Angular Stomatitis (Angular Cheilitis)

Angular stomatitis, also known as angular cheilitis, is an inflammatory condition that affects the corners (angles) of the mouth. It is characterized by painful, cracked, or inflamed areas at the corners of the mouth. It can occur on one or both sides and is often associated with soreness, redness, and the formation of sores or fissures.

Causes of Angular Stomatitis

Several factors can contribute to the development of angular stomatitis:

1. Fungal Infections:
   The most common cause of angular stomatitis is an overgrowth of Candida albicans, a yeast that naturally resides in the mouth. When the immune system is weakened or the balance of oral flora is disrupted, Candida can proliferate and cause infection at the mouth's corners.

2. Bacterial Infections:
   Staphylococcus aureus or other bacteria can also contribute to angular cheilitis, particularly when the mouth corners are moist and prone to infection.

3. Nutritional Deficiencies:
   Deficiencies in essential vitamins and minerals can make individuals more susceptible to angular stomatitis:

   • Vitamin B2 (riboflavin) deficiency is particularly associated with this condition.
   • Deficiencies in iron, vitamin B12, or folic acid can also contribute.

4. Poor Denture Fit:
   Ill-fitting dentures can cause irritation and create conditions where saliva collects in the corners of the mouth, leading to an environment conducive to fungal or bacterial infections.

5. Excessive Saliva:
   Conditions like drooling or salivary gland issues can create excess moisture at the mouth’s corners, encouraging infections and irritation.

6. Dry Skin:
   Dry lips or chapped skin from environmental factors (e.g., cold weather, dehydration, or sun exposure) can lead to cracking in the mouth corners, which may get infected.

7. Immunosuppression:
   Individuals with weakened immune systems—such as those with HIV/AIDS, diabetes, or people undergoing chemotherapy—are at higher risk for developing angular cheilitis.

8. Allergic Reactions:
   An allergic reaction to lipstick, toothpaste, or other oral hygiene products may cause inflammation and lead to angular stomatitis.

9. Systemic Diseases:
   Conditions like diabetes mellitus or HIV can impair the immune response, making the skin more vulnerable to infections like angular cheilitis.

10. Environmental Factors:
    Cold weather, wind, or prolonged exposure to moisture can irritate the corners of the mouth, making them more susceptible to cracking and infection.

Symptoms of Angular Stomatitis

The symptoms of angular stomatitis can vary in severity but typically include:

• Painful Cracks or Fissures: One or both corners of the mouth are cracked, bleeding, or sore.
• Redness and Inflammation: The affected areas appear inflamed, red, and swollen.
• Dryness or Scaling: The skin at the corners of the mouth may become dry or scaly.
• Soreness or Tenderness: The corners of the mouth are tender, and eating or speaking may cause pain.
• Crusting or Ulcers: In severe cases, the cracks may form ulcers or scabs.
• Itching or Burning Sensation: A feeling of irritation in the affected areas is common.

Diagnosis of Angular Stomatitis

Diagnosis is typically based on physical examination. The healthcare provider will inspect the affected areas and inquire about symptoms and possible contributing factors. Additional diagnostic tests may include:

1. Swab Cultures:
   A sample of the infection (either fungal or bacterial) may be taken for testing to identify the causative organism.

2. Blood Tests:
   To check for underlying deficiencies in vitamins (such as B2, B12, folic acid, or iron) or to assess other conditions like diabetes or immune dysfunction.

3. Biopsy:
   In rare cases, a biopsy may be done to rule out other conditions, such as oral cancer or autoimmune diseases.

Treatment of Angular Stomatitis

Angular stomatitis can be treated successfully with Homoeopathic medicines.

Prevention of Angular Stomatitis

To reduce the risk of angular stomatitis:

• Maintain Good Oral Hygiene: Brush and floss regularly and clean dentures properly.
• Hydrate the Skin: Use lip balms or moisturizers to prevent dryness and chapping of the lips.
• Avoid Smoking: Smoking can irritate the skin and contribute to dryness and cracking.
• Address Nutritional Deficiencies: Ensure adequate intake of vitamins, particularly B2, B12, and folic acid, through diet or supplements.
• Manage Chronic Conditions: Proper management of chronic conditions like diabetes, HIV, or other immune-related disorders can reduce the risk of infections.
• Wear Well-Fitting Dentures: Ensure that dentures fit properly to avoid irritation of the mouth’s corners.

Prognosis

The prognosis for angular stomatitis is generally good, especially if treated promptly and appropriately. Most cases resolve with treatment and proper care. However, if left untreated or if underlying conditions like immune system dysfunction or vitamin deficiencies are not addressed, the condition can become chronic or recurrent. Regular follow-up and management of contributing factors can help prevent future episodes.