the child complains of a burning sensation or soreness in the mouth. On visual inspection, you can see that the tongue, cheeks, or lips are slightly swollen. The child has a lot of saliva, a layer of plaque accumulates on the tongue. Sometimes there is a sour smell from the mouth.

In children, allergic stomatitis often develops as a symptom of a general allergic reaction. Pollen, food or medications can cause it. In the contact form, the irritant enters the body from the orthodontic structures that the child wears on his teeth, with chewing sweets or with toothpaste. In younger schoolchildren and preschoolers, it can occur against the background of carious lesions.

Treatment for oral allergies

In addition to consulting an allergist, you will need to receive recommendations from a dentist. First of all, further contact with the allergen is excluded:

• hyporallergenic diet - exclude hot spices, pickled and smoked foods, red fruits, rinse your mouth with clean water or an antiseptic solution after eating;
• with a drug-induced disease, a revision of the therapeutic course is required;
• if irritants are part of the prosthesis, the latter is removed, after the completion of the treatment of stomatitis, the patient is made a structure from a different material;
• sometimes it is necessary to change the rinse aid and toothpaste.

Also, the doctor will recommend taking medications in tablet form and topical ointments. To eliminate pain in children, it is recommended to use drugs designed to facilitate teething. These are Dentol-baby, Calgel, Dentinox. Since with the development of allergic stomatitis in a child, a bacterial infection often joins, antibiotic treatment may be required. The rest of the therapy practically does not differ from the "adult" one.

Group of drugs	Examples of	Contraindications by age
Antihistamines	Suprastin	up to 3 years (there is a type of medicine for children)
	Cetrin	syrup - up to 2 years; tablets - up to 6 years
	Fenistil	up to 1 month
	Loratadin	up to 2 years
Antiseptic	Ingalipt	up to 1 year (up to three years of age, use with caution as prescribed by a doctor)
	Holisal	up to 1 year
	Hexoral	up to 3 years
	Kamistad	up to 3 months
	Vinylin	children are not recommended due to the lack of information on the safety of use in this age category
Local pain relievers	Lidochlor	contraindicated in young children
	Lidocaine Asept	up to 2 years old, apply with a tampon
Accelerating tissue regeneration	Propolis - spray	up to 12 years
	Solcoseryl	not recommended under 18

If the disease is severe, the doctor may prescribe corticosteroid therapy. In some cases, they are dripped. The drugs of this group are extremely rarely used in the treatment of children, since in such cases there is a high risk of recurrence of the inflammatory process.

Treatment of allergic stomatitis at home

Facilities traditional medicine can be an excellent addition to medication prescribed by a doctor and a hypoallergenic diet.

When treating children, it is not recommended to resort to the active use of home formulations, while if we are talking about stomatitis in an adult, which was caused by prosthetics, they will be useful and effective. Among the most popular are the following recipes:

1. Potato compress. Grate the raw potato tuber on a fine grater and apply for 10 - 15 minutes. Can be pre-wrapped in sterile gauze.
2. Fresh carrot juice. Grate raw carrots, squeeze out the juice. Dilute with warm boiled water in a 1: 1 ratio. Hold in mouth for 2 minutes and spit it out.
3. Honey infusion. Use with caution, as bee products are highly allergenic. 1 tbsp Pour chamomile with a glass of boiling water and leave for 5 minutes. Add liquid natural honey (2 tablespoons). rinse the mouth 3-4 times a day for 1 minute.
4. Herbal oil. Mix equal amounts of linseed and sea buckthorn oil with propolis and rosehip oil. Melt propolis in a water bath. With the resulting composition, you need to lubricate the wounds by rinsing your mouth before that.
5. Infusion of calendula and chamomile. Mix 1 tsp. chamomile with 1 tsp. dried and chopped calendula. Pour a glass of boiling water over. Insist for half an hour. Use for rinsing the mouth, but no more than four times a day. If you repeat the procedure more often, there is a risk of overdrying the mucous membrane.

