Mouth inflammation: A warning sign from our body

mouth inflammation

What is mouth inflammation?

A mouth inflammation is a reaction triggered by our body to aggression. In normal circumstances, inflammation is meant to protect us from all substances not recognized by our bodies. But it becomes destructive when it lasts too long or occurs in unwanted areas.

Oral inflammation can affect different mouth sites, including the tongue, cheeks, roof, lips, and gums.

The telltale signs are redness, painful ulcerations or canker sores, and increased saliva production. Your general condition may also deteriorate with malaise, fever, and swollen lymph nodes. If the situation worsens, don't delay seeing your doctor.

Oral inflammation is often painful and can interfere with simple daily activities such as eating, swallowing, drinking, and speaking. These situations represent an emergency that must be managed as quickly as possible.

Diagnosis of mouth inflammation

The diagnosis is made in the manner of a detective who wants to solve a crime. It is sometimes simple and obtained from the interrogation and the visual evaluation of the injuries. These lesions can be:

  • Erythema: Redness of the tissues of the mouth.
  • Papule: A small, solid, raised bump, not filled with liquid or pus.
  • Pustule: A small, inflamed, blister-like lesion filled with pus.
  • Ulceration: Also called canker sore or aphthous ulceration. It is a deep lesion that results in tissue loss. Canker sores are usually painful.

The diagnosis sometimes can be hard to establish and requires a more thorough clinical examination.
Your doctor may order additional tests. He or she may ask you to have a blood test, blood sugar test, kidney and liver function test, HIV test, syphilis test, and an X-ray.
Sometimes, a biopsy must be performed to confirm the diagnosis. It consists of removing a piece of tissue for microscopic examination.

Mouth inflammation types

Mouth inflammation can have various origins. Different terms can be used depending on the cause. For example, aphthous stomatitis refers to inflammation associated with aphthae or canker sores. And herpetic stomatitis refers to inflammation associated with the herpes virus.
Among the most common forms of mouth inflammation:

Mouth inflammation due to an infection

Bacterial infection


Bacterial infection can affect the mouth tissues directly or through the bloodstream.
Local mouth infection is manifested primarily by gum disease. Under certain conditions, aggressive oral bacteria will proliferate and irritate the gum. The gum becomes inflamed with redness, swelling, and bleeding.
The general bacterial infections most involved in oral inflammation are tuberculosis and syphilis. They cause painful ulcers in different parts of the mouth, with swelling of the nodes under the lower jaw.

Viral infection


Some viruses can affect our mouths, causing fluid-filled blisters that eventually break open to give painful ulcers. The herpes simplex virus is the most common of these and causes herpetic gingivostomatitis characterized by the appearance of small blisters in the mouth with an extension around the lips. Other viruses involved are varicella-zoster and HIV.

Fungal infection


The most common fungal infection of the mouth is candidosis or oral thrush. The fungus is called Candida Albicans.
In healthy people, it lives in the mouth without causing any damage. But certain factors, such as poor oral hygiene and a weakened immune system, can make it pathogenic and able to proliferate and invade the deep tissues.
Although any site in the mouth can be affected, the tongue and palate are the most affected. Candidiasis leads to diffuse red areas in the mouth with a burning sensation and discomfort, bad taste, and dry mouth.

Other forms of mouth inflammation

Aphthous stomatitis


Aphthous stomatitis is a collection of painful sores in the mouth. It affects at least 15-20% of the population and appears as a yellow ulcer, round or oval shape, with a red outer ring. They usually last 8 to 10 days and disappear without leaving a scar.

There are three types of aphthous ulcers: minor, major, and herpetiform.
The most frequent is the minor aphthous ulcer, where a small number of ulcers of small diameter between 2 and 5mm appear.
Major canker sores have more severe symptoms with ulceration of 1 to 3 cm in diameter that occurs either singly or two or three at a time and last longer, from 4 to 6 weeks.
Herpetiform canker sores have ulcers similar to those of minor canker sores, but in this form, the number of ulcers is increased and often involves up to 50 separate lesions. It resembles the ulceration seen in herpetic infection without involving the herpes virus.

