Stomatitis: symptoms and what it looks like in the mouth

You noticed a sore in your mouth and immediately started searching for photos of stomatitis. I understand. Let's calmly go through what it looks like, how it differs from other conditions, and at what point it's time to see a doctor.

What stomatitis is

Stomatitis is inflammation of the oral cavity and lips. It may include redness of the mucosa and cause single or multiple ulcers. The mechanism is not fully understood: most likely, the immune system reacts to irritants and attacks unrecognized molecules with lymphocytes, and ulcerative lesions appear on the mucosa. Local causes include insufficient hygiene as well as gastrointestinal diseases. Stomatitis itself is not contagious, but the cause that triggered it may be contagious.

Early signs of stomatitis

Sores appear on the oral mucosa, gums, or lips. There may be dry mouth and sensitivity of the soft tissues. In the catarrhal form, the mucosa becomes swollen, painful, and hyperemic, may be covered with a white or yellow coating, and there is increased salivation, bleeding gums, and bad breath. In people with weakened immunity, a secondary infection is possible.

What stomatitis looks like in the mouth: types of eruptions

Aphthous stomatitis produces one or more aphthae — painful round ulcerations with a white or beige fibrinous coating in the center and red inflamed mucosa around them. Canker sores, as they are also called, are small and round, usually with a red edge and a gray center, on the inner side of the cheek, under the tongue, or deep in the mouth. In herpetic stomatitis, vesicles form on the mucosa and rupture after about 3 days.

• a round ulcer with a white or beige center and a red rim;
• vesicles that rupture and turn into sores;
• swollen, reddened mucosa with a coating;
• single or multiple lesions at the same time.

Symptoms of different types of stomatitis

Herpetic stomatitis begins with a sharp rise in temperature and drowsiness, and is accompanied by gingivitis and viscous saliva. Aphthae generally heal within 1–1.5 weeks without scars. If there are several ulcers, this may be a symptom of other conditions: hand, foot, and mouth disease, in which a rash appears on the hands and feet; lichen planus with a white lacy pattern on the cheeks; Crohn's disease and celiac disease; weakened immunity.

What it resembles and what it can be confused with

Stomatitis is not contagious and should not be confused with a cold sore. A cold sore appears on the lips or around the mouth and often begins with tingling, itching, or burning. Sometimes it looks like a small cluster of tiny sores inside the mouth. With stomatitis, the tissue around the ulcer looks normal, and there are usually no pronounced general symptoms — except in advanced forms, especially in children, when there may be fever and feeling unwell.

When to see a doctor

The doctor examines the oral cavity and assesses the appearance of the ulcers, their location, and how often they recur; there are no specific tests for detecting stomatitis. You should see a dentist or general practitioner if an ulcer persists for longer than 3 weeks, looks different from previous ones (larger or closer to the back of the throat), bleeds, or becomes more painful and redder. Ulcers elsewhere on the body or painful, red, swollen joints are also a reason to seek care.

By itself, this is not a reason to call an ambulance. 103 or 112 — if the condition is life-threatening, for example with a sudden sharp deterioration in well-being.

This material is for reference: a diagnosis is not made from photographs, and only a doctor can definitively determine what is in your mouth.

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