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Causes of allergic stomatitis

The occurrence of allergic stomatitis can be associated with the penetration of the allergen into the body or direct contact with the oral mucosa. In the first case, allergic stomatitis will serve as a manifestation of a systemic reaction (to pollen, medicines, mold, food, etc.); in the second - a local reaction to irritating factors directly in contact with the mucous membrane (toothpaste, dentures, medicinal lozenges for sucking, mouth rinses, etc.).

The development of contact allergic stomatitis is most often associated with increased sensitivity to materials used in dentistry: drugs for application anesthesia, metal fillings, braces, orthodontic plates, crowns, acrylic or metal dentures.

Acrylic dentures are allergic factors, as a rule, residual monomers, in rare cases - dyes. When using metal dentures, an allergy may develop to alloys containing chromium, nickel, gold, palladium, platinum, etc. In addition, caries, chronic tonsillitis, as well as pathogens and products that accumulate in the denture bed, play a certain role in the pathogenesis of allergic stomatitis. their vital functions, which irritate the mucous membrane.

Contact allergic stomatitis is more often observed in patients suffering from chronic gastrointestinal diseases (gastritis, cholecystitis, pancreatitis, colitis, dysbiosis, helminthiasis, etc.), endocrine pathology (diabetes mellitus, hyperthyroidism, climacteric disorders, etc.). This is because organic and functional disorders with these diseases, they change the reactivity of the body, cause sensitization to contact allergens.

Other allergic diseases contribute to the development of severe forms of stomatitis: drug disease, food allergies, rhinitis, urticaria, eczema, Quincke's edema, asthmatic bronchitis, bronchial asthma, etc.

Allergic stomatitis does not always occur in isolation; sometimes it is part of the structure of systemic diseases - vasculitis, hemorrhagic diathesis, exudative erythema multiforme, systemic lupus erythematosus, scleroderma, Behcet's disease, Lyell's syndrome, Reiter's syndrome, Stevens-Johnson's syndrome, etc.

Classification of allergic stomatitis

Depending on the nature clinical manifestations distinguish between catarrhal, catarrhal-hemorrhagic, bullous, erosive, ulcerative-necrotizing allergic stomatitis.

From the point of view of etiology and pathogenesis, allergic stomatitis includes medicinal, contact (including prosthetic), toxic-allergic, autoimmune dermatostomatitis, chronic recurrent aphthous stomatitis and other forms.

Taking into account the rate of development of symptoms, allergic reactions of immediate and delayed types are distinguished: in the first case, allergic stomatitis, as a rule, proceeds in the form of angioedema of Quincke. If a delayed-type allergic reaction occurs, the symptoms of allergic stomatitis are most often detected a few days after exposure to the allergen. Sometimes allergic stomatitis on dentures develops after 5-10 years of their use, that is, after a long period of asymptomatic sensitization.

Symptoms of allergic stomatitis

The manifestations of allergic stomatitis depend on the form of the disease. So, for catarrhal and catarrhal-hemorrhagic allergic stomatitis, xerostomia (dry mouth), burning, itching, impaired taste sensitivity (sour taste, metallic taste), discomfort and soreness when eating are characteristic. An objective examination determines the hyperemic and edematous mucous membrane of the oral cavity, "lacquered" tongue; with a catarrhal-hemorrhagic form against the background of hyperemia, petechial hemorrhages stand out and bleeding of the mucous membrane is noted.

Bullous allergic stomatitis occurs with the formation of vesicles of various diameters with transparent contents in the oral cavity. Usually, after opening the blisters, allergic stomatitis turns into an erosive form with the formation of erosions on the mucous membrane covered with fibrinous plaque. The appearance of ulcers is accompanied by a sharp increase in local pain, especially when talking and eating. When individual defects merge on the mucous membrane, extensive erosive surfaces can form. A deterioration in general well-being is possible: loss of appetite, weakness, fever.