The exact causes of aphthous stomatitis are not yet recognized, and only a few probable factors have been identified, among them:
  • Stress
  • Nutritional deficiency, especially in iron, vitamin B12, and folic acid
  • Genetic predisposition
  • Trauma
  • Allergy to certain foods
  • Certain systemic diseases

Inflammation of the mouth due to injury or irritation


Any injury inflicted to the mouth can cause inflammation and ulceration. They can be due to accidental biting of the lip or cheek, ill-fitting dentures, and mouth burns from hot food or drinks.

In addition, some people may be hypersensitive to certain foods and chemicals, which can irritate or trigger some allergic reactions, leading to a burning sensation in the mouth. Acidic foods, cinnamon flavors, or astringents can be irritating, as can some components of some products such as toothpaste, mouthwashes, candies, and gums.

Oral inflammation due to nutritional deficiency


Inflammation of the mouth can be related to a nutritional deficiency.
A deficiency of the B vitamins can lead to inflammation of various parts of the mouth, including the gums, tongue, and lips.
Vitamin C is highly linked to periodontal or gum disease. A deficiency of this nutrient can aggravate gum inflammation and lead to rapid loosening of the teeth.
A deficiency of iron can cause paleness and lead to ulceration, irritation, and inflammation of different areas in the mouth.
Other essential nutrients for oral health are vitamin A, vitamin D, calcium, copper, zinc, and magnesium.

Oral inflammation due to certain health disorders


Many health conditions lead to oral symptoms. Among them:

  • Blood disorder: Neutropenia is the decrease of immune cells circulating in the blood. The mouth may have a single or small number of ulcers with painful and severe gum disease.
    Anemia is a blood disorder where hemoglobin, a protein that transports oxygen in the blood, decreases. Anemia can lead to ulceration, irritation of the tongue with pain in contact with food, and inflammation of the corners of the mouth.
    Leukemia or blood cancer is the proliferation of immune cells that have not completed their maturation in the blood and a decrease in the number of normal mature cells. Leukemia increases the risk of mouth infection and can lead to ulceration, oral tissues swelling, and gingival overgrowth with severe bleeding.
  • Dermatological disease: Some skin diseases such as pemphigus, pemphigoid, or lupus can injure the mouth.
    These are autoimmune diseases in which the immune system breaks down and attacks the body's cells.
    Among the tissues affected are those of the mouth. Pemphigus and pemphigoid cause blister-like lesions that break off and leave painful ulcers. Lupus causes pink-colored sores.
    Another skin disease that affects about 1% of the population is lichen planus. It is due to abnormal immune reactions that attack the cells of the mouth and cause the formation of white spots. This disease is worsened by stress, and if left untreated, it can develop into a malignant lesion.
  • Metabolic disorder: Diseases that affect the body's metabolism, such as diabetes mellitus, can affect the mouth by increasing the risk of infections and aggravating gum disease. Diabetes also causes dry mouth, thus, depriving it of the protective and lubricating role of saliva.

Oral inflammation induced by chemotherapy and radiotherapy


Cancer treatments, including chemotherapy and radiotherapy, act on the malignant tumor but also the oral cells. These treatments can cause irritation, ulceration, and burning in the mouth. They also cause dry mouth and increase the risk of viral, bacterial, and fungal infections by weakening the immune system.
These symptoms are sometimes associated with difficulty chewing, swallowing, or speaking.

Smoking and stomatitis


Tobacco is the main factor of oral cancers. Smokers are 20 times more exposed to the disease than non-smokers. It is also an aggravating factor in mouth ulcerations.
Tobacco smoke exposes the mouth to nearly 55 carcinogenic substances, dries out, and increases the acidity and temperature of the mouth. It disrupts the oral microbiome and decreases the resistance to oral infections. The risks of smoking increase significantly with the number of packs smoked per day.

