Stomatitis on the lip and cheeks: what it is and what it looks like

A painful sore on the inner side of the lip or on the cheek is a problem almost everyone is familiar with. Most often it is stomatitis: inflammation of the oral mucosa, which in most cases resolves on its own within a week or two. Below: what it looks like, where it comes from, and in which situations you cannot do without a doctor's examination.

What stomatitis on the lip and cheek is

Stomatitis is inflammation of the oral cavity and lips. It can manifest as redness of the mucosa, single or multiple ulcers, dry mouth, and increased sensitivity of the soft tissues. The mechanism is not fully understood: most likely, the immune system reacts to molecules it cannot recognize, and lymphocytes attack them. The result of such an attack is ulcerative formations on the mucosa.

Stomatitis itself is not contagious, but the cause that triggered it may be contagious — for example, herpes simplex virus. Ulcers in the mouth are common and in typical cases heal on their own.

What stomatitis on the inner side of the lip looks like

A classic aphtha is a rounded painful ulceration with a white or beige fibrinous coating in the center and red inflamed mucosa around it. Aphthae heal in about 1–1.5 weeks and usually leave no scars, only occasionally becoming chronic.

There may be several ulcers at once. The phrase "large stomatitis on the lip" is not a separate diagnosis: it is usually used to describe an ulcer larger than usual. A noticeably larger size than previous ulcers is an independent reason to see a doctor.

Stomatitis on the cheeks and under the lip: specific features

Ulcers more often appear inside the mouth — on the cheeks, lips, or tongue; they also occur under the tongue and deep in the throat. On the cheek, an ulcer is easy to bite or catch with a toothbrush, so it makes itself felt for a long time when eating and talking.

The outer side of the lips is a typical site for herpes, whereas stomatitis under the lip develops on the mucosa inside. The catarrhal form is described separately: the mucosa becomes swollen, painful, and reddened, covered with a white or yellow coating, salivation increases, and bleeding gums and bad breath are possible.

Causes of stomatitis

Single ulcers are more often associated with trauma or irritation: biting the cheek, poorly fitting dentures, braces, rough fillings or a sharp tooth, cuts and burns while eating, allergy, irritation from a toothbrush or toothpaste, fatigue, and stress. Less often, hormonal changes, heredity, deficiency of iron, zinc, folic acid, vitamins B and D, certain medications, and smoking cessation play a role.

Several ulcers are sometimes a symptom of hand, foot, and mouth disease, lichen planus, Crohn's disease, or celiac disease, or of weakened immunity. Among the general predisposing factors are insufficient or excessive hygiene, dehydration, vitamin deficiency, anemia, chemotherapy, smoking, and stress. According to statistics, 65% of older people with dentures suffer from stomatitis.

How stomatitis differs from herpes

These are different things. Aphthae are not contagious, whereas herpes is caused by herpes simplex virus. A cold sore on the lips appears on the lips or around the mouth and often begins with tingling, itching, or burning; sometimes it looks like a cluster of small pinhead-sized sores inside the mouth. Herpetic stomatitis is more acute: with a sharp rise in temperature, drowsiness, blisters on the mucosa that burst after about three days, gingivitis, and viscous saliva.

When to see a doctor

You should see a dentist or doctor if an ulcer persists for longer than three weeks, does not resemble previous ones, bleeds, or becomes more painful and red. A long-healing ulcer is sometimes a sign of oral cancer. Diagnosis begins with taking a medical history and a visual examination: there are no special tests such as biopsy or culture to identify stomatitis. The doctor's reference points are the appearance of the ulcers, their location, and recurrence; the tissue around the ulcer looks healthy, and there are no pronounced systemic symptoms.

• the ulcer does not heal for longer than three weeks;
• the ulcer is larger than usual or located closer to the back of the throat;
• the ulcer bleeds, reddens, and hurts more;
• ulcers appear simultaneously on the skin or genitals, and the joints ache and swell.

Stomatitis by itself is not a reason to call an ambulance; 103/112 — for difficulty breathing, swelling of the face or throat, loss of consciousness, or severe uncontrolled bleeding.

This material is for reference: it does not replace a doctor's consultation, and you decide together with your dentist whether to observe the ulcer or go for an examination.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer