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"description": "Стоматит — воспалительный процесс слизистой оболочки полости рта различной этиологии. Характеризуется покраснением, отечностью слизистой (катаральный стоматит), образованием пузырьков и эрозий (афтозный стоматит), изъязвлений (язвенный стоматит) в полости рта, болезненностью и жжением, особенно при приеме пищи",
"etiology": "<ul>\r\n<li>Вероятные причины и предрасполагающие факторы развития стоматита: </li>\r\n<li>микроорганизмы-возбудители инфекционных заболеваний (бактерии, вирусы, микоплазмы) </li>\r\n<li>некачественное питание </li>\r\n<li>механическое или термическое повреждение полости рта, </li>\r\n<li>обезвоживание организма, вызванное поносом, рвотой, недостаточным потреблением воды, длительным повышением температуры тела, повышенным выделением мочи, большой кровопотерей </li>\r\n<li>недостаточная или избыточная гигиена полости рта </li>\r\n<li>некачественно сделанные или плохо установленные зубные протезы </li>\r\n<li>по статистике 65 % пожилых людей с зубными протезами страдают от стоматита </li>\r\n<li>применение медикаментов, уменьшающих слюноотделение </li>\r\n<li>авитаминоз (витамин А, витамин B, витамин С), нехватка железа или фолиевой кислоты </li>\r\n<li>курение </li>\r\n<li>злокачественные опухоли в области шеи, носа или глотки </li>\r\n<li>гормональные колебания (беременность, переходный возраст и д.р.) </li>\r\n<li>анемия </li>\r\n<li>побочные действия химиотерапии </li>\r\n<li>продромальный период ВИЧ-инфекции </li>\r\n<li>Зубные пасты и очистители для рта, содержащие лаурилсульфат натрия. </li>\r\n</ul>\r\n<p> </p>",
"pathogenesis": "<p>Ведущее место в патогенезе заболевания слизистой оболочки полости рта отводится инфекционно-аллергическому фактору. Наблюдается изменение реактивности организма, его сенсибилизация, выражающаяся в повышенной чувствительности к протею, стафилококку, стрептококку, кишечной палочке. </p>\r\n<p>Ряд авторов отдают предпочтение в патогенезе заболевания аутоиммунным процессам, когда большое значение имеет перекрестная иммунная реакция. Выражается по следующему принципу: на слизистой оболочке полости рта и кишечника имеются различные микроорганизмы и вырабатывающиеся на их присутствие антитела могут по ошибке атаковать эпителиальные клетки слизистой оболочки из-за сходства их антигенной структуры с таковой некоторых бактерий. </p>\r\n<p>Предполагается аллергическая природа возникновения рецидивирующих афт. В качестве аллергена могут быть пищевые продукты, зубные пасты, пыль, глисты и продукты их жизнедеятельности. </p>\r\n<p>Аутоиммунная теория позволяет связать возникновение патологических элементов с нарушением клеточного и гуморального иммунитета как местного, так и общего. </p>\r\n<p>Не менее важную роль в развитии заболевания играют провоцирующие факторы, в частности — погрешности в диете, функциональные расстройства центральной и вегетативной нервной системы, прием различных лекарственных средств, хронические соматические заболевания, гипо- и авитаминозы, а также очаги фокальной инфекции. </p>\r\n<p> </p>",
"diagnostics": "<p>Клинической картины, субъективных жалоб и внимательного осмотра стоматологом достаточно, чтобы правильно поставить диагноз. Иногда прибегают к лабораторной диагностике: ПЦР-исследование на кандидоз и герпес, бакпосев соскоба или мазка. А при неподдающихся лечению стоматитах показано общее обследование для выявления системных заболеваний, которые и стали основной причиной стоматита.</p>",
"treatment": "<p>Обычно какой-либо специфической терапии не требуется, достаточно ограничиться щадящей диетой и частыми полосканиями полости рта. Можно применять ополаскиватели с антисептическими свойствами: настои трав: ромашки, календулы; разбавленные водно-спиртовые растворы аптечных настоек (календула, эвкалипт ), различные готовые ополаскиватели. </p>\r\n<p>Для снижения болевой симптоматики могут применяться препараты, содержащие местно анестезирующие средства. Частично помогает употребление леденцов, которые увеличивают слюноотделение, благодаря которому улучшается орошение раны слюной и также достигается некоторый антисептический и отвлекающий эффект. Такое же действие оказывает раствор пищевой соды и воды; отвар ромашки; мёд. </p>\r\n<p>Использование антибактериальных препаратов является агрессивным методом лечения стоматитов. Их применяют, если имеется реинфицирование язвочек, чаще всего применяются препараты, в состав которых входит хлогексидина биглюконат. Длительное использование таких препаратов вызывает образование пятен на зубах и пломбах, которые проходят после окончания лечения. </p>\r\n<p>Противовирусные мази оказывают хороший эффект, если стоматит имеет вирусную природу. </p>",