The most severe in its manifestations is the necrotic ulcerative form of allergic stomatitis. In this case, a sharp hyperemia of the mucous membrane with multiple ulcers, covered with a dirty-gray fibrinous plaque, and foci of necrosis is determined. Ulcerative-necrotizing allergic stomatitis occurs against the background of severe pain when eating, hypersalivation, high temperature, headache, submandibular lymphadenitis.

Common symptoms in allergic stomatitis may include functional disorders of the nervous system: insomnia, irritability, cancerophobia, emotional lability.

Diagnosis of allergic stomatitis

Examination of a patient with allergic stomatitis is carried out by a dentist with the involvement of related specialists, if necessary: \u200b\u200ban allergist-immunologist, a dermatologist, a rheumatologist, an endocrinologist, a gastroenterologist, etc. In this case, the collection and analysis of an allergic history and the identification of a potential allergen are important.

During a visual assessment of the oral cavity, the doctor notes the moisture content of the mucous membrane, its color, the presence and nature of defects, the type of saliva. During the dental examination, attention is drawn to the presence of dentures, fillings, orthodontic appliances in the oral cavity; their composition and terms of wearing, discoloration of metal prostheses, etc.

Chemical-spectral analysis of saliva and determination of pH make it possible to make a qualitative and quantitative assessment of the content of trace elements and to assess the ongoing electrochemical processes. Additional studies for allergic stomatitis may include biochemical analysis of saliva with determination of enzyme activity, determination of pain sensitivity of the mucous membrane, hygienic assessment of prostheses, scraping from the mucous membrane for Candida albicans, etc.

Allergic examination involves an exposure test (temporary removal of the prosthesis with an assessment of the reaction), a provocative test (returning the prosthesis to its place with an assessment of the reaction), allergic skin tests, and an immunogram study.

Differential diagnosis of allergic stomatitis must be carried out with hypovitaminosis B and C, herpetic stomatitis, candidiasis, mucosal lesions in leukemia, AIDS.

Allergic stomatitis treatment

Therapeutic measures for allergic stomatitis will depend on the cause that led to the development of the disease. The fundamental principle of the treatment of allergic diseases is the exclusion of contact with the allergen: adherence to the diet, medicinal product, refusal to wear dentures, change of mouthwash or toothpaste, etc.

Drug therapy for allergic stomatitis usually involves the appointment of antihistamines (loratadine, dimethindene maleate, chloropyramine, etc.), vitamins of group B, C, PP, folic acid. Local treatment of the oral mucosa is carried out with antiseptics, anesthetic drugs, enzymes, corticosteroid drugs, healing agents (sea buckthorn oil, etc.).

Patients who have allergic stomatitis as a complication of dental treatment need further consultation with a dentist-therapist, orthopedic dentist, orthodontist; replacement of fillings or crowns, replacement of the bracket system, prosthesis base, etc.

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Target setting. Examine the clinical picture and measures emergency care in acute allergic conditions. To get acquainted with the clinical manifestations in the oral cavity of drug and microbial allergies, learn differential diagnosis and treatment methods.

Anaphylactic shock... Distinguish between mild, moderate and severe forms of anaphylactic shock. With a mild form in the prodromal period, patients complain of weakness, itching of the skin, sore throat, and abdominal pain. If you do not provide help in a timely manner, then the patients will lose consciousness.
In severe cases, patients lose consciousness in the first minutes (sometimes seconds). The skin first turns pale, then acquires a cyanotic hue, cold sweat appears on the forehead. Blood pressure drops progressively and may not be detected, as vascular collapse develops. Pulse threadlike, barely detectable. The pupils are dilated, react weakly (or do not react) to light (during fainting, the pupils react actively to light). Often clonic seizures, remotely audible dry wheezing, involuntary defecation and urination.