Tobacco also causes a particular form of inflammation called nicotine stomatitis. It leads to multiple red spots on the roof of the mouth that disappear within weeks of quitting.

In addition, smoking is linked to leukoplakia, a thick, whitish, non-detachable plaque. It can form on the lips, gums, and mucous membrane of the cheek. Leukoplakia accounts for 85% of pre-cancerous lesions that affect the mouth.

Oral cancer


Oral cancer represents 3% of all cancers. Each year, 500,000 new cases are diagnosed. The main factor is tobacco and alcohol consumption.

The most common form is called squamous cell carcinoma, which can occur in any part of the oral mucosa, but the most affected areas are the edges of the tongue, the lower lip, the floor of the mouth, the gum, the roof, and the inner part of the cheeks.

The most frequent symptom is an irregular, elevated ulcer or lesion in the mouth that does not heal. At the early stage, it is not painful, but at an advanced stage, it can cause significant pain.

Factors that worsen mouth inflammation

Some factors significantly increase the risk of mouth inflammation. Among them:

  • Smoking
  • Alcohol consumption
  • Poor oral hygiene
  • An unbalanced diet
  • Health conditions that weaken our immune system
  • Treatment by chemotherapy or radiotherapy

Wo are the people at the highest risk?

Oral inflammation can affect anyone, but some people are more vulnerable. Among them:

  • People with HIV, herpes, syphilis, or tuberculosis are frequently affected by stomatitis.
  • People with blood, metabolic, or hormonal disorders are also more affected.
  • The elderly are more susceptible to oral candidiasis, a fungal infection caused by Candida Albicans. They may also develop shingles resulting from the reactivation of the varicella-zoster virus.

Treatment of mouth inflammation

Any oral inflammation that lasts more than ten days should lead you to visit your doctor.

First, he or she will establish a diagnosis, and look for causes and aggravating factors to indicate the appropriate treatment to follow.

Whatever the cause is, you will be prescribed an antiseptic and an analgesic to counter the infection and relieve the pain.

Then, your dentist will clean your mouth by removing tartar, cavities, and dental infections and extracting teeth that are too damaged.

If your mouth does not produce enough saliva, you may suffer from xerostomia or dry mouth. Treatments include salivary substitutes, chewing gums, oral lubricants, or salivary gland stimulants.

In case of an oral inflammation related to a nutritional deficiency, you should correct it through a food supplement or your diet.

If syphilis or tuberculosis infection is confirmed, your doctor will plan treatment with antibiotics. For viral stomatitis, you will need to take antivirals.
If you have oral candidiasis, you will need to apply topical antifungals to the lesions.

Weakening of the immune system due to certain diseases, such as AIDS or blood/metabolic disorders, must be managed.

Your doctor will suggest corticosteroid therapy for canker sores and certain autoimmune diseases.

Finally, if a medication is the root cause of mouth inflammation, it must be stopped or replaced.

During the mouth inflammation treatment, you should:
  • Follow the medication prescribed by your doctor.
  • Follow a thorough daily oral hygiene routine.
  • Use additional tools for tooth brushing, such as dental floss and antimicrobial mouthwashes.
  • Avoid smoking.
  • Avoid hot, spicy, and acidic foods, as they can aggravate pain when in contact with inflamed areas.
  • Opt for fresh foods such as milk, yogurt, and ice cream, and drink enough water to hydrate your mouth.

Prevention

Prevention of all forms of oral inflammation begins with a daily oral hygiene routine. Brush your teeth at least twice a day and clean your interdental spaces with dental floss or an interdental brush.

Have regular visits to your dentist for check-ups and a professional cleaning to prevent gum disease.

Last but not least, pay attention to your diet. A healthy and balanced diet is essential for your oral and general health.