Contact Stomatitis Treatment & Management

Updated: Dec 15, 2017
  • Author: Antonella Tosti, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Removal of the causative agent is essential in contact stomatitis.

Systemic steroids are rarely required for contact stomatitis. Intraoral topical steroids are prescribed in severe cases of contact stomatitis.

Sucking on ice cubes provides temporary relief from contact stomatitis.

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Consultations

Consult with a dermatologist for evaluation of underlying skin disorders and for patch testing.

Consult with dentists for evaluation of dental restorations and teeth occlusion.

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Diet

Advise patients with contact stomatitis to avoid spicy foods. Instruct contact stomatitis patients to avoid soft drinks, candies, and chewing gums in case of allergy to flavoring agents. Recommend that contact stomatitis patients avoid the causative food in cases of contact urticaria.

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Prevention

Advise contact stomatitis patients to avoid known causative agents (see Diet).

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Long-Term Monitoring

Replacement of dental restorations and prostheses may be very expensive and stressful for patients and should not be recommended when their causative role in contact stomatitis is doubtful. [54]  Removal of fillings or restorations does not always produce a complete resolution of symptoms, even in patients with positive patch test results to mercury or other dental compounds. Replacement is advisable when the mucosal lesions are adjacent to dental restorations, especially in cases of localized lichenoid reactions. [55]  Titanium may be a satisfactory alternative for patients who are allergic to palladium and other transition metals.

Sensitization to nickel is common in the general population. Establish relevance before removal of dental metal. Avoid prostheses containing transition metals in patients with history of nickel dermatitis.

Sensitization to palladium chloride is associated with nickel allergy due to cross-sensitization.

Establish relevance before removal of dental restorations in patients with sensitization to mercury derivatives.

Gold allergy is often not relevant, and dental gold removal may not prove curative.

Sensitization to acrylates is usually relevant. Patch testing with acrylates may cause active sensitization. Active sensitization to metals or acrylates as a consequence of dental procedures is rare.

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