Urgent care... The patient must be laid down so that the legs are slightly raised. 0.5 ml of 0.1% adrenaline solution is urgently injected intravenously in order to normalize blood pressure... If adrenaline cannot be administered intravenously, it is administered subcutaneously or intramuscularly. If necessary, the injection of adrenaline is repeated after 10-15 minutes. To avoid an overdose of adrenaline, mezaton can be administered intravenously (0.3 or 0.5 ml of a 1% solution in 20-40 ml of a 20% glucose solution).
With anaphylactic shock, biologically active substances, primarily histamine, are released into the blood in large quantities. Therefore, it is urgent to inject intravenously antihistamines, as well as corticosteroids (50-100 mg of hydrocortisone, or 30 mg of prednisolone, or 4.8 mg of dexamethasone in 10 ml of 20% glucose solution). If corticosteroids are not available for intravenous administration, then 135 mg of hydrocortisone is injected intramuscularly. Next, you need to give the patient oxygen, provide an influx of fresh air, apply a heating pad to the legs. When indicated (bronchospasm), 10 ml of a 2-4% solution of aminophylline in 10 ml of a 20% glucose solution is injected intravenously. To improve cardiac activity, 1 ml of 0.06% corglikon solution is added to these solutions. A resuscitator is called in without fail, after removal from anaphylactic shock, the patient is hospitalized.
The defeat of the oral mucosa with drug allergies. Diagnosis of such lesions is not difficult if there are skin rashes. A carefully collected allergic anamnesis also allows to establish the allergic genesis of manifestations in the oral cavity and to suggest a specific allergen. It is also important to take into account the features of the clinical course of drug allergy, in particular the nature of the rash. Medicinal allergic rashes on the mucous membranes and skin are polymorphic. They can be spotty, papular, vesicular, bullous, etc. Rashes on the skin and mucous membranes of the mouth with drug allergies can resemble the rashes observed in eczema, erythema multiforme, lichen planus, lichen rosacea.
Drug allergy is characterized by a sudden paroxysmal onset with the involvement of several organs and systems in the process, sometimes with severe general symptoms and a febrile state, as well as the relative independence of symptoms from the acting medication. The same medicine can cause a wide variety of allergic changes and the same allergy symptom can be caused by a wide variety of medicines.
Catarrhal changes with drug allergies can be observed on the entire mucous membrane of the mouth and lips or in some of its areas. At the beginning of the development of the process, patients note a slight burning or itching in the affected area, then pain and dryness in the oral cavity appear. On examination, limited or diffuse foci of bright red hyperemia, sometimes with a bluish tint, are revealed. The mucous membrane is usually edematous, with pronounced imprints of teeth on the cheeks and lateral surface of the tongue. The tongue is hyperemic, there is atrophy of the filiform papillae, which look like varnished. Gingival papillae are enlarged, swollen, painful, bleed easily when touched. Sometimes on the hyperemic mucous membrane of the mouth there may be hemorrhagic rashes. Catarrhal changes usually occur on the 2-4th day after repeated administration of the allergen drug, less often at a later date. Catarrhal symptoms are usually mild. They are quickly eliminated after the withdrawal of allergenic medications.
To differentiate catarrhal lesions of the oral cavity of allergic genesis follows from similar manifestations in diabetes mellitus, hypovitaminosis B12, B2, fungal infections.

