Stomatitis disease is an inflamed and sore inside of the cheeks, gums, tongue, lips, and palate. Stomatitis can severely affect speech; eating ability, nutrition, body image, sleep and overall quality of life. The ulceration causes pain, bleeding and infection. Stomatitis treatment includes oral hygiene, antiviral medication, topical or parental analgesia. Nurses play an important role in maintaining and restoring healthy oral cavity through nursing interventions.
The patient will report less discomfort in her mouth while eating or drinking and mucous membranes will be free from harmful plaque. Nurse will help to prevent secondary infection throughout hospital stay.
Definition of Stomatitis Disease:
Stomatitis refers to inflammation of the mucous membrane of the mouth including the inside of the cheeks, gums, tongue, lips and palate.
Types of Stomatitis Disease:
There are three types of stomatitis, those ares-
- Kanker Sore (Aphthous Stomatitis),
- Cold Sore (Fever Blisters),
- Herpes Stomatitis.
These are discussed in the below:
1. Kanker Sore (Aphthous Stomatitis):
Kanker Sore (Aphthous Stomatitis) is a single pill or a cluster of small pits or ulcer in the mouth. Usually kanker sore appears on the cheeks, tongue, or inside the lip.
2. Cold Sore (Fever Blisters):
Cold Sore (Fever Blisters) is filled with fluid that usually appears on lip or around the lips.
3. Herpes Stomatitis:
Herpes Stomatitis is a viral infection of the mouth that cause sores and ulcers. Usually in age children between six months to five years aged. Herpes simplex1 (HSV1) virus is the cause of infection.
Causes of Stomatitis Disease:
Various types of causes for stomatitis are mentioned in the below:
- Bacteria/Virus (Herpes Simplex type-1).
- Nutritional deficiency (Vitamin B12, Folic acid, Iron or Zinc).
- Sudden weight loss.
- Food sensitivities to potatoes, citrus, fruits, strawberries, chocolate, eggs, cheese or nuts.
- Inflammatory bowel disease.
- HIV/ AIDS.
- Weak immune system.
- Hormonal changes.
- Stress and lack of sleep.
- Use of certain medications such as Chemotherapy, Diuretics, Anticholinergics, Antihistamines and decongestants, Steroids, Antidepressants.
- Allergic reaction.
- Accidental injury.
- Sharp tooth surface, dental braces or retainers.
- Tobacco or irritating foods or chemicals.
Sign and Symptoms of Stomatitis Disease:
There are different types of sign and symptoms for stomatitis disease are mentioned in the below:
- Blister over gums, palate, check, tongue or lip,
- Difficulty of eating, drinking and swallowing,
- Drooling, pain and swelling,
- Red patches,
- Oral dysaesthesia,
- Burning mouth syndrome.
Test and Diagnosis for Stomatitis Disease:
Various ways of test and diagnosis system for stomatitis disease are given in the below:
- Bacterial or viral swabs culture,
- Patch tests,
- Blood test.
Treatment for Stomatitis Disease:
There are different types of treatment for stomatitis disease; those are mentioned in the following:
- Oral hygiene,
- Identify and treat cause,
- Use antiviral drug acyclovir,
- Coating agents such as bismuth Salicylate, Sucralfate, or other Antacids,
- Topical Analgesics, such as Benzydamine Hydrochloride,
- In severe pain use Topical Anesthetics, such as Lidocaine viscous (might impair gag reflex for a short period),
- Oral or parenteral analgesics such as Tylenol or ibuprofen when not control by above medication,
- Apply a paste of Triamcinolone,
- Water-soluble lubricants for mouth and lips,
- Rinse and expectorate after meals with Inj.Dexamethasone (0.5mg) / 5ml water.
- In nutritional deficiency is the cause of Stomatitis take floate (folic acid), vitamin B12.
Treatment of severe stomatitis sore may includes-
- Aphthasol paste (Anti-inflammatory paste),
- Lidex gel,
- Peridex mouthwash.
Prevention of Stomatitis Disease:
Various types of prevention for stomatitis disease are given in the below:
- Wash hands frequently,
- Keep toys, brush clean and don’t share with others,
- Don’t share dishes, cups, or eating utensils,
- Don’t kiss affected person.
Nursing Intervention for Stomatitis Disease:
There are different types of nursing interventions for stomatitis disease, those are mentioned in the following:
- Give cool, noncarbonated, non-acidic drinks, such as water, milk shakes, or diluted apple juice to patient.
- Encourage use of a straw to make swallowing easier.
- Provide high in protein and vitamins containing diet to promote healing and new tissue growth.
- Serve frequent small meals or snacks spaced throughout the Day to maintain fluid balance and nutrition.
- Offer cool, bland, easy-to-swallow foods such as frozen pops, ice cream, mashed potatoes, gelatine, or applesauce to patient to avoid tissue trauma and pain.
- Encourage client to suck on vitamin C or sugarless candy or chew sugarless gum to stimulate salivation.
- Encourage a fluid intake of at least 2500 ml/day unless contraindicated.
- Apply topical analgesia over lesion 15 to 20 minutes before meals, or painted on each lesion immediately before mealtime.
- Give Acyclovir to patient that fights the virus causing the infection.
- Give pain killer acetaminophen or ibuprofen for pain as order.
- Administer medications, which may include antifungal agent, or topical or systemic analgesics.
- Give mouth care and gently brush teeth every day instruct and assist client to perform oral hygiene using a soft bristle toothbrush or sponge-tipped swab.
- Discontinue flossing if it causes pain.
- Encourage client rinse mouth frequently with warm saline solution, baking soda and water, or Chlorhexidine, Gluconate (Peridex) or mist oral cavity frequently using a spray bottle.
- Numbing medicine (Viscous Lidocaine) apply to patient mouth to ease severe pain.
- Avoid use of products that contain lemon and glycerine and mouthwashes containing alcohol.
- Lubricate client’s lips frequently.
- If stomatitis is not severe, encourage client to use artificial saliva to lubricate the oral mucous membrane.
- Make sure gets plenty of sleep and rests as much as possible.
- Encourage client to chew on ice during chemotherapy infusion, especially if receiving 5-fluorouracil.
- Avoid serve hot beverages, salty, spicy and citrus based foods and explain to patient.
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