Updated on April 26, 2024
6 min read

What is Stomatitis and How Does It Affect Oral Health?

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What is Stomatitis?

Stomatitis is a general term for inflammation of the mouth and lips. It includes conditions that affect the tongue, gums, and other parts of the mouth. Some types of stomatitis involve ulcers (sores).

Vector illustration of aphthous stomatitis

Common Symptoms of Stomatitis

Potential symptoms of stomatitis include:

  • Painful soreness in your cheeks, lips, tongue, or mouth in general
  • Visible sores (ulcers) or lesions
  • Pain when chewing or swallowing

Depending on the cause, you might notice other symptoms, such as a headache, fever, or malaise (feeling sick). 

If you have these symptoms, you should consult a doctor. The underlying cause may require prescription medication or other professional treatment. 

6 Potential Causes of Stomatitis in the Mouth

1. Nutritional Deficiencies

Deficiencies in certain nutrients can lead to stomatitis. These include iron and vitamins B2, B3, B6, B9 (folic acid), and B12. You may develop stomatitis if you have:

  • A diet with poor levels of these nutrients
  • An underlying health condition that causes them not to be absorbed properly

These deficiencies can cause cell damage and make it hard for your body to replace the cells in your mouth, lips, tongue, and other areas.

In addition, some research suggests that zinc deficiency may contribute to canker sores.3, 4

2. Allergies or Irritation

Stomatitis can result from an allergic reaction or chronic mouth irritation.5,6 If you’re allergic to cinnamon, peppermint, or certain metals, exposure may cause your lips or the lining of your mouth to become sore and inflamed.

One form of stomatitis is unique to smokers, called stomatitis nicotina.7 It shows up as a painless white patch on the roof of the mouth. This occurs because of repeated exposure to heat and generally goes away if you stop smoking.

3. Infections

Your mouth, throat, and gums can all become inflamed due to a bacterial or viral infection. Fungal infections are also possible (denture stomatitis is usually fungal, i.e. a form of thrush).5,8 Poor oral hygiene is an important factor in bacterial or fungal stomatitis.

Cold sores caused by herpes are also a kind of stomatitis.9 These aren’t necessarily affected by oral hygiene, but stress may cause outbreaks once you have the virus (see below).

HIV is also a risk factor for mouth ulcers, as it weakens your immune system, which can lead to a secondary infection. Severe forms of necrotizing gingivitis are sometimes seen in HIV patients.10

4. Stress

Stress can affect mouth inflammation, including canker sores and cold sores. Like rosacea, hives, and other inflammatory conditions, stomatitis may flare up due to emotional stress.

One study found higher levels of psychological stress in students with recurring canker sores.2 These can also be brought on by stress. After the initial herpes infection, the virus remains in your body, and stress can contribute to later outbreaks.

5. Chronic Illnesses

Systemic illnesses such as diabetes and Crohn’s disease can make stomatitis more likely to develop. This is because they contribute to inflammation and can affect your immune system.

For example, people with dentures are more likely to develop denture-related stomatitis from an oral yeast infection if they also have diabetes.11 Crohn’s disease can also cause a specific type of stomatitis.12

6. Cancer Treatment and Other Medications

People undergoing radiation or chemotherapy for cancer sometimes experience a condition called mucositis.13 This is inflammation that can affect mucous membranes throughout the digestive tract.

When mucositis affects your mouth, it can be considered a form of stomatitis. It can’t be completely prevented during cancer treatment, but your doctor may encourage good oral hygiene to help mitigate the symptoms.

Certain medications, including some antibiotics, can also have stomatitis as a side effect.14

How is Stomatitis Diagnosed?

To diagnose a specific form of stomatitis, your dentist or doctor will want to physically examine you and get an accurate history of your symptoms. Canker sores, for example, are usually easy to diagnose based on their appearance and how long you’ve had them.

Your doctor may also ask questions about your diet, lifestyle, recent history, and any existing or previous illnesses you’ve had. In some cases, a blood test or tissue biopsy may be needed.

How to Treat Stomatitis

Treatment for stomatitis depends on the type and cause and may include:1,2,3,4

  • Topical medication (to reduce pain from a cold sore or canker sore)
  • Dietary supplements such as B vitamins, iron, and zinc
  • Antihistamines to block allergies
  • Antibiotics, antivirals, or antifungal agents
  • Good oral hygiene
  • Stress management

The appropriate course of treatment for you may include more than one of the above.

Can a Dentist Treat Stomatitis?

A dentist can diagnose and treat stomatitis. However, certain causes, such as malnutrition or Crohn’s disease, may need treatment beyond the scope of dentistry.

If you notice unusual changes in the appearance or feeling of your mouth, your dentist should be able to help identify the cause and apply the right treatment.

How to Prevent Stomatitis

Not every cause of stomatitis can be prevented, but you can reduce your risk of developing mouth ulcers or other inflammation by:

  • Maintaining good oral hygiene, including brushing daily with a soft toothbrush
  • Eating a balanced diet to avoid nutrient deficiencies
  • Getting regular exercise and quality sleep
  • Avoiding excessively hot or spicy food
  • Avoiding foods you know to irritate you or that you’re allergic to
  • Minimizing tobacco use
  • Getting proper medical care for any chronic health conditions you have

Types of Stomatitis

A common type of stomatitis is recurrent aphthous stomatitis (canker sores).1 These oral ulcers can develop even if you’re perfectly healthy. They typically heal on their own within about a week, but they can recur frequently.

It isn’t clear what causes canker sores, but it may be due to an immune response to irritation, an allergy, or a nutrient deficiency. There’s no cure, so treatment is mainly aimed at pain relief.

Other types of stomatitis include:

  • Allergic stomatitis — Mouth inflammation brought on by allergens like cinnamon, peppermint, and various metals.
  • Angular cheilitis — Inflammation around the corners (angles) of your lips. Drooling, mouth breathing, poor diet, and a lack of teeth are all risk factors.
  • Denture-related stomatitis — Sometimes, the area under a denture, especially an upper denture, can become inflamed. This is generally caused by a Candida infection (oral thrush).
  • Herpetic stomatitis — Acute mouth inflammation that occurs when someone is first infected with herpes or to the cold sores that appear in later outbreaks.
  • Geographic tongue — Also known as migratory stomatitis, this condition involves inflamed areas on the tongue that migrate over time.
  • Necrotizing stomatitis Trench mouth, cancrum oris, and other conditions fall under this category. These aggressive forms of gingivitis cause gum tissue to die and slough off.

Summary

Stomatitis refers to inflammation of the lining of your mouth, your lips, or your tongue. Depending on the cause, it can overlap with throat, gum, or other inflammation.

Canker sores are a common form of stomatitis and don’t have a clear cause or cure. But other types of stomatitis exist, and treatment can be tailored to the specific condition.

See your dentist or doctor if you notice any unusual symptoms or pain involving your gums, cheeks, lips, tongue, or other areas of your mouth.

Last updated on April 26, 2024
14 Sources Cited
Last updated on April 26, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Sánchez, J., et al. “Recurrent Aphthous Stomatitis.” Actas Dermo-Sifiliográficas, 2020.
  2. Rao, A. Kaleswara, et al. “The association between psychological stress and recurrent aphthous stomatitis among medical and dental student cohorts in an educational setup in India.” Journal of Indian Association of Public Health Dentistry, 2015.
  3. Özler, G.S. “Zinc deficiency in patients with recurrent aphthous stomatitis: a pilot study.” The Journal of Laryngology & Otology, 2014.
  4. Mirza, Waqas. “Oral Supplemental Interventions for the Management of Recurrent Aphthous Stomatitis (RAS) –  a Systematic Review and Meta-Analysis.” University of the Western Cape, 2022.
  5. Nield, Linda S. “Stomatitis.” Textbook of Pediatric Care, American Academy of Pediatrics, 2016.
  6. Zang, Xiaoyi, et al. “Clinical observation of allergic contact stomatitis treated with Kangfuxin solution as adjuvant: case report.” Annals of Translational Medicine, 2022.
  7. van der Wal, Jacqueline E. “Stomatitis Nicotina.” Encyclopedia of Pathology, 2018.
  8. Rocha Gauch, Lurdete Maria, et al. “Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil.” Brazilian Journal of Microbiology, 2018.
  9. Aslanova, Minira, et al. “Herpetic Gingivostomatitis.” StatPearls, 2023.
  10. Kato, Hirofumi, and Akifumi Imamura. “Unexpected Acute Necrotizing Ulcerative Gingivitis in a Well-controlled HIV-infected Case.” Internal Medicine, 2017.
  11. Martorano-Fernandes, Loyse, et al. “Oral candidiasis and denture stomatitis in diabetic patients: Systematic review and meta-analysis.” Brazilian Oral Research, 2020.
  12. Atarbashi-Moghadam, Saede, et al. “Pyostomatitis Vegetans: A Clue for Diagnosis of Silent Crohn’s Disease.” Journal of Diagnostic Research, 2016.
  13. Brown, Timothy J., and Arjun Gupta. “Management of Cancer Therapy–Associated Oral Mucositis.” JCO Oncology Practice, 2020.
  14. Jinbu, Yoshinori, and Toshio Demitsu. “Oral ulcerations due to drug medications.” Japanese Dental Science Review, 2014.
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