Erosive lesions of the oral mucosa... More often occur after taking sulfonamides, iodine, acetylsalicylic acid, prednisolone series drugs. The onset of the disease is characterized by a burning sensation and itching in certain areas of the mucous membrane and skin. A few hours or days later, single or multiple erythemal spots and subepithelial blisters of various sizes (from 3 to 10 mm or more) appear on the mucous membrane. The bubbles are usually filled with clear liquid; due to constant injury from teeth, solid food or dentures, the blister cover quickly ruptures, exposing erosive surfaces. Erosion causes soreness and bleeding to touch. Localization of lesion elements can be very different, including keratinized and non-keratinized areas of the oral mucosa.
In some cases, erosion merges, spreading to the entire mucous membrane of the mouth. The tongue is usually coated, swollen. Gingival papillae are swollen, hyperemic, bleed easily. The submandibular lymph nodes are enlarged, painful on palpation.
Sometimes, on taking sulfonamides and iodine preparations, so-called fixed erythema or erosion develops. With repeated administrations of these drugs, the corresponding changes are repeated on the previous strictly limited areas of the mucous membrane or skin. Therefore, they are called fixed. In the mouth, fixed lesions are more often localized on the back of the tongue.
The general condition of patients with erosive lesions of the oral cavity does not always suffer. In a mild form, minor malaise may occur without an increase in body temperature. In more severe cases, when the entire mucous membrane of the mouth and most of the skin is involved in the process, the body temperature may rise, and the state of health may worsen. There is an increase in regional lymph nodes, they are mobile, painful on palpation.
Conditions in which all the mucous membranes and skin are involved in the inflammatory process are described in the literature as mucocutaneous syndromes (Layla, Stevens-Johnson).
It is necessary to differentiate erosive lesions of the oral mucosa of allergic genesis from similar lesions with exudative erythema multiforme, pemphigus, acute herpetic stomatitis.
Anamnesis (burdened allergic heredity) is essential in the diagnosis of allergic lesions, additional methods examinations (histamine-peptic index, specific release of histamine by leukocytes, basophil degranulation test, etc.). Skin tests can only be performed during remission.
Treatment... Depending on the severity and prevalence of the pathological process, antihistamines are prescribed intramuscularly (1% solution of diphenhydramine, 2 ml 2 - 3 times a day, or 2% solution of suprastin, 1 ml 2 - 3 times a day, or diphenhydramine, 0.05 g 3 times a day, or suprastin 0.025 g 3 times a day, tavegil 0.001 g 2 times a day, diazolin 0.1 g 2 times a day, fencarol 0.05 g 3 times a day, e-aminocaproic acid, protease inhibitors - trasilol, counterkal). A good therapeutic effect is observed from intravenous administration of 10 ml of 30% sodium thiosulfate solution. In mild cases, withdrawal of the allergen medication is sufficient.
Local treatment includes irrigation of the oral cavity with anesthetic aerosols, corticosteroids, antihistamine baths, application of ointments containing corticosteroids. Usually, after three days of using these drugs, there is a significant decrease in the inflammatory process, a tendency to epithelialization of erosions. At this stage, corticosteroids can be canceled by limiting local treatment to antiseptic rinsing and applications of keratoplastic agents (carotolin, rosehip and sea buckthorn oil, oil solution of vitamins A, E, etc.).
Prevention. The allergen drug is canceled for a long time or for life.

Contact allergic stomatitis... According to the mechanism of occurrence of changes in the oral mucosa with contact allergies, they are referred to as delayed-type reactions. The cause of these changes is an increased sensitivity to materials and preparations used in dentistry. Most often, an allergic reaction occurs when using acrylic dentures.
Changes in the mucous membrane usually appear 7-14 days after contact with the allergen in the form of hyperemia, punctate hemorrhages. Bubbles and erosion are much less common. Typically, the lesions of the oral mucosa are limited to the point of contact with the material. Sometimes the lesions spread to the skin around the mouth, to other areas.
One of the first symptoms of contact allergy is a burning sensation of the mucous membrane of the mouth and dryness, to which loss of taste and nausea can be added. In severe cases, dizziness and respiratory failure are possible.
It is believed that the decrease in the tolerance of prostheses increases with the increase in the time elapsed after their manufacture.
In addition to methyl methacrylate and dyes that make up the prosthesis, alloys used in dentistry (cobalt chromium, etc.) and even gold can be allergens. The claims that mercury from amalgam causes sensitization of the body is highly exaggerated, given the frequency of amalgam use and cases of hypersensitivity to it. But if an allergy to amalgam occurs, then it is manifested by burning, hyperemia, swelling, and sometimes the appearance of erosion.
When diagnosing, great importance is attached to anamnesis, since contact allergy is more often observed in persons with an "allergic history". An elimination test is important - removing the prosthesis from the oral cavity for 3 - 5 days. Withdrawal from the use of prostheses led to significant improvement, and the use of them led to relapse. For diagnostic purposes, skin tests and other laboratory methods can be used.