"prevention": "<p> Профилактикой стоматитов является правильный уход за полостью рта, пропаганда здорового образа жизни и обучение правилам личной гигиены начиная с детского возраста.</p>",
"clinical_picture": "<p>Катаральный стоматит является самой распространенной формой стоматитов. Слизистая оболочка полости рта становится отечной, гиперемированной и болезненной. Пациенты предъявляют жалобы на болезненность во время принятия пищи, увеличение слюноотделения, иногда на кровоточивость и на неприятный запах изо рта. В некоторых случаях при катаральном стоматите слизистая покрыта желтовато-белым налетом. </p>\r\n<p>Язвенный стоматит может являться запущенной формой катарального стоматита или же развиваться как самостоятельное заболевание. При язвенном стоматите поражена вся слизистая оболочка, тогда как при катаральном – только ее верхний слой. На начальном этапе катаральный и язвенный стоматит имеют сходную симптоматику, но через 3-5 дней после начала заболевания повышается температура тела, и увеличиваются регионарные лимфатические узлы. Пациенты предъявляют жалобы на резкую болезненность во время принятия пищи, многие из них отказываются от еды. Нарастают симптомы общей слабости, появляется головная боль. Особенно ярко проявляются симптомы язвенного стоматита у детей и ослабленных больных. </p>\r\n<p>При афтозном стоматите слизистая оболочка полости рта покрывается множественными или единичными афтами – язвами овальной или округлой формы. От здоровой ткани афты отграничены узкой красной каймой, а в центре афтозной язвы имеется серый или желтый налет. Афтозный стоматит начинается с симптомов общего недомогания, после повышения температуры тела слизистая полости рта становится болезненной, далее в областях болезненности появляются афты. </p>\r\n<p>При инфицировании полости рта вирусом простого герпеса диагностируют острый герпетический стоматит. Продромальный период отсутствует, заболевание начинается с резкого подъема температуры до фебрильных значений, общее самочувствие пациентов тоже страдает. При осмотре слизистая полости рта гиперемирована, отечна, иногда имеются очаги кровоточивости десен. Большинство пациентов с герпетическим стоматитом предъявляют жалобы на увеличение слюноотделения и на появление неприятного запаха изо рта. Через несколько дней на слизистой появляются группки мелких пустул и везикул и присоединяются симптомы некротических изменений эпителия. </p>\r\n<p>Язвенно-некротический стоматит или стоматит Венсана клинически характеризуется появлением на слизистой рта язв и эрозий и повышением температуры тела до субфебрильных значений. Пациенты предъявляют жалобы на болезненность и кровоточивость десен, со временем присоединяется гнилостный запах изо рта. Для язвено-некротического стоматита характерно начало процесса с десневого края, далее воспаление переходит на другие участки слизистой оболочки. </p>\r\n<p>Аллергический стоматит может быть любой степени тяжести, начиная от катаральной формы и заканчивая язвено-некротической. По распространению аллергический стоматит может быть локализованным или диффузным. При воздействии на слизистую лекарственными веществами, которые и стали аллергенами, аллергический стоматит обычно носит катаральный или катарально-геморрагический характер. Пациенты предъявляют жалобы на сухость во рту и зуд, прием пищи становится болезненным. Слизистая оболочка полости рта отечна, гиперемирована, при длительно-текущем аллергическом стоматите отмечаются атрофические изменения сосочков языка.</p>",
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