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The reasons

The defeat of the lips, extending to the mucous membrane and the red border, is called cheilitis, and the pathological process localized in the area of \u200b\u200bthe tongue is called glossitis. Both cheilitis and glossitis are more often distinguished as symptoms of various diseases and are considered as an independent pathology in very rare cases. Allergy to lips and tongue occurs:

1. In case of hypersensitivity to chemicals, which include components of dental materials (metal alloys, ceramics, cements, etc.), decorative cosmetics, oral care products (toothpastes, rinses), office supplies (pencils, pens with the habit of holding in your mouth), candy, and chewing gum. Also, the etiological factor may be the use of musical instruments, when working with which contact with the lips is required to create sound.
2. With increased sensitivity to sunlight.
3. In patients with atopic dermatitis, eczema, chronic stomatitis.

The types of lesions of the lips and tongue of an allergic nature can be presented in the list:

• contact cheilitis;
• contact glossitis;
• actinic cheilitis;
• atopic cheilitis;
• eczematous cheilitis.

Symptoms

Contact allergic cheilitis is caused by a delayed-type reaction and is recorded mainly in women; lip allergy symptoms include:

• severe itching;
• severe swelling;
• redness;
• burning sensation;
• the appearance of small bubbles;
• erosion after the opening of the bubbles;
• peeling.

The disease worsens after repeated contact with the allergen. With a widespread lesion, patients complain of soreness, which increases during eating, talking. Allergic contact glossitis, or allergy in the tongue, in many cases is combined with cheilitis; the tongue turns red, the papillae are atrophied when viewed, gustatory sensitivity may be impaired.

Actinic cheilitis is understood as inflammation of the lip tissue caused by the influence of sunlight. The exudative form is manifested by the presence of a rash on the lips in the form of bubbles, after which erosion and crusts are found, painful when in contact with food, with pressure, with lip movement. There is also swelling and redness, itching of varying intensity. Patients suffering from the dry form of actinic cheilitis complain of burning sensation and severe dryness of the lips, the appearance of peeling - gray, whitish scales. The lips turn red, erosion may appear.

Atopic cheilitis is a pathology that occurs most often in children who have been diagnosed with atopic dermatitis.

Changes are most pronounced in the area of \u200b\u200bthe corners of the mouth and are manifested by itching, pain when opening the mouth, a feeling of tightness, dryness and flaking, cracks that bleed when damaged. Allergies around the mouth can be complicated by the addition of a bacterial, viral or fungal infection.

Acute eczematous cheilitis is characterized by:

• redness and swelling of the lips;
• intense itching;
• the presence of a rash in the form of bubbles;
• the presence of erosion and "serous wells", crusts;
• peeling.

"Serous wells" are erosions that remain after the blisters have opened due to the presence of serous discharge. Drying of the "well" leads to the appearance of yellowish crusts.

In the chronic course of eczematous cheilitis, there is a thickening of the lip tissue, the appearance of a rash in the form of bubbles, nodules. Painful cracks, crusts, and peeling areas appear.

Chronic aphthous stomatitis is a disease with a chronic recurrent course, the exact cause of which is unknown. It is characterized by the presence of aft - erosions or ulcers localized on the mucous membrane of the oral cavity. Scientists are inclined to believe that the development of aphthous stomatitis is due to allergic mechanisms in combination with a violation of the immune status. The presence of chronic pathology of the gastrointestinal tract, infection with viruses, bacteria and fungal agents is of decisive importance. The vast majority of patients are children of various age groups. Symptoms of oral allergy occur such as:

1. Burning and itching in the affected area.
2. Soreness while talking, eating.
3. The presence of aphthae of a round or oval shape on the mucous membrane of the lips, tongue, cheeks, gums.

Aphthae are observed for two weeks, can become covered with a grayish tinge or transform into deeper lesions - ulcers that heal with scarring.

Diagnostics

For this, a survey is conducted with a detailed clarification of aspects of professional activity, a description of episodes of exacerbations, if they happened in the past. For example, the patient may notice that the rash and itching appeared after using certain lipstick or visiting the dentist.

Additionally, diagnostic tests such as general analysis blood, skin tests. In the case of aphthous stomatitis, it is necessary to search for foci of chronic infection, therefore, the range of examination methods is significantly expanding, including a biochemical blood test, electrocardiography, X-ray of the chest organs, determination of markers of chronic hepatitis, etc. dermatologist, if necessary, patients are consulted by doctors of related specialties.

Treatment

In the case of allergic contact cheilitis and / or glossitis, it is necessary to find the allergen and further prevent contact with it (replace the denture, use other cosmetics). Antihistamines, cromones (cetirizine, ketotifen), ointments with glucocorticosteroids (elok) are used.

With actinic cheilitis, the main preventive measure for exacerbations is to reduce the duration of exposure to the sun, especially if the patient's professional activity involves working in conditions of solar insolation. Prescribe creams with the effect of sun protection, ointments with glucocorticosteroids, vitamin therapy.

• In the therapy of atopic cheilitis, they use:
• antihistamines (tavegil, zyrtec);
• desensitizing agents (sodium thiosulfate);
• glucocorticosteroids (prednisolone, mometasone);
• sedatives (seduxen).

You can also use histaglobulin - a drug that is a complex of human immunoglobulin and histamine. It has an anti-allergic effect by inactivating free serum histamine. Introduced intradermally.

Treatment of eczematous cheilitis is carried out with antihistamines, desensitizing, sedative drugs. Local therapy with the use of corticosteroid ointments is mandatory. The effect of a helium-neon laser is also used.

In the treatment of chronic aphthous stomatitis necessary drugs are antihistamines (zaditen), vitamins (ascorutin), antiseptics (miramistin), local anesthetics (lidocaine), immunostimulants (imudon). Films with atropine, antibacterial agents, anesthetics are used. Solcoseryl is prescribed to restore the epithelium. It also requires the rehabilitation of foci of chronic infection, physiotherapy (helium-neon laser).

proallergen.ru

The reasons

Allergies can occur in patients at any age, even if in the past no inappropriate reactions to plants, medications, pollen and other allergens were noticed. The appearance of such reactions of the body may indicate malfunctioning of the immune system or genetic changes in the patient's body. Blood cells, which are responsible for the formation of antibodies to pathogenic microorganisms, at some point can react negatively to substances in the body, which causes allergies.

According to experts, about a third of the world's population suffers from severe allergies. About 20% of all rashes occur in the mouth.

Experts distinguish two groups of causes of the onset of the disease:

1. Substances that enter the patient's body. These include medications, pollen, mold, and more. Such substances can cause peculiar reactions of the immune system, expressed in rashes, burning and itching of soft tissues, the oral mucosa. Immunity can react adversely not only to potent and antibiotic drugs, but also to any other drugs. A negative reaction of the skin and mucous membranes can also be caused by hormonal disruptions or poor ecology;
2. Substances that come into contact with the oral mucosa. These include objects that have a direct effect on the mucous membrane and irritate it. For example, low-quality dentures can cause allergic reactions. Pathogenic microorganisms and their waste products that accumulate in the prosthesis bed can irritate the mucous membrane. Contact type allergic stomatitis can be triggered by medications used in dental treatment.

Classification

Experts distinguish between the following forms of the disease:

• Catarrhal form
• Catarrhal-hemorrhagic form
• Bullous form
• Erosive form
• Necrotic ulcerative form

Depending on the pathogenesis (origin) and etiology (causes), allergic stomatitis includes drug, toxic-allergic, contact and autoimmune dermostomatitis, recurrent chronic aphthous stomatitis and other forms.

According to the rate of development of clinical manifestations, allergies of the delayed and immediate types are distinguished. In the first case, the symptoms are revealed some time after the irritating influence. In the second case, the disease proceeds in the form of Quincke's edema (acute angioedema, life-threatening to the patient).

Clinical manifestations

Common symptoms

In most cases, the symptoms of allergic stomatitis are as follows:

1. Swelling and hyperemia (redness) of the oral mucosa
2. Burning, itching, swelling in the mouth, pain with any irritation of the mucous membrane
3. Swelling, excessive shine and smoothness of the tongue
4. The possibility of a rash on the labial surface
5. The presence of watery blisters, in case of bursting of which sores are exposed

IMPORTANT: Allergy to dentures can be complemented by symptoms such as attacks of bronchial asthma, sore throat, bitterness and tingling in the mouth, changes in salivation.

Symptoms in children

Since the oral cavity is connected with other organs ( respiratory system, gastrointestinal tract), the baby may have digestive problems, difficulty breathing, excessive salivation, loss of taste.

According to experts, such signs are usually provoked by the following factors:

• Consuming junk food
• Overheating of the body
• Extensive tooth decay
• Taking medications
• In some cases, placing a seal, wearing a bracket system

Treatment of children's illness can be complicated by chronic pathologies and weakness of the immune system.

Diagnostics

Diagnosis of a disease involves the collection of information by a specialist about the allergen for its rapid identification and initiation of therapy. It also requires a visual examination of the state of the oral mucosa. In the presence of orthodontic or dental structures, their service life and the material from which they are made are established.

The doctor conducts a chemical analysis of the composition of saliva (taking into account the acidity level). This is necessary to identify trace elements and their content in saliva, to establish current electrochemical reactions. Sometimes a biochemical analysis is required to determine the enzymatic activity and the patient's pain threshold.

Additionally, the analysis of the composition of the installed structures is carried out, the taking of allergy samples and scrapings from the mucous membrane to check for the fungus Candida albicans.

Treatment

Before treating the disease, it is necessary to identify and eliminate the cause of its occurrence. When symptoms appear, you should visit a dentist, according to his appointment, a visit to an endocrinologist, dermatologist, gastroenterologist, allergist-immunologist may be required.

The specialist first of all pays attention to the condition and color of the mucous membrane, the presence of ulcers and their location, the quality and condition of the installed dental fillings and prostheses. To find the main allergen, a number of the following tests are required:

1. General analysis of blood and urine
2. Chemical spectral analysis of saliva
3. Scraping from the mucous membrane
4. Biochemical analysis of saliva for enzymatic activity
5. Immunogram (indicators of the patient's immune system)
6. Skin allergy tests

IMPORTANT: If there are dental or orthodontic constructions, the doctor can temporarily remove them and understand how effective this measure is.

In case of allergic stomatitis, treatment requires the elimination of contact with the allergen, therefore, it may be necessary to revise the diet, replace structures, medications and oral care products. With development against the background of eczema, lupus erythematosus, urticaria, bronchial asthma and other ailments, treatment of a systemic disease is necessary.

For treatment, antihistamines (antiallergic) drugs can be prescribed, for example, Zodak, Tavegil, Suprastin, Loratadin, Fenistil. In severe cases, the doctor will prescribe intravenous injections of glucocorticosteroids. With severe pain, pain relievers are required (Analgin, Ketorol, Ibuprofen). Additionally, the doctor may prescribe the intake of vitamins C, B, PP and A. Mild forms of the disease are treated with wound-healing and antiseptic mouth rinses with Chlorhexidine or Miramistin solutions. To treat the affected area, dental gel-like products Kamistad and Cholisal, Solcoseryl paste, sea buckthorn oil are used.

Forecast and prevention

Timely detection of the disease allows you to quickly (within a couple of weeks) eliminate it in the initial stages. In other cases, the treatment lasts much longer.

Prevention requires the following measures:

• Proper nutrition
• Strengthening the immune system
• Regular oral hygiene, control over its condition
• Timely treatment of caries and gum diseases
• Preventive visits to the dentist for removing dental plaque, correcting dentures and replacing them if necessary
• Use of quality materials in the treatment and prosthetics